Title Mapping Micro-Hotspots: A Pilot Project to identify Key Risk Factors for Cholera Persistence: Effective Mitigation Strategies in Narayanganj and Sitakunda, Bangladesh. Purpose Develop and validate a methodology to identify micro-hotspots within high- ranking Priority Areas for Multisectoral Intervention (PAMIs) and analyze key risk factors driving cholera persistence in Narayanganj and Sitakunda, Bangladesh. Identify and promote the most effective, context-specific cholera mitigation strategies to inform evidence-based public health interventions in Narayanganj and Sitakunda. Location The pilot project will be implemented in Narayanganj- Dhaka and Sitakunda - Chattogram in Bangladesh Estimated Duration The contract period will be 12 months from the beginning of the contract Reporting       to                         Technical Supervisor of this assignment Chief of WASH, UNICEF, Bangladesh   1.Background Bangladesh is a large and densely populated country in South Asia with an estimated population of 166.2 million people (2022), the 8th most populous country in the world. Its capital, Dhaka city, has a population of 10.3 million.1             1 Bangladesh Bureau of Statistics, Ministry of Planning. Population and Housing Census, Preliminary_Report_(English)_August_2022.Pdf ; 2022. Accessed February 27, 2023. https://drive.google.com/file/d/1Vhn2t_PbEzo5-NDGBeoFJq4XCoSzOVKg/view   Bangladesh is an endemic country with one of the world’s highest burdens of cholera, with an estimated 109,052 cholera cases annually. At the same time, a population of 66,495,209 is at risk, with an annual incidence rate of 1.64/1,000 population. The cholera cases in high-risk populations and cholera-prone areas may exceed 2/1,000 population (range 1-5), suggesting an occurrence of 450,000 hospitalized cases and >1 million infections per year.2 Seasonality in cholera transmission is evident in Bangladesh, which has a biannual peak3. Dhaka city had the last large outbreak in 2022, leading to a large two-dose vaccination campaign.4 Cholera “hotspots” or Priority Areas for Multisectoral Interventions (PAMIs) are geographically limited areas where cultural, environmental, and socioeconomic conditions facilitate the transmission of disease and where cholera persists or reappears regularly. An analysis was conducted between November 2022 and February 2023. The PAMIs were selected based on the previous five years’ epidemiological data (Jan 2018-Dec 2022), at the upazila or thana level. Out of the 495 upazilas and 30 thanas (after merge), 144 geographical units were identified as PAMIs with 53 and 91 upazilas or thanas with a very high and high risk of cholera respectively. The very high-risk units represent 10% (n=53) of the upazilas/thanas of the country, including a population of 18,443,471 (11% of the estimated national population in 2022) and covering 25% of the registered diarrhea cases during the studied  period.  The  91  units,  identified  as  high  risk,   represented 17% of the units (N=91), included a population of 27,761,695 (17% of the estimated population in 2022) and covered 24% of diarrhea registered cases.   Figure 1: Map of Cholera PAMI, Bangladesh   To better understand the dynamics of cholera epidemics on a manageable scale and to more effectively implement targeted interventions, a methodology needs to be developed to complement the identification of priority areas for multisectoral interventions for Cholera Control (PAMI) with micro-hotspots with the highest historical cholera transmission. This project aims to conduct a more granular analysis of high-priority PAMIs (Priority Areas for Multisectoral Intervention) by shifting from upazila- or thana-level identification to finer-scale micro-hotspots at the village or union/ward level for better targeted intervention. Using nationwide cholera surveillance line-listing data—including patient addresses, we will:   Identify persistent cholera clusters at granular levels, Define spatial distribution of cholera cases Investigate contextual drivers (environmental, socioeconomic, and behavioral factors) influencing epidemic patterns.       2 . https://www.gtfcc.org/wp-content/uploads/2025/06/national-cholera-plan-bangladesh.pdf 3 Khan AI, Rashid MM, Islam MT, et al. Epidemiology of Cholera in Bangladesh: Findings From Nationwide Hospital-based Surveillance, 2014-2018. Clin Infect Dis. 2020;71(7):1635-1642. doi:10.1093/CID/CIZ1075 4 WHO. Mega OCV Campaign in the Capital! Accessed February 27, 2023. https://www.who.int/bangladesh/news/detail/29-06-2022-mega-ocv-campaign-in-the-capital   The ultimate goal is to develop locally adapted, feasible, and costed cholera mitigation strategies tailored for micro-level implementation in both urban (Narayanganj) and rural (Sitakunda) settings. A step-by-step approach needs to be developed to define micro-hotspots on a district level within high- ranking