TERMS OF REFERENCE
CONSULTING SERVICE FOR THE SUPERVISION OF THE
CONSTRUCTION AND REHABILITATION OF HEALTH FACILITIES
AS PART OF THE
Support to the Health System Strengthening for the Prevention and Care Management of Non-Communicable Diseases Programme (HSSP)
BACKGROUND
The Government of Jamaica has received two loans from the Inter-American Development Bank (IDB) to support the Health Systems Strengthening for the Prevention & Care Management of Non- Communicable Diseases (NCD) Programme.
The programme objective is to improve the health of Jamaica’s population by strengthening comprehensive policies for the prevention of Non-Communicable (Chronic) Diseases (NCDs) risk factors and improved access to an upgraded and integrated primary and secondary health network in prioritized areas with an emphasis on chronic disease management, that provide more efficient and higher quality care. This is a hybrid programme with a policy-based operation, a programmatic policy-based loan series (PBP) and an investment loan that will invest in the physical infrastructure and equipment of Jamaica’s health sector.
The Policy-Based Loan will look at policies that will consolidate regulatory measures to address the preventable causes of NCDs and to reorient health systems to address prevention and control of NCDs through a people-centred primary health chronic care model.
The Investment Loan, in turn, will finance activities to consolidate integrated health networks and improve the management, quality and efficiency of health services. The Policy Based Loan will benefit the Jamaican population at-large, while the Investment Loan will have approximately 800,000 potential direct beneficiaries who reside in the catchment areas of the health services networks that will receive investments.
The Investment Programme being implemented by the Ministry of Health and Wellness (MOHW) has two (2) major components and an allocation to support programme administration and evaluation:
Component 1 – Organization and consolidation of integrated health services networks
This component will finance the purchase of medical equipment and the improvement of infrastructure for primary health care services in the catchment areas of three priority hospitals to increase their capacity in health promotion and disease prevention, especially regarding chronic, non-communicable diseases. The investments will focus on strengthening the diagnostic and screening capability as well as the clinical and resolutive capacity of health clinics.
This Component will further finance the upgrading and or expansion of three (3) hospitals selected on criteria relating to strategic role in the national hospital network, supply-demand gap analyses, and physical needs assessment. The hospitals will benefit from infrastructure upgrading and or expansion as well as modernization.
Sub-Component 1.1 – Strengthening Primary Care
1.1 The purpose of this subcomponent is to increase the physical capacity for service provision at the primary care level in three (3) priority geographical areas. Approximately ten (10) health centres have been identified to receive investments in medical equipment and infrastructure refurbishment and expansion. The subcomponent will finance: (i) the preparation of building designs for the construction of new infrastructure on the sites of existing facilities (three centres), expansion of existing structures (four centres), and refurbishing (three centres); (ii) the physical works required for infrastructure improvement; (iii) the purchase of medical equipment including essential diagnostic and treatment items for NCDs, such as sphygmomanometers, electrocardiogram machines, pulse oximeters, defibrillators, computerized chemistry machines, etc.); (iv) engineering services for construction supervision; and (v) corrective and preventive maintenance of medical equipment.
Sub-Component 1.2 – Increasing the Capacity and Efficiency of Hospital Services
This subcomponent will address urgent needs to enhance patient safety and services in three (3) hospitals whose catchment areas contain the health centres identified in subcomponent 1.1. financing from this subcomponent will be allocated to:
(i) the building and engineering designs for the infrastructure improvement and expansion;
(ii) the construction in three hospitals according to contracted plans and designs;
(iii) the purchase of medical equipment to raise clinical capacity to partially account for existing demand;
(iv) the purchase of imaging equipment, including computerized tomography machines;
(v) purchase of industrial style laundry machines;
(vi) construction supervision services; and
(vii) the design and implementation of a corrective and preventive equipment maintenance programme.
Component 2 – Improvement of Management, Quality and Efficiency of Health Services
This component will provide technical assistance to design and implement the Chronic Care Model (CCM) in the participating health services networks; to review and develop care pathways and protocols; and to prepare change management, continuous quality improvement and social media marketing for behaviour change strategies. It will also finance the implementation of the fourth Jamaica Health and Lifestyle Survey. This component will further support:
- the creation of a strong foundation for a digital health ecosystem, including the adoption of standards for interoperability, system architecture, updated governance structure, and other key elements;
- the design and implementation of a sustainable Electronic Health Record (EHR) platform focusing on digitalization of key processes within the improved CCM; and
- the strengthening of telehealth/telemedicine/telementoring capacity to include chronic care management, and the establishment of norms and processes for its institutionalization.
- the strengthening of telehealth/telemedicine capacity through the expansion of the ECHO model, the inclusion of chronic care in the platform, and the establishment of norms and processes for its institutionalization.
The Loan also supports Programme Administration and Evaluation.
