Terms of Reference (ToR) for Institutional Contract (Avobe USD 10,000)     Title Implementing Maternal, Immunization & Nutrition tracking system through enhancement of OpenSRP based system at community level Purpose To support DGHS, MOHFW for strengthening maternal Immunization & Nutrition tracking system Location EPI: 64 district and 12 City corporation Maternal & Nutrition: 54 upazilas in 10 districts [39 upazilas from Sherpur, Kurigram, Khagrachari, Sunamganj, Bhola, and 15 upazilas from Cox’s Bazar, Cumilla, Kishoreganj, Sirajganj and Bagerhat], and 8 CBE Nutrition upazilas; ECCD/Early identification of developmental delay module implementation support in EPI locations (16 districts, 8 city corporations) and 2 CBE districts Estimated Duration 24 months Start date: 1st November 2024- October 2026 Reporting to Technical Supervisor of this assignment Health Manager, Health Section     1. Background Bangladesh’s achievement in the national Expanded Programme on Immunization (EPI) is globally recognized as an example of a success story for Low-and Middle-Income Countries (LMICs). On contrary, the landscape of maternal mortality hasn’t been changed a lot over the years. According the BMMS (Bangladesh Maternal Mortality and Health Care Survey) in 2016, Maternal Mortality Ratio (MMR) in Bangladesh was 196 per 100,000 live births, showing no evidence of difference from the BMMS in 2010 estimate of 194 per 100,000 live births. Key indicators on the use of maternal health service shows why MMR has’t been decreased enough for the last decades. The percentage of institutional delivery was only 53.4%, skilled attendant at delivery was 59% and women received at least one ANC visit was only 58% in 2019 survey. One innovative way to address this gap and ensure not only the quality and but the continuity of care is to connect maternal health service with child’s vaccination through individual tracking system and manage them together in an integrated way. Though Bangladesh's routine health information system has rapidly developed into one of the world's largest deployers, an integrated individual tracking system to guarantee the continuum of care from maternal service to vaccination is absent. There have been multiple and fragmented tracking systems in pilot phase without any integrated approach. Thus, this ToR aims to develop and implement an integrated and robust individual tracking system through OpenSRP to ensure the continuum of care to improve both maternal and newborn health. With OpenSRP system, pregnant women will be registered by the community health providers either at point of the household visits or their routine facility visits. Once they are registered, a unique Shared Health Record ID (SHR ID) will be created. At the same time, based on the information of their Last Menstrual Period (LMP), an automatic follow-up schedule of ANC, delivery, PNC and child’s immunization will be generated. It will enable the provider to identify the correct denominator in their respective catchment area. Following the schedule, pregnant women will be informed on the time of their next ANC, PNC, delivery and immunization through the SMS reminder sent from the system. This innovation can help ensure the continuum of necessary care provided to pregnant women and newborn and improve their awareness and practices related to health. Though Bangladesh achieved a lot in immunization but still there are gaps in the program like equitable coverage in urban and rural, HTR and Non HTR and administrative coverage and survey coverage. We have only administrative immunization coverage for sub-block, community, ward, union and Upazila level which is based on estimated denominator or previous year’s vaccination data. There was always a big difference in administrative coverage and survey coverage in all CES. Also survey coverage only available up to District level which is also not for each year which is a major constrain to find out immunization coverage gap in specific area or community especially Hard to Reach (HTR) areas where there is possibility of untouched house hold by health worker. The focus on the use, quality, and analytics of health and nutrition data through appropriate information systems is a crucial step towards delivering high-quality programs at scale. Efforts have been underway to systematically record routine service data and analyze it at regular intervals to identify bottlenecks, solve problems, and track progress. However, several gaps remain, particularly related to the quality and reliability of data at the community level. Currently, there is no systematic review of community health and nutrition services. Review meetings are being held at the Union and Upazila levels, but these meetings primarily focus on administrative issues and lack critical data analysis to improve the program. Additionally, the separation of DGHS and DGFP within the MoHFW poses a major bottleneck to harmonizing indicators, data collection, and reporting systems across these two divisions, which