REVISION: 2) Bid submission deadline extended to: Thursday, 30 October 2025 at 11:00HRS local time (GMT+6.00) 1) Pre-bid briefing is on Wednesday, 8 October 2025 at 11:00AM Local time (GMT6.00) Join the meeting now Meeting ID: 367 531 804 588 4 Passcode: TH73nr76 Terms of Reference (ToR) for Institutional Contract Summary: Title: Post-Assessment of existing service availability, coverage, healthcare-seeking behavior, stakeholder mapping, and gap analysis of Expanded Program on Immunization (EPI) in eight Districts Purpose The purpose of this post-assessment is to understand the progress made in terms of service accessibility and availability of immunization, immunization coverage, reduction in zero-dose and under-immunized children, improvements in healthcare-seeking behavior, and overall improvement of immunization service delivery and coverage in low-performing rural areas, especially in HTR areas. It will also assess the sustainability of these interventions, stakeholder involvement, and remaining gaps in service delivery and coverage. In addition, this will also assess the availability and access to UNICEF-supported services through District Evidence-Based Planning and Budgeting in eight selected Districts. Location Eight Districts – Narayanganj, Sylhet, Moulvibazar, Sunamganj, Bandarban, Rangamati, Jamalpur, Netrokona.   Field visits will be required to all eight districts for data collection, Focus Group discussions, key informant interviews, and HTR mapping. Estimated Duration Eight months started from 01 October 2025 Reporting to the Technical Supervisors for this assignment Dr. Riad Mahmud, Health Manager (Immunization) Dr. Farhana Rahman, Health Officer (C&E) Md. Jahid Hossen Shahed, Health Officer (eEPI) Dr. Pankoz Kumar Vhowmik, Health Officer (EPI)   1. Background This assessment aims to assess the outcomes and impact of interventions that were implemented in eight Districts — Sylhet, Moulvibazar, Sunamganj, Bandarban, Rangamati, Jamalpur, and Netrokona — from September 2022 to June 2025. These initiatives included strengthening Expanded Programme on Immunization (EPI) services through enhanced HR support, evidence-based planning, digital solutions like GIS-based online microplanning, E-Tracker, and VaxIN, and community engagement strategies and interventions. While support to strengthen EPI was provided to all eight districts. The Government of Bangladesh, with support from UNICEF and other partners, has been implementing targeted interventions to enhance the availability and accessibility of Expanded Programme on Immunization (EPI) services in low-performing rural settings. These efforts focused on reducing zero-dose and under-immunized children, improving EPI service delivery and coverage, ensuring cold chain establishment and maintenance functionality, enhancing supervision, and recruitment of health workers for vacant posts. Furthermore, community engagement activities included school campaigns, advocacy with public representatives, religious leaders, community dialogues, public hearings, courtyard meetings, and street dramas, enhancing awareness and increasing demand for immunization services. This assessment will also explore the role of GIS-based service mapping to identify service gaps and improve decision-making. The purpose of this post-assessment is to understand the progress made in terms of service accessibility and availability of immunization, immunization coverage, reduction in zero-dose and under-immunized children, improvements in healthcare-seeking behavior, and overall improvement of immunization service delivery and coverage. It will also assess the sustainability of these interventions, stakeholder involvement, and remaining gaps in service delivery and coverage. Furthermore, this assessment will capture the progress of GIS-based online microplanning, real-time reporting, and mapping, which visually represent service accessibility, availability, highlight coverage gaps, and support decision-making for targeted interventions. The results of this assessment will be used to generate evidence for strategic planning of Bangladesh EPI as well as publication in peer-reviewed international journals. 2. Objectives, Purpose, and Expected Results The primary objectives of this post-assessment are to: Literature review, including Global and National strategies on PHC and Immunization, and previous assessment report Assess service availability and accessibility: Assess the availability, readiness, and accessibility of EPI service delivery in eight Districts after the implementation of targeted interventions from September 2022 to June 2025. Measure Improvements in Immunization Coverage: Assess improvements in immunization coverage, with a focus on reducing zero-dose and under-immunized children and enhancing equitable distribution of service delivery points. Analyze UNICEF-supported HR recruitment progress and their contribution to immunization coverage, and the PHC and immunization service delivery monitoring system. Analyze Healthcare-Seeking Behavior: Study changes in healthcare-seeking behavior, especially in Hard-to-reach areas, and assess the effect of community engagement initiatives such as interpersonal communications, Imam-led dialogues, CG meetings, street dramas, folk songs, etc. Evaluate the effectiveness of community engagement activities like school campaigns, Imam meetings, CG Group meetings, street dramas, and courtyard meetings on improving immunization rates and healthcare-seeking behavior.   