Programme Administration and Evaluation
This allocation will support the MOHW in terms of strengthening its institutional capacity for project implementation. It will finance, inter alia, the consultants of the Project Execution Unit (PEU), specialized technical services, independent auditing, as well as surveys and studies regarding the implementation of the programme and evaluation of its impact. The PEU is structured to provide additional capability in the areas of project management, procurement, financial management, infrastructure upgrading, medical equipment specification, and health information technology. Technical and fiduciary staff from the MOHW will work closely with the PEU specialists so that the MOHW benefits from knowledge transfer and capacity strengthening.
OBJECTIVE OF THE CONSULTANCY
The main objective of the consultancy is to support the MOHW and its PEU with construction related project management expertise, particularly as it relates to effectively providing support to the execution of Component 1- Organization & Consolidation of integrated health services networks especially with regards to Health Centers.
The Construction Engineer Health Centre Consultant will be responsible for the technical, administrative, financial and environmental supervision of all the activities relating to Component 1, following the required procedures as outlined in the Project Operation Manual (POM) and ensuring the construction related activities are completed within the specified time and budget. This includes the fulfillment of the contractual commitments, such as technical specifications, methodology, occupational safety plan and other documents that are part of the contract, according to the good practices that these works entail.
The focus of this consultancy will be on Health Centers, however the other non-health center related activities may be required to be undertaken in order to keep the overall project on track.
Scope of Work
The Construction Engineer shall be responsible for ensuring compliance by the contractor with the contract signed with the PEU, in all its technical, economic and administrative components. The Construction Engineer shall coordinate his or her supervisory activities with the contractor, who shall be designated for such purpose by the Requesting Unit. The Construction Engineer shall assume the responsibility of supervising the work until its completion and settlement of the contract; he/she shall also assist the contractor in the corresponding decision making in the execution of the work.
The documents that will serve as basis for the SUPERVISION are all the plans, technical specifications, bill of quantities, chronogram, as well as the budget for the execution of the work by the Contractor.
The scope of services provided by the consultant will include:
- Prior to the start of the works, the Construction Engineer will review the contractual documents (Plans, Technical Specifications, list of quantities, and other technical documents) in order to verify the quantities contracted. After the review, he will submit a report no later than 5 days after receiving the order to start the supervision activities
- Supervise, direct, monitor and coordinate with Contractor/Contractors and sub-contractors for all works on site, related to Health Centers.
- Ensure that all works performed by Contractor/Contractors conforms with contract documents and government specifications.
- Measure the quantities of work executed, in order to verify, certify and approve the work estimates submitted by the contractor
- Verification and approval of possible workshop plans, preparatory plans, details or adjustments, within the framework of what was contracted during the execution of the work
- Perform quality assessments on all works performed by Contractor and all sub-contractors and submit to the PEU Civil Engineer/Construction Specialists (CE/CS) and PEU Project Manager (PM)
- Assist in ensuring that project schedule and planned sequence of works are attained by Contractor and sub-contractors.
- Assist in planning and reviewing related construction program including procedures, plant layout, equipment and manpower, schedule and costs.
- Assist in updating progress schedules weekly with PEU CE/CS.
- Be the focal point for site control system: budgeting, cost control, prepare site diaries, assist in taking off quantities, preparing time related schedule of materials and assist in Contractor and sub-contractor evaluation.
- Implement and ensure that the strictest safety government standards are maintained by the Contractor and perform scheduled and scheduled safety inspections to ensure all working conditions are in compliance with the government standards.
- Verify and check that the dump of the construction’s waste is the one approved by the entities in charge of this activity
- Assist in establishing and keeping all records and documents of all onsite deliveries by Contractor including material, equipment and manpower in an approved filing system established by PEU CE/CS and PEU PM.
- Review and approval of materials to be used in the construction of the works and that their storage is carried out based on the recommendations of the manufacturer, standards and good construction practices that apply to it, as well as the sites are adequate in quantity and dimensions for their protection. Alert the PEU CE/CS and PEU PM when it is determined that the contractor fails to provide adequate resources (Manpower, Equipment) to meet Project Requirements.
- Assist in verifying all invoices and certificate for payment to Contractors and sub-consultants and submit to PEU CE/CS.
- Assist in managing all security for third party contractors, consultants related to the project.
- Assist in ensuring that all necessary preparatory works is done to facilitate civil and structural works, including on-site provisions for contractors, coordination with work for utilities in the vicinity, patient relocation is undertaken as appropriate
- Ensure that Construction related activities are completed in a timely manner in order to keep project schedule on target and within budget.
- Recommend justified Change Orders for the adequate execution of the works. The Construction Engineer may not order the contractor to carry out work that involves an increase in any of the amounts provided for in the corresponding contract without a duly authorized Change Order or amendment.
- Participate in the provisional reception and acceptance of the work, and prepare the corresponding report including the list of observations to be fulfilled by the contractor.
- Participate in the final reception and acceptance of the work and prepare the final supervision report, with the recommendation for the financial settlement of the contract.
- Determine the delays in the execution schedules and participate in deliberation with the PEU, Construction Supervising Firm (CSF) and with the contractor the application and quantification of fines according to the contract, if necessary.
Other responsibilities:
- The Construction Engineer must visit the construction sites, according to the contractor’s and CSF schedule.