is essential for assessing coverage. Furthermore, there is a lack of capacity within the government to fully utilize the data's potential. Through the supportive supervision mechanism, capacity within the Government will be developed by providing on-the-job AI-powered training. This approach will ensure the use of data for improved resource planning, progress tracking, and increased accountability. In last decade, MoH&FW has taken various initiatives and innovations in development of health information systems under the framework of Digital Bangladesh and Vision 2021. And UNICEF has been a long-time partner of MoH&FW to support the HMIS system in Bangladesh. Through this program, HMIS in Bangladesh will be strengthened through the integrated individual tracking system. This will ultimately contribute to increase the rate of completion of ANC, institutional delivery, PNC and child’s vaccination coverage.       2. Objectives, Purpose and Expected Results Ensure scalability of OpenSRP to register 100% of pregnant women and children in selected areas Enhance module of mother & child registration, ANC, Delivery, PNC service, immunization, disability, SCANU/ KMC follow-up in the system Develop and update dashboard to track unvaccinated, partially vaccinated, fully vaccinated children, identify the high-risk pregnant women to ensure the institutional delivery Facilitate the generation of a Unique Health ID for each citizen via the SHR system. Digitalize the community health workers activity monitoring and mentoring system Identify the skill gaps of the CHWs Provide onsite mentorship support to overcome the skill gaps Categorization of the CHWs performance and provide targeted mentoring support Enhance strategic use of community data at all levels through coordination and review meetings    3. Description of Assignment   Category 1: Support DGHS to enhance individual maternal, immunization & nutrition tracking system using OpenSRP.   Feature upgradation, deployment and maintenance for Maternal & Immunization eTracker and GMP module as per requirement from stakeholders (including development and optimization of microplanning tool for MNCH, EPI, ECD including Early identification of developmental delay module upgradation, and nutrition) Low birth weight identification, Community KMC and community follow-up of facility KMC with DHIS2 integration in 10 REMN districts and 5 CBE Districts. Notification will be sent from DHIS2/OpenMRS with patient information and all service data to OpenSRP. OpenSRP community follow-up information will push back to DHIS2/OpenMRS. SMS push feature for reminders should be integrated Built in library with AI supported algorithm for mentoring and learning, performance ranking and management for CHWs, AI-powered individual and location-based problem analysis and recommendation feature, CHW dashboard for review meetings at ward, union, upazila level (Integrated tool with interoperability with other MIS tools)   Category 2: Support and maintenance of all features in OpenSRP based Maternal, Immunization & Nutrition tracking system and dashboard   Technical support to ensure smooth data entry/ fixing bugs for EPI eTracker in 64 district and 12 City corporation Technical support to ensure Maternal eTracker implementation with ensure smooth data entry/ fixing bugs in total 54 upazilas in 10 districts [39 upazilas from Sherpur, Kurigram, Khagrachari, Sunamganj, Bhola, and 15 upazilas from Cox’s Bazar, Cumilla, Kishoreganj, Sirajganj and Bagerhat], and 8 CBE Nutrition upazilas; ECCD/Early identification of developmental delay module implementation support in EPI locations (16 districts, 8 city corporations) and 2 CBE districts   Category 3: Customize instance of OpenSRP for community level population registration & service information   FDMN community eTracker includes EPI development with implementation support for 6 PHC facility catchment area. Population registration and CHW service information data will be collected through OpenSRP and that will be synced with OpenMRS system Aalo clinic outreach service module development. Population registration and CHW service information data will be collected through OpenSRP and that will be synced with OpenMRS     Category 4: Development and implementation support of CHW Activity Monitoring and mentoring module   Development and implementation support of CHW Activity Monitoring and mentoring module. Digitalize the GMP-EPI, REMN, MIYCN microplan, including travel plan, prioritization and task CHW activity monitoring checklist, feedback and review process feature   Category 5: Data integration & sharing   SCANU community follow-up with DHIS2 SCANU tracker integration in 10 REMN Districts (including all Upazilas of these districts). Notification will be sent from DHIS2/OpenMRS with patient information and all service data to OpenSRP. OpenSRP community follow-up information will push back to DHIS2/OpenMRS. SMS push feature for reminders should be integrated Integration with VaxIN Transfer of all microplan