PAMI’s. Once the micro-hotspots are defined, the main cholera transmission routes within them need to be identified and a costed Cholera mitigation strategy developed. This methodology is adapted from a similar approach successfully implemented in the Rwanda5 and Democratic Republic of the Congo (DRC)6, where micro-hotspot identification and targeted interventions were used to address persistent cholera transmission in sanctuary zones. Under this project, the adapted methodology will be applied to both an urban (Narayanganj) and a rural (Sitakunda) high-ranking PAMI to develop feasible, sustainable, and context-specific cholera control strategies. In a later phase, the impact of these recommended interventions can be studied in the implementation phase of the defined sustainable response strategy.     Project sites: Narayanganj District: Narayanganj is the sixth-largest city in Bangladesh, located approximately 16 km (10 miles) southeast of the capital, Dhaka. It has a population of nearly 1 million. The Narayanganj District comprises one city corporation and five upazilas: Narayanganj Sadar, Bandar, Rupganj, Sonargaon, and Araihazar. According to the 2022 census, the Narayanganj City Corporation had 255,468 households and a population of 967,951, with an average household size of 3.74. The city corporation is divided into 27 wards and 184 city mahallas. The upazilas are further subdivided into 39 unions, 759 mauzas, and 1,172 villages. Between May 2016 and April 2025, a total of 5,799 stool samples were collected in Narayanganj. Of these, 5,678 were tested using Rapid Diagnostic Tests (RDTs), with 1,484 (26.1%) returning positive results. Culture testing was performed on 3,952 samples, yielding 750 positive cases (18.9%).   ·Sitakunda Upazila (Chattogram District): Chattogram, the second-largest city in Bangladesh, had a metropolitan population of 5.38 million as of 2023. It borders Sitakunda to the north. The adjacent town of Sitakunda includes one designated urban settlement, Sitakunda Town, which has a population of 36,650. The town is divided into 9 wards and 22 mahallas, with 6,914 households and an average household size of 5.3. The population includes 18,662 men and 17,988 women. According to the 2011 Bangladesh census, the ten unions of Sitakunda Upazila collectively comprise 112 villages. During the surveillance period from May 2016 to April 2025, a total of 12,412 stool samples were collected at BITID. Of these, 12,393 Rapid Diagnostic Tests (RDTs) were conducted, with 2,538 cases (20.4%) testing positive. Culture tests for Vibrio cholerae were performed on 5,137 samples, resulting in 838 positive cases (16.3%). These areas have been selected based on consistent cholera reporting, presence of vulnerable communities, and the availability of baseline data.         5 2012, WASH activities for cholera prevention in communities living adjacent to Lake Kivu or Rusizi river. Cyangug province, Rwanda (6th World Water Forum, Marseille, France). 6 2021, Cholera persistence factors in the Kalemie sanctuary site, Tanganyika, DRC. (PNECHOL MD)   2.Objectives, Purpose and Expected Results General Objective   This project aims to develop and pilot a methodology for identifying cholera micro-hotspots within high- ranking PAMIs and to characterize the key contextual risk factors associated with cholera persistence in two contrasting settings: Narayanganj (urban) and Sitakunda (rural). While the project will focus on identifying and mapping micro-hotspots at a more granular level and analyzing historical and contextual data to determine key risk factors, it will also design and costed cholera mitigation strategies. However, the implementation and evaluation of these strategies, including assessment of their effectiveness by an observational study, will be proposed for a subsequent phase of work. During this project we will focus on the identification of micro-hotspots using surveillance and hospital data, analysis of contextual and environmental risk factors (e.g., WASH access, population density, mobility) and stakeholder consultations to validate findings and prioritize the interventions, development of a feasible, locally adapted cholera mitigation strategy.   2.2Specific Objectives To develop a methodology to identify micro-hotspots by mapping the spatial and temporal patterns of cholera cases and using a variety of epidemiological parameters collected over the past 5 years in Narayanganj and Sitakunda. To develop a costed, context-specific strategy for cholera prevention and control, including improvements in water, sanitation, and hygiene (WASH), social behavior changes interventions, and oral cholera vaccination (OCV) strategies. This requires: To evaluate household- and community-level knowledge, attitudes, and practices (KAP) related to cholera, hygiene, sanitation and water use. To identify socio-behavioral, and infrastructural risk factors contributing to recurring cholera outbreaks in both settings. 