- Holding regular meeting as needed (weekly or otherwise) on site with the CSF, Contractor’s representative and personnel designated by the Employer during the period of supervision to assess the progress of the work.
- Supervise the maintenance and custody of the construction log documenting the actions taken and reflecting the agreements and commitments made; corrective measures and/or technical solutions relevant and necessary for compliance with the works and safety standards. The work log shall be delivered to the contractor upon presentation of the Final Supervision Report.
- Submission of weekly supervision reports, which must include at least the following content:
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- Introduction.
- General description and location of the project.
- Contractual information.
- Contractor information and supervision.
- Project organization chart.
- Occupational safety measures taken.
- State of the project in execution, referring to the economic, financial and physical progress of the work.
- Calculation of quantities of work and determination of accumulated volumes.
- Performance of the contractor’s technical staff.
- Minutes of the weekly joint meetings with the contractor.
- Evidence and copies of communications with the contractor.
- Photographic report of the work and its progress.
- Relevant aspects during the period of execution of the works
Key Task and Responsibilities
- Supervise, direct, monitor and coordinate project activities and the procurement process associated with Component 1 of Programme;
- Liaising with PEU CE/CS and team and consultants and at times members of the public as an integrated effort to progress works;
- Maintaining quality and quantity control;
- Assist in planning and reviewing construction programme to ensure project is on time;
- Focal point on site control systems as it relates to relates to record keeping, cost control, contractor and sub-contractor evaluation;
- Assist in assessing and minimizing risk;
- Establish and maintain safety programme;
- Assist in managing all security efforts and environmental health on site;
- Alert PEU team on early detections of project delay;
Reporting/Supervision
The consultant activities will be supervised directly by the Civil engineer/Construction Specialist (CE/CS) and indirectly by the Project Manager (PM) within the PEU.
The Construction Specialist/Civil Engineer and/or Project Manager shall have a maximum of 5 working days to accept, make suggestions, observe or reject each of the reports submitted by the Construction Engineer.
The Construction Engineer shall transfer to the MOHW PEU the intellectual property of the products resulting from the contract and undertakes to deliver all the information gathered and may not use, either partially or totally, any product of this consultancy without the MOHW’s written authorization. Taking into account that the information handled is of a confidential nature, the Construction Engineer may use it only as a professional portfolio but may not use, sell, distribute or dispose of, in part or in whole, any product of this consultancy, without the written authorization of the MOHW.
Administrative Relationship
The Construction Engineer shall address any doubts regarding the project to the person assigned as the PEU Civil Engineer/Construction Specialists (CE/CS) and PEU Project Manager (PM), who shall monitor, solve doubts and indicate the guidelines established or not in this document, so that the contracting objectives are met.
Reports shall be submitted by the Construction Engineer to the PEU for consideration and approval, as described in this paragraph.
Every final document and/or report approval letter, which is considered as approved by the MOHW/PEU, must be approved by the person designated by the PEU, in order to be part of the consultancy products.
Deliverables and Timeframe
The Construction Engineer shall prepare and submit to the MOHW/PEU for consideration and approval the following products. Furthermore, the Construction Engineer shall deliver products as two (2) electronic copies on CD duly labeled.
| # | Required Product | Frequency | Delivery date | Supervision |
| 1 | 4.1 Preliminary Report
4.2 Containing the analysis of the review of the quantities of works, with its relevant observations and recommendations. This report will be delivered |
Once | No later than 5 days after NTP | CE/CS /PM |
| 2 | 4.3 Weekly progress reports
To include: at least the following information: work progress, financial status of the contract and narrative description of the works executed during the week being reported, photographs that show evidence of the progress of the work in an orderly manner and any other information of interest in the development of the project. |
Weekly | No later than 2 calendar days after the end of the reporting week | CE/CS /PM |
| 3 | Special Reports
Any other report or documentation that may be required either by the Contractor or at the initiative of the MOHW PEU.
|
As required | As required | CE/CS /PM |
| 4. | Final Report
A descriptive report covering all phases of the execution of the work up to the final settlement of the works, which shall be submitted to the MOHW/PEU for consideration and approval. |
As required | This report will be delivered 3 weeks after the completion of the Project | CE/CS/PM |
Qualifications and Experience
- Degree in Construction Management/Engineering, or Equivalent qualification;
- Minimum 5 years professional and management working experience;
- Working familiarity with the construction industry (building construction and supervision);
- Proficiency in Computer Software, AutoCAD release 2014 or later (or other construction related software), MS Word, Microsoft Project, Excel and PowerPoint;
- Project management Certificate will be an asset;
- Experience in preparing and presenting reports;
- Good interpersonal and communication skills;
- Ability to work in diverse teams;
Payments Schedule and Consultancy Conditions
The contract will be for a period of 2 years, with the possibility for extension or where otherwise determined under the relevant clause of the contract.
The MOHW and PEU will provide physical space and necessary tools for the development and execution of the consultant’s activities.
The contract’s amount will be distributed in 24 equal monthly payments that will be dependent on satisfactory implementation of activities and the delivery of required products, as agreed between the MOHW/PEU and the consultant.