data from DHIS2 to OpenSRP Interoperability of OpenSRP with eMIS tool (community and facility module) and Maternal and Child Benefit Program (MCBP) MIS tool (to exchange individual tracking data based on NID)   Category 6: Capacity building   Support two days hands on training for MNCH, Nutrition and ECCD eTracker for 54 upazilas in 10 REMN districts, 8 CBE nutrition upazilas Support one day hands on training for community follow up of SCANU, community KMC and KMC follow-up (54 upazilas of 10 REMN districts, and 5 CBE Upazilas for KMC and KMC follow up only) One day refresher training 54 upazilas in 10 REMN districts, 8 CBE nutrition upazilas One day national level capacity building training for health managers on data for action using dashboard Support seven 2-day training sessions for community providers and supervisors, and health managers in 7 upazilas in Bhola on CHW activity monitoring and mentoring module Development of Training manual for different components   Category 7: Facility assessment with GIS functionality   Develop data entry form for different types of facility with assessment information and GIS location Share API to extract facility information with GIS location   Category 8: Dashboard development with GIS functionality   Extensive public dashboard development and optimization (Maternal health, Newborn health, IMCI and Child Health, nutrition, EPI, ECCD)   OpenSRP Manager dashboard including MNCH, nutrition, EPI, GMP, KMC, community follow up, ECD - Early identification, and etc.) [with role-based login options at national, divisional, district, upazila, union and community level, as required, with custom filters and report generation option] for monitoring and effective data for action of users and health managers with GIS functionality   Feature upgradation, deployment and maintenance for public dashboard, OpenSRP Manager dashboard and OpenSRP user dashboard     4. Deliverables     Tasks Product/deliverables Time frame Category 1: Support DGHS to enhance individual maternal, immunization & nutrition tracking system using OpenSRP. Feature upgradation, deployment and maintenance for Maternal & Immunization eTracker and GMP module as per requirement from stakeholders (including development and optimization of microplanning tool for MNCH, EPI, ECD including Early identification of developmental delay module upgradation, and nutrition)     Conduct requirement analysis workshop to finalize the requirements and submit report System upgradation, deployment and maintenance through customization of existing OpenSRP system based on the requirement of stakeholders for Maternal & Immunization eTracker and GMP module Development, upgradation and optimization of microplanning tool for MNCH, EPI, ECD including Early identification of developmental delay module October 2025           Low birth weight identification, Community KMC, Community SCANU and community follow-up of facility KMC and facility SCANU with DHIS2 integration in 10 REMN districts and 5 CBE Districts. Notification will be sent from DHIS2/OpenMRS with patient information and all service data to OpenSRP. OpenSRP community follow-up information will push back to DHIS2/OpenMRS. SMS push feature for reminders should be integrated   System upgradation, deployment and maintenance for Low-birth-weight identification System upgradation, deployment and maintenance for Community KMC System upgradation, deployment and maintenance for Community SCANU Notification will be sent from DHIS2/OpenMRS with patient information and all service data to OpenSRP. Integration with DHIS2 based SCANU/ KMC tracker to OpenSRP SCANU/ KMC community follow-up module for 10 REMN districts and 5 CBE Districts.   December 2024   Built in library with AI supported algorithm for mentoring and learning, performance ranking and management for CHWs, AI-powered individual and location-based problem analysis and recommendation feature, CHW dashboard for review meetings at ward, union, upazila level (Integrated tool with interoperability with other MIS tools)   Conduct requirement analysis workshop to finalize the requirements and submit report Developed AI supported algorithm for mentoring and learning, performance ranking and management for CHWs Developed AI-powered individual and location-based problem analysis and recommendation feature CHW dashboard will be developed for review meetings at ward, union, upazila level (Integrated tool with interoperability with other MIS tools)   December 2025   Category 2: Support and maintenance of all features in OpenSRP and dashboard Technical support to ensure smooth data entry for EPI eTracker in 64 district and 12 City corporation   Support provided for EPI eTracker implementation in 64 district and 12 City corporation November 2024- October 2026 (every month report)   Technical support to ensure Maternal eTracker implementation in total 54 upazilas in 10 districts [39 upazilas from Sherpur, Kurigram, Khagrachari, Sunamganj, Bhola, and 15 upazilas from Cox’s Bazar, Cumilla, Kishoreganj, Sirajganj