2.3Purpose: Develop and validate a methodology to identify micro-hotspots within high-ranking Priority Areas for Multisectoral Intervention (PAMIs) and analyze key risk factors driving cholera persistence in Narayanganj and Sitakunda, Bangladesh. Identify and promote the most effective, context-specific cholera mitigation strategies to inform evidence-based public health interventions in Narayanganj and Sitakunda. Expected Results/Outputs A validated, replicable methodological framework for micro-hotspot identification within high- priority cholera-prone areas. A comprehensive KAP report providing insights into community-level drivers of cholera risk. A detailed risk factor analysis highlights the interplay of behavioral, social, and infrastructural determinants in cholera transmission. A costed cholera mitigation strategy document, including intervention packages customized for urban and rural settings, with policy recommendations for scalable implementation.   3.Description of Assignment   The project focuses on developing a replicable and evidence-based methodology to identify micro- hotspots of cholera within two high-ranking Priority Areas for Multisectoral Interventions (PAMIs): Narayanganj (urban) and Sitakunda (rural) in Bangladesh. It also includes identifying key risk factors for cholera persistence and proposing context-specific, costed cholera mitigation strategies. The assignment involves: Micro-Hotspot Identification: Develop a methodology to map cholera micro-hotspots at the village/ward level using 5 years of surveillance data (2018–2022), including patient addresses and epidemiological parameters. Analyze spatial and temporal patterns of cholera cases to pinpoint persistent clusters in Narayanganj and Sitakunda. Risk Factor Analysis: Conduct a comprehensive analysis of environmental (e.g., WASH access), socioeconomic (e.g., population density, mobility), and behavioral (e.g., hygiene practices) risk factors driving cholera transmission. Evaluate household- and community-level knowledge, attitudes, and practices (KAP) related to cholera, water use, and sanitation through surveys and stakeholder consultations. Development of Mitigation Strategies: Design costed, locally adapted cholera prevention and control strategies, incorporating WASH improvements, social behavior change interventions, and oral cholera vaccination (OCV) plans. Engage stakeholders to validate findings and prioritize interventions tailored to urban (Narayanganj) and rural (Sitakunda) contexts. Significance: This project will enhance cholera control in Bangladesh by enabling precise, evidence-based interventions at the micro-level, addressing the high cholera burden in vulnerable urban and rural settings. The methodology and strategies developed will inform scalable public health interventions, with potential for adaptation to other cholera-endemic regions.   2. Key Activities   Phase Activities Inception Phase Finalize protocol and work plan Obtain approvals for assessment and publishing Develop/adapt tools for data collection Hire and train project team teams Data Collection Conduct quantitative household KAP surveys Conduct 10 Key Informant Interviews (KIIs) Conduct 2 Focus Group Discussions (FGDs) Retrieve and clean 5-10 years of epidemiological surveillance data Collect GPS and environmental data   Data Analysis Statistical analysis of household, demographic, and epidemiological data Thematic coding and analysis of qualitative data GIS spatial analysis and micro-hotspot mapping Integration of all findings Strategy Development Identify key risk factors Propose tailored cholera mitigation strategies Estimate cost of proposed strategies Reporting & Dissemination Produce draft and final analytical report Develop a policy brief Conduct stakeholder validation workshop Present findings to DGHS, DPHE, local government, and national taskforce   Month Activities Month 1-2 Finalization of protocol, approval for assessment, tool development, recruitment, training Month 3-4 Data collection in Narayanganj and Sitakunda Month 5-6 Data collection in Narayanganj and Sitakunda Month 7-8 Data cleaning, analysis, and interpretation Month 9-10 Development of a costed strategy for multisectoral intervention. Month 11-12 Report writing, validation workshops, dissemination of findings   Boundaries and Specific Issues Geographic Focus: The project is limited to two PAMIs—Narayanganj (urban) and Sitakunda (rural)—representing both urban and rural cholera transmission dynamics. Data Access: The bidder must coordinate with national institutions such as DGHS, IEDCR to access surveillance data. Permissions and ethical clearance are mandatory. Logistical Constraints: Fieldwork in densely populated or hard-to-reach areas may pose challenges. Adequate risk mitigation strategies should be in place (e.g., local hiring, mobile data collection). Budget Cap: The total budget is USD 80,000-100,000, including all personnel, fieldwork, logistics, and indirect costs. Cost-efficiency is expected. Collaboration with Stakeholders: Bidders must demonstrate capacity to collaborate with multiple actors including government bodies (DGHS, DPHE), local governments, and NGOs. Data Privacy & Ethics: Strong emphasis is placed on ethical conduct, informed consent, confidentiality, and community engagement.   