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;
- 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:
This allocation will support the MOH 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 MOH will work closely with the PEU specialists so that the MOH benefits from knowledge transfer and capacity strengthening.
The Government of Jamaica (GoJ) and the Inter-American Development Bank (IDB) have negotiated a loan agreement to improve health system efficiency in Jamaica. The objective of the Support for the Health Systems Strengthening Programme (HSSP) is to improve the health of Jamaica’s population by strengthening comprehensive policies for the prevention of Non-Communicable (Chronic) Diseases. As part of the initial preparation activities for the project the Ministry is required to establish a Project Execution Unit (PEU).
Objectives of the Consultancy
The main objective of the consultancy is to support the MOH and its PEU with structural Engineering Services, particularly as it relates to identifying defects and offering solutions to correct these deficiencies identified at select Health Facilities.
The Structural Engineering Firm will be responsible for the identification, documentation and design of structural engineering solutions relating to Component 1, completed within the specified time and budget.
Scope of Work
The scope of services provided by the consultant firm will include:
- Assessment of all civil and structural engineering activities related to the Hospitals & Health Centers as directed by the Civil Engineer.
- Engage in consultations with local MOHW staff regarding structural related issues at requested facilities.
- Ensure adequate consultations are conducted with hospital/health center Management regarding issues identified to reduce disruptions.
- Liaise with the procurement specialist to develop terms of references for works related to repair and preventative maintenance operations.
- Perform structural analysis, calculations and design, development and review designs for specific areas requiring structural repair.
- Assist review and recommendation of specifications and engineering data (based off calculations etc.) as it relates to structural works.
- Prepare in detail the work bid documents for technical works
- Ensure work quantity and quality are representative of structural design documents.
- Ensure building permits if necessary are sought and obtained from appropriate authorities before work starts if necessary
- Ensure that all necessary preparatory works are done to facilitate repair work
- Assessment of existing Health Facilities Infrastructure
- Recommend interventions in Health Facilities infrastructure as necessary
- Conduct related Project activities coordination, monitoring and reporting
- Production of progress reports within the times specified by the PEU Project Manager
- Oversee the ongoing execution of work plans
- Conduct meetings with contractors
- Receive and review contractor’s reports and invoices etc.
- Provide timely information to enable the Project Manager/Civil Engineer to meet with and update relevant stakeholder groups on the developments associated with repair works.
Key Task and Responsibilities
- Assess Health Facilities for Infrastructural deficiencies
- Develop Solutions to remedy the deficiencies identified:
- Detailed drawings of intervention required for each issue identified
- Bill of Quantities of materials, labour and all other inputs required for complete repairs
- Develop tender documents for works identified
- Assist in responding to queries from relevant stakeholders; contractors, staff etc.
- Review and evaluate the request for proposals and bid documents associated with repairs /corrections identified;
- Manage the process of receiving the various endorsements & approvals for the project, with the guidance of the Project Manager/Civil Engineer and within the scheduled timeline;
- Assist with the preparation & Evaluation of Bid documents and request for proposals for these corrections/repairs;
- Coordinate with the PEU to ensure that all necessary permits and licenses are sought and received prior to the implementation of the repairs;
- Ensures compliance with Agreements governing the Project;
- Prepare reports as required;
- Liaising and communicating with the stakeholders/beneficiary of the Project to ensure smooth implementation at the various facilities;
- Be responsible for day-to-day correspondence, information sharing and filing under the aspect of the Project, ensuring that appropriate follow-up actions are taken;
- Prepare and distribute to all stakeholders, minutes of meetings, reports etc as required;
- Oversee contractors and consultant’s activities on the Project and provide reports to the Project Manager/Civil Engineer as needed;
- Liaise with project partners on day-to-day implementation of these project activities;
Reporting/Supervision
The Consultant Structural Engineer will be supervised by