and Bagerhat], and 8 CBE Nutrition upazilas; ECCD/Early identification of developmental delay module implementation support in EPI locations (16 districts, 8 city corporations) and 2 CBE districts   Support provided for Maternal eTracker implementation in 10 district and 8 CBE Nutrition upazilas. Support provided for ECCD/Early identification of developmental delay module implementation in EPI locations (16 districts, 8 city corporations) and 2 CBE districts November 2024- August 2026 (every month report)   Category 3: Customize instance of OpenSRP for community level population registration & service information FDMN community eTracker includes EPI development with implementation support for 6 PHC facility catchment area. Population registration and CHW service information data will be collected through OpenSRP and that will be synced with OpenMRS system   Conduct requirement analysis and submit report Develop OpenSRP module as per requirement analysis which will collect population registration and CHW service information. OpenSRP data will be synced with OpenMRS system for 6 PHC facility   December 2024   Aalo clinic outreach service module development. Population registration and CHW service information data will be collected through OpenSRP and that will be synced with OpenMRS •     Conduct requirement analysis and submit report •     Develop OpenSRP module as per requirement analysis which will collect population registration as per defined catchment area and CHW service information. •    OpenSRP data will be synced with OpenMRS system for 6 Aalo clinic November 2025 Category 4: Development and implementation support of CHW Activity Monitoring and mentoring module Development and implementation support of CHW Activity Monitoring and mentoring module. Digitalize the GMP-EPI, REMN, MIYCN microplan, including travel plan, prioritization and task CHW activity monitoring checklist, feedback and review process feature   Conduct requirement analysis workshop to finalize the requirement and submit report Develop CHW activity monitoring as per requirement analysis Implementation support for CHW activity monitoring throughout the project period     January 2025   Category 5: Data integration & sharing SCANU/KMC community follow-up with DHIS2 SCANU tracker integration in 10 REMN Districts (including all Upazilas of these districts). Notification will be sent from DHIS2/OpenMRS with patient information and all service data to OpenSRP. OpenSRP community follow-up information will push back to DHIS2/OpenMRS. SMS push feature for reminders should be integrated Develop SCANU and KMC community follow-up module development as per requirement analysis Support DHIS2/OpenMRS technical team to develop module (API) and send notification from DHIS2/OpenMRS with patient information and all service data to OpenSRP Develop module to send OpenSRP community follow-up information using API to DHIS2/OpenMRS.     January 2025   Integration with VaxIN   Individual vaccine consumption and vaccine status will be integrated with VaxIN January 2025   Transfer of all microplan data from DHIS2 to OpenSRP DHIS2 based all microplan data will be migrated to OpenSRP December 2024   Interoperability of OpenSRP with eMIS tool (community and facility module) and Maternal and Child Benefit Program (MCBP) MIS tool (to exchange individual tracking data based on NID) Mapping different systems data structure like eMIS and Maternal and Child Benefit Program (MCBP) Develop interoperability between different systems like eMIS and Maternal and Child Benefit Program (MCBP)   December 2025   Category 6: Capacity building Support two days hands on training for MNCH, Nutrition and ECCD eTracker for 54 upazilas in 10 REMN districts, 8 CBE nutrition upazilas     Support the training Conduct the training and submit activity report Provide training manuals to the participants November 2025   Support one day hands on training for community follow up of SCANU, community KMC and KMC follow-up (54 upazilas of 10 REMN districts, and 5 CBE Upazilas for KMC and KMC follow up only)   Support the training Conduct the training and submit activity report Provide training manuals to the participants December 2025 6.3 One day refresher training 54 upazilas in 10 REMN districts, 8 CBE nutrition upazilas   Support the training Conduct the refresher training on mother & child registration, immunization service, maternal health service, nutrition service, SCANU/KMC follow-up and disability and submit activity report Provide training manuals to the participants December 2025   6.4 One day national level capacity building training for health managers on data for action using dashboard Support the training Conduct the training and submit activity report December 2025 Support seven 2-day training sessions for community providers and supervisors, and health managers in 7 upazilas in Bhola on CHW activity monitoring and mentoring module   Support the training Conduct the training and submit activity report Provide training manuals to the participants April 2025 Development of Training manual for different components   Developed the training manual with high quality content and image   December 2024 Category 7: Facility assessment with GIS functionality 7.1 Develop data entry form for different types of facility with assessment information and GIS location   Submit requirement analysis report. Developed the data entry form for different types of facility with assessment information and GIS location November 2025   7.2 Share API to extract facility information with GIS location   Submit requirement analysis report. Developed the API as per requirement analysis. December 2025 Category 8: Dashboard development with GIS functionality Extensive public dashboard development and optimization (Maternal health, Newborn health, IMCI and Child Health, nutrition, EPI, ECCD)   Conduct requirement analysis workshop to finalize the requirements and submit report Public dashboard will be developed with professional visual appearance and GIS functionality. All relevant module like Maternal health, Newborn health, IMCI and Child Health, nutrition, EPI, ECCD, Birth & Death notification will be included June 2025 8.2 OpenSRP Manager dashboard including MNCH, nutrition, EPI, GMP, KMC, community follow up, ECD - Early identification, and etc.) [with role-based login options at national, divisional, district, upazila, union and community level, as required, with custom filters and report generation option] for monitoring and effective data for action of users and health managers with GIS functionality   Conduct requirement analysis workshop to finalize the requirements and submit report Based on the HRIS authentication with role-based login options at national, divisional, district, upazila, union and community level, as required, with custom filters and report generation option Maternal and EPI program could view individual level information for gap analysis and monitoring and effective data for action with GIS functionality June 2025 Feature upgradation, deployment and maintenance for public dashboard, OpenSRP Manager dashboard and OpenSRP user dashboard   Provide technical support on upgradation, deployment and maintenance for public dashboard, OpenSRP Manager dashboard and OpenSRP user dashboard June 2026       5. Reporting requirements   An Inception Report should be submitted two weeks after the start of the assignment. Also need to submit software requirements specification (SRS) for “CHW Activity Monitoring and mentoring module”, “Facility assessment with GIS functionality” and “Dashboard development with GIS functionality”. After this point, written monthly reports should be submitted by email by the 1st week of the next month. Monthly progress meeting will be held in UNICEF.     6. Payment Schedule   10% of total fee upon submission of the inception report. 30% of total fee on submission of report of activities after 6 months of activities completion 30% of total fee on submission and approval of report of completed deliverables after 12 months 30% of total fee on submission and approval report of completed deliverables at the end of 24 months    7. Qualification requirement of the company/institution/organization   The agency should The agency should have a strong technical team having skills on ICT and HMIS led by an expert having at least 10 years of relevant working experience. Have at least 5 years of experience in large-scale web-based Health Management Information System (OpenSRP implementation, customization, database administration, maintenance data-security etc). Experience relating to multi-sectoral engagement and field experience Preference will be given to agencies that have experience of working with GIS based app for survey and data collection for coverage Demonstrated expertise in data validation and data quality assurance. The agency should have previous experience working with UN agencies, large NGOs or Government, but it is not mandatory. The agency is expected to be able to leverage sufficient and experienced manpower to carry out the assignment effectively and efficiently. Preference will be given to agencies that have sufficient experience of collecting data in the field using OpenSRP platforms with DGHS. The contractor should appoint an English-speaking project leader with at least 5 years of proven work experience in leading similar projects and deal with sensitive and confidential information, especially those associated with vulnerable individuals.   7a. Qualification requirement of the team (optional)   In addition, the project leader should: Able to write clear, brief, analytical reports. Boost a track record of undertaking such activities with reputed organizations, governments, or similar. Submit details of projects undertaken and completed, name of the s with their contact numbers, year of undertaking and completion, coverage of survey work, etc. Legal documentation that demonstrates the organization is registered to operate in Bangladesh must be presented.