4.Deliverables Inception Report Household and qualitative datasets GIS cholera hotspot maps Draft and Final Analytical Report (including risk profiles and policy recommendations) Summary Policy Brief Presentation of findings to DGHS, DPHE, local governments, and cholera stakeholders 5.Reporting requirements   The selected organization will be responsible for submitting the following reports and deliverables in a timely manner. All reports must be submitted both electronically (in PDF and editable Word format) and, upon request, in two hard copies. The reports should be addressed to the designated UNICEF technical supervisor and relevant stakeholders from DGHS, DPHE, and IFRC. 1.Inception Report Deadline: Within 4 weeks of signing the contract. Content: Detailed work plan, refined methodology, sampling strategy, data collection tools, fieldwork logistics, team composition, quality control mechanisms. Format: PDF and Word. 2.Monthly Progress Reports Deadline: Submitted by the 1st of each month during the contract period. Content: Status of activities completed, challenges faced, mitigation measures, upcoming plans. Format: PDF and Word. 3.Minutes of Key Meetings Deadline: Within 2 working days after each meeting with stakeholders (e.g., UNICEF, DGHS, DPHE, local authorities). Format: Word document. 4.Mission/Field Visit Reports Deadline: Within 10 days of completion of each major field activity (data collection, stakeholder engagement, etc.). Content: Locations visited, participants, activities conducted, observations, issues encountered, and next steps. Format: PDF and Word. 5.Draft Analytical Report Deadline: Within 3 weeks of completion of fieldwork. Content should follow the structured format detailed below. Format: PDF and Word. 6.Final Analytical Report Deadline: Within 2 weeks of receiving consolidated feedback from UNICEF and key partners. ·Content Format: Cover Page Table of Contents List of Figures and Tables List of Acronyms Executive Summary (2–5 pages)   Introduction & Background Objectives and Scope Methodology Ethical Considerations Limitations Results and Discussion GIS Maps and Spatial Analysis Key Risk Factors and Hotspot Profiles Recommendations (programmatic, policy, and research) Annexes (data tools, transcripts, survey results, references, photos, etc.) Format: PDF, Word, and Excel (where applicable for data). 7.Summary Policy Brief Deadline: With the final report. Length: 2–4 pages. Audience: Policymakers and partners. Content: Key findings, hotspot summary, risk factors, and practical recommendations. 8.Presentation Materials Deadline: At least 2 weeks prior to the dissemination workshop. Format: PowerPoint (PPT), PDF. 9.Dissemination Workshop Report Deadline: Within 2 weeks after each workshop or stakeholder presentation. Content: Participants, presentations, feedback received, follow-up actions. All deliverables must adhere to high standards of scientific rigor and language clarity and should comply with UNICEF's ethical research and data protection protocols. Payment Schedule   Installment Payment Conduction 1 30% Protocol development and initial planning meetings with stakeholders and Inception Report submitted within 30 working days on contract signing 2 40% Draft    report    writing,    internal             validation               and             stakeholder consultations 3 30% Final report submission, validation workshops, dissemination to partners and government Qualification requirement of the company/institution/organization Relevant Experience The organization should have a minimum of five (5) years of demonstrated operational experience in conducting public health projects, research, epidemiological studies, WASH-related assessments, or operational research projects in similar settings. Experience working in cholera-endemic areas or on disease surveillance, health behavior studies, or WASH interventions in South Asia, particularly Bangladesh, is highly desirable. ·Track Record of Similar Assignments The organization must have successfully completed (in the last 5 years) or currently be implementing at least three (3) contracts of similar nature, scope, and complexity with government agencies, UN organizations, international NGOs, or donor-funded projects.   Each contract should demonstrate experience in conducting: Mixed-methods operational project, research or health/WASH-related studies, assessment Household surveys and/or KAP assessments, Stakeholder interviews and focus group discussions, Data analysis (quantitative and qualitative), and GIS-based mapping and hotspot identification (preferred). ·Technical and Managerial Capacity The organization must demonstrate its ability to mobilize a qualified, multidisciplinary team with the required technical expertise as described in the “Team Qualification Requirements.” The organization must have in-house or associated capacity for data quality assurance, ethical compliance, data protection, and reporting. ·Financial Management The organization must have sound financial systems and the ability to manage donor funds in line with international accounting standards and donor compliance requirements. Financial statements or audit reports for the last two fiscal years may be requested during the selection process. 7a. Qualification requirement of the team (optional) The following qualifications and experience are suggested to ensure the effective execution of this project: Team Composition (Indicative) Role Suggested Number Indicative Profile   Team               Leader             / Principal Investigator (PI)     1 Advanced degree (Master’s or PhD) in Public Health, Epidemiology, Environmental Health, or related field; minimum 20 years of experience in health systems research or infectious disease control, with proven leadership in field-based studies. Prior experience working on cholera or WASH-related programs preferred. Co-Principal Investigator                           / Senior Researcher   1 Advanced degree in Public Health, Epidemiology, Social Sciences, or Statistics; 15+ years of experience in operational research project; experience in quantitative and qualitative study design, and coordination with government or UN partners.   Data     Analyst              / Statistician   1 Degree in Biostatistics, Epidemiology, Public Health, or related field; 10+ years of experience in statistical analysis (using R, SPSS, or STATA), GIS mapping (QGIS/ArcGIS), and data visualization; familiarity with health surveillance data. Qualitative Research Specialist   1 Social science background (e.g., Anthropology, Sociology, Development Studies); experience conducting and analyzing FGDs and KIIs using NVivo or manual coding; experience working in health, WASH, or behavior change settings in South Asia.   Field Supervisors   2 Bachelor’s or Master’s in Public Health, Social Sciences, or Development Studies; experience in managing field teams for survey data collection; familiarity with mobile data tools (e.g., KoboToolbox, ODK).   Role Suggested Number Indicative Profile Enumerators / Field                         Data Collectors   ~8–10 Secondary or tertiary education; prior experience conducting household KAP surveys; training in research ethics and data collection tools; fluency in Bangla. GIS                 Specialist (optional                         or shared role)   1 Experience in spatial epidemiology or public health mapping using GIS platforms; able to integrate epidemiological and WASH infrastructure data for hotspot analysis. Language Requirements All team members must be proficient in English and Bangla. The ability to translate and communicate technical concepts clearly in both languages is essential. Additional Competencies (Preferred) Prior experience working in cholera-affected or high-risk settings in Bangladesh. Familiarity with the policy and institutional framework of the Government of Bangladesh, especially DGHS, DPHE, and local authorities. Demonstrated ability to produce high-quality reports and deliver presentations to stakeholders at the national level. Evaluation Process and Method: EVALUATION CRITERIA FOR TECHNICAL PROPOSAL     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; (25) 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; (30) 10   10 05 05 PRESENTATION Presentation of the proposed methodology, approach, proposed data collection tools 10 TOTAL MARKS 70   Those proposals receiving a minimum technical score of 42 points (70%) out of total score of 60 points (for desk review) will be requested to make presentation of their proposals.  After the presentation, the technical scores of the bidders invited for the presentation will be finalized.   For this RFP, bidders (after presentation) who score at least 49 points out of 70 points will be considered technically compliant and their Financial Proposals will be opened for further review. The final selection of the bidder will be based on a quality and cost basis as specified in the RFP. The bidder achieving the highest combined technical and financial score (subject to any negotiations and the various other rights of UNICEF detailed in the RFP) will be proposed for award of Contract.   For this RFP, the Technical Proposal has a total score of 70 points. Bidders must score 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.