Conduct GIS-Based Service Mapping: Utilize GIS-based service mapping to visually represent immunization coverage, zero-dose pockets, and service gaps for evidence-based decision-making. Stakeholder Mapping, Engagement, and Identifying Gaps: Evaluate the involvement of community leaders, local governments, religious leaders, CSOs, and NGOs in service delivery and community awareness, highlighting gaps in coordination and distribution of service delivery Generate Evidence for Strategic Planning and Global Publication: Develop actionable evidence suitable for publication in renowned international journals (e.g., The Lancet, Nature) to inform future national immunization strategies aligned with the IA2030 and global best practices. The purpose of this post-assessment is to: Measure the Result: Assess the effectiveness of interventions on EPI service delivery and PHC service coverage, including digital and programmatic innovations, human resource deployment, and enhancement of community outreach service. Identify Gaps and Challenges: Highlight service delivery gaps, logistical challenges, and barriers to healthcare-seeking behavior. Support Evidence-Based Planning: Provide strategic recommendations for scaling successful initiatives and addressing identified gaps. Enhance Policy Advocacy: Strengthen national health policies through evidence-based recommendations that support sustainable improvements in immunization and primary health care services. Contribute to Global Knowledge: Document findings for global knowledge-sharing and publication, contributing to best practices in national immunization programs. The post-assessment is expected to deliver the following results: Enhanced Understanding of Service Coverage: Clear insights into changes in EPI and PHC service availability and access, particularly in hard-to-reach areas. Identification of Zero-Dose and Under-Immunized Populations: Comprehensive mapping and analysis of zero-dose children, under-immunized populations, and service inequities through GIS-based mapping and tools. Evidence of Improved Community Engagement: Documentation of the impact of community-led initiatives—including school campaigns, CG meetings, Imam dialogues, and street dramas—on immunization rates and healthcare-seeking behaviors. Data-Driven Decision-Making Tools: Generation of GIS-based maps, dashboards, and analytics to inform national health strategies, digital health strategies and targeted interventions. Strategic Recommendations for Scale-Up: Practical recommendations for addressing service gaps, enhancing community engagement, and improving immunization equity in rural settings, particularly in HTR areas. Global Knowledge Contribution: Peer-reviewed publications in renowned international journals to share best practices and lessons learned from health interventions in Bangladesh. 3. Description of Assignment The assessment will cover the following key components: Post-Assessment of Immunization and PHC Services – Strategy, Structure, Coverage, Service Mapping, Healthcare-Seeking Behavior, and Delivery Challenges   Service Availability and Readiness Assessment: Mapping of pre- and new EPI service delivery points and PHC facilities. Verification of HR support (supported by UNICEF) and infrastructure readiness. Review of GIS-based online microplanning, E-Tracker registrations, VaxIN implementation, evening and Friday EPI sessions. Stakeholder Mapping, Healthcare-Seeking Behavior Analysis, and engagement analysis: Assess the involvement of community leaders, local government, religious leaders, NGOs, CSOs, and Community Groups (CG). Identification of gaps in communication and coordination among stakeholders.   Community-based interviews of caregivers to understand demand and service utilization. Identification of barriers to access and reasons for under-immunization. Analysis of community engagement activities, including CG meetings, Imam-led dialogues, public hearings, etc. Assesses the effectiveness of school campaigns, Imam meetings, community dialogues, and cultural programs.   Gap Analysis and Recommendations: Identify gaps in service delivery and the workforce. Provide actionable recommendations to address these gaps and improve service equity. Special focus on RCA activities, household IPC visits, and HTR immunization coverage. 4. Methodology of Assessment The assessment will adopt a mixed-methods approach, combining both qualitative and quantitative techniques to ensure a comprehensive understanding of immunization and PHC services. The agency will refine and detail the methodologies for literature review, primary and secondary data collection, and analysis, making use of desk reviews, interviews, and field visits at health facilities and within communities. During the inception phase, the agency will conduct an in-depth desk review of past evaluations, progress reports, programme documents, grey literature, and other relevant documentation to identify key implementation challenges. Findings from this desk review and secondary data analysis will inform the final design of primary data collection strategies, which will integrate both qualitative and quantitative methods. A documented and replicable sampling plan must be prepared, outlining the approach for each methodology. Primary data collection will include site visits, direct observation, and key informant interviews with stakeholders ranging from policymakers to service providers, in order to identify barriers and enablers within the national health system. The qualitative component will use structured and semi-structured interviews to explore social norms, policy and management issues, supply-side bottlenecks, and cultural practices and beliefs. In-depth interviews and focus group discussions with beneficiaries will further identify gaps and barriers to service access, cultural or behavioral factors influencing health-seeking, and provide insights into knowledge and attitudes specific to target populations. The geographic focus of the assessment will include eight districts. A detailed assessment plan—including tools, teams, and methodology—will be presented to UNICEF for technical clearance prior to fieldwork, through an inception meeting and report. All tools and instruments for desk/document review, institutional mapping, and primary data collection must be submitted to UNICEF for review and approval before use. The assessment will employ a combination of the following methods for data collection: Desk and document review Institutional mapping Quantitative surveys Qualitative interviews and focus group discussions  A. Desk Review Conduct a systematic desk review of key documents (e.g., CES, Health Strategy, immunization strategy, IA2030, disease surveillance reports, previous evaluations, programme documents, presentations, intervention log frames, project proposals, HMIS, and KABP quantitative/qualitative findings). Review literature to support mapping of existing services in the selected Districts. B. Secondary Analysis of Existing Data Analyze input, output, and outcome data from CCs and other relevant sources (covering both beneficiaries and, where possible, non-beneficiaries). Use real-time HMIS data for service coverage and trends. Review disease surveillance reports for context on morbidity and outbreak patterns. Utilize health facility administrative data and registers. Incorporate project-specific M&E data from partner CSOs. C. Primary Data Collection* Conduct interviews with key decision-makers (approx. 20 people) and service end-users/beneficiaries. Apply surveys or other quantitative methods where appropriate. Undertake direct observation of facilities and community-based services (approx. 10 facilities across selected CCs). Carry out health facility assessments and exit client interviews. Conduct interviews and/or focus group discussions with key informants and community members (approx. 5 vulnerable groups, 10 un-/underserved areas, and 5 focus groups per CC), ensuring attention to sex, age, and missed children/women. D. National and Sub-National Workshops Review Conduct national workshops to facilitate group discussions on EPI and PHC service strategies. Support advocacy and dissemination of findings at both national and City Corporation levels. For national and City Corporation-level results sharing and policy advocacy, dissemination activities and consultative meetings will be organized in agreement with UNICEF and the CCs. In addition to the final report, dissemination materials will include policy briefs (with user-friendly infographics where appropriate) and a PowerPoint presentation for use in policy dialogues and roundtables. All materials will be developed and finalized in consultation with UNICEF and the CCs, ensuring alignment on key findings and messages. The data collection and analysis will be guided by the following overarching study questions: Overarching Study Questions: Service Availability and Implementation Strategy What is the current status of immunization service delivery in the eight Districts? How are the implementation strategies for EPI and PHC services planned and executed? Which organizations are involved in the delivery of these services, and what are their specific roles? How is the HR structure organized for EPI and PHC service delivery? Are the coverage and completeness of services monitored regularly? If yes, how? How effective is the HMIS system in tracking immunization and healthcare services? What is the quality and accuracy of yearly EPI and PHC plans? How are monitoring, feedback, and review meetings conducted? Are they regular and effective? How is GIS-based online microplanning, VaxIN, and E-Tracker integrated into service delivery? Identification of Missed and Vulnerable Populations Who are the missed children, women, and vulnerable groups (slums, high-risk areas, missed communities, etc) in the community? What are the main reasons these groups are missed or underserved? Can you identify the unserved and underserved areas? What is the estimated total population of vulnerable groups (slums, high-risk areas, missed communities, etc) in these areas? Why do these areas have limited or no services? What strategies are currently in place to reach these populations? How effective have Friday and evening EPI sessions, community dialogues, Imam meetings, and street dramas been in identifying and reaching these populations? Challenges in EPI and PHC Service Delivery What are the main challenges in delivering EPI and PHC services in your area? Are there logistical barriers (e.g., vaccine storage, cold chain issues, transportation)? What resource gaps (HR, materials, financial) exist in service delivery? How effective are the community engagement activities in addressing service gaps? What are the common challenges in GIS-based online microplanning, E-Tracker registration, and VaxIN implementation? How do RCA and IPC activities help in identifying under-immunized children? Does the community have accessibility issues? Are there any gaps for supervision and monitoring from the government? Opportunities and Recommendations for Scale-Up What are the opportunities for scaling up EPI and PHC services in rural and remote rural areas? How can the findings from this assessment be used to improve EPI and PHC service delivery planning? What GIS-based mapping strategies would help in identifying zero-dose and under-immunized children? How can the integration of community-based interventions (CG meetings, Imam dialogues, school campaigns) be strengthened? What strategies would you recommend for improving HR recruitment in these Districts? How can data-driven decision-making be improved to ensure equitable service delivery? Stakeholder Engagement and Collaboration Who are the main stakeholders involved in EPI and PHC service delivery? How effective is the collaboration between health service providers, local government, and community leaders? What role do religious leaders, community groups (CG), CSOs, and NGOs play in supporting EPI and PHC services? Are there regular coordination meetings between these stakeholders? What challenges exist in stakeholder communication and collaboration? What improvements can be made to enhance multi-sectoral collaboration for better service delivery? GIS-Based Assessment and Spatial Analysis Have GIS-based tools been used to map service availability? How effective have these tools been in identifying service gaps? Are there specific high-risk zones identified through GIS analysis? How is real-time data from GIS-based online microplanning, E-Tracker, and VaxIN integrated into spatial mapping? What recommendations do you have for enhancing GIS-based monitoring? Data Collection Methods: Household Surveys and Community Dialogues Facility (PHC) Assessments and Key Informant Interviews GIS Mapping and Spatial Analysis Desk Review of Health Records, E-Tracker Data, and VaxIN Reports Focus Group Discussions (FGDs) with community leaders, health workers, and parents Exit interview These methods will ensure comprehensive data collection from various levels to address all critical aspects of EPI and PHC service delivery and community engagement. The assessment will utilize a mixed-methods approach, combining qualitative and quantitative methods: Desk Review of Health Records, GIS-based online microplanning data, E-Tracker Data, and VaxIN Reports Household Surveys and Community Dialogues Facility Assessments and Key Informant Interviews GIS Mapping and Spatial Analysis Focus Group Discussions (FGDs) with community leaders, health workers, and parents 3.3 Ethical and other considerations This study will be held to the highest standards employed by UNICEF. This means the agency will abide by the following: UNICEF Procedure for Ethical Standards in Research, Evaluation, Data Collection and Analysis UNICEF Strategic Guidance Note on Institutionalizing Ethical Practice for UNICEF Research UNEG Ethical Guidelines for UN Evaluations   The agency is expected to explain ethical considerations for the assessment, specifically spelling out how the above guidelines will be followed/met. Any specific ethical considerations or strategies necessary to prevent or avoid COVID-19 infection and spread should be addressed and detailed in the proposal. Further, ethical clearance must be obtained during the inception period, before any data collection with human subjects begins. The ethical clearance letter should be attached as an annexure to the final report. All data collected through this assignment, reports, and dissemination materials are the intellectual properties of UNICEF and shall not be used for purposes other than those approved by the registered Institutional Review Board during the ethical clearance.    Additionally, the study will be human rights-based (including child rights) and gender sensitive. All applicable data will be disaggregated by sex, age, and ability level. The agency is advised to refer to the UNEG Guidance on Integrating Human Rights and Gender Equality in Evaluation, which is applicable to assessments like this one.   6. Deliverables The post-assessment is expected to generate the following comprehensive deliverables: SL# Deliverables Items covered/included Time frame Payment schedule 1 Inception report Inception report including desk review, review of existing documents & data sources, and specification of assessment tool/questionnaire, finalize primary data collection methodology, and obtain ethical approval Detailed implementation plan of assessment, including person/facility/area Study plan matrix (including accompanying data analysis dummy tables) 2 weeks 10%   Comprehensive draft Assessment Report Detailed analysis of EPI service availability, immunization coverage, healthcare-seeking behavior, and stakeholder engagement in eight Districts. Detailed analysis of PHC service availability, healthcare-seeking behavior, and stakeholder engagement in eight Districts (list above). Clear documentation of GIS-based service mapping, identifying zero-dose pockets, under-immunized communities, and service gaps. In-depth assessment of community engagement strategies, implementation challenges, and health-seeking behaviors in rural areas, particularly in HTR areas. Strategic recommendations for EPI and PHC services in low-performing rural areas, particularly in HTR areas. 6 weeks 20%   GIS-Based Service Maps Comprehensive GIS-generated maps showcasing: Service availability and accessibility. Identification of zero-dose and under-immunized children. Mapping of High Risk (HR)  areas and vulnerable communities. 4 weeks 20%   Comprehensive Assessment Report, Summary Briefs, and Policy Recommendations Comprehensive Assessment Report with in-depth analysis, accompanied by Summary Briefs and Policy Recommendations tailored for key stakeholders. Concise policy briefs highlighting key findings and actionable recommendations for decision-makers and stakeholders. Specific guidelines to improve immunization coverage, service accessibility, and health-seeking behavior. Identification of best practices and success stories to be replicated in other Districts. Focus on evidence generation, best practices in immunization, and community-based interventions. EPI Equity Analysis 4 weeks 20%   National and CC level Dissemination Workshop for Key Stakeholders Organize a high-level dissemination workshop to share findings, maps, and strategic recommendations. Engagement of key stakeholders, including DGHS, Civil Surgeons, UH&FPOs, UNICEF, WHO, NGOs, and community leaders. 4 weeks 20%   Publication of Findings in International Journals (minimum 2) Development of manuscripts for submission to peer-reviewed international journals (The Lancet, Nature, etc.). Highlighting the effectiveness of VaxIN, E-Tracker, and GIS-based planning in improving immunization equity. 4 weeks 10%   5. Reporting requirements   The agency should submit the report electronically (“PDF” or “Word file”) and a hard copy (after incorporating all the feedback from UNICEF).  Reports & deadlines are listed for consideration: -   Inception report with tools within 2 weeks of signing the contract; Initial draft report on assessment within 6 weeks of submission of the inception report; Final draft report on assessment within 6 weeks of submission of the inception report; Workshop materials, identified policy briefs, and infographics within 12 weeks of submission of the inception report; All raw and analysed data and final data collection tools (14 weeks post inception report) The manuscripts for publicaitons   The other report should be submitted:   Mission Reports within 10 days of each mission; how many missions? Technical Reports on a monthly/quarterly/six-monthly basis; quarterly?   6. Payment Schedule   First payment (10%) – Upon clearance of the inception report. Second payment (20%) – Upon approval of the draft comprehensive assessment report (pre-workshops), as agreed with UNICEF. Third payment (40%) – Upon finalization and approval of GIS-based service maps, comprehensive assessment report, summary briefs, and policy recommendations. Fourth payment (20%) – Upon dissemination of the report at the National and District–level workshops for key stakeholders, and submission of the final report with all finalized materials. Final payment (10%) – Upon development of manuscripts and submission to a minimum of two international journals.   7. Qualification requirements of the company/institution/organization   Agency and members of the team, including the leader, to have expertise and proven substantial experience of at least 10 years in research in public health Adequate knowledge and exposure to EPI, PHC, and health situation and programs in Bangladesh and the sub-continent Skills in quantitative and qualitative analysis and synthesis, knowledge of gap analysis/needs assessment methodologies, knowledge of methodologies and approaches with hard-to-reach populations Acknowledged the Ethical Review Board (either internal or external) approval process of proposals Good report writing, presentation, and verbal communication skills Experience with UN or UNICEF is an advantage Publications in a peer-reviewed journal are an advantage   8. Evaluation Process and Method   EVALUATION CRITERIA FOR TECHNICAL PROPOSAL (if through LTA this section may not be required)    CATEGORY POINTS OVERALL RESPONSE * Understanding of, and responsiveness to, UNICEF Bangladesh Office requirements; * Understanding of scope, objectives and completeness of response; * Overall concord between UNICEF requirements and the proposal.   (05) 02 02 01 METHODOLOGY AND DETAILED TIMELINE * Quality of the proposed approach and methodology; * Suitability of the approach: To what extent the methodology is designed in response to the needs of the TOR; * Quality of proposed implementation plan, i.e, how the bidder will undertake each task, and time-schedules; *Risk assessment - recognition of the risks/peripheral problems and methods to prevent and manage risks/peripheral problems. * Timelines proposed must be detailed and realistic; (35) 10 10   05   05   05 ORGANISATIONAL CAPACITY and PROPOSED TEAM * Professional expertise of the firm/company/organization, knowledge and experience with similar projects, contracts, clients, and consulting assignments * Team leader: Relevant experience, qualifications, and position with firm; * Team members - Relevant experience, skills & competencies; * Organization of the team and roles & responsibilities; * Publications in a peer-reviewed journal;   (30) 10   05 05 05 05     TOTAL MARKS   70   For this RFP, the Technical Proposal has a total score of 70 points. Bidders must score a minimum of 49 points to be considered technically compliant and in order for the Financial Proposals to be opened. The financial proposal has a total score of 30 points.   The final selection of the bidder will be based on a quality and cost basis as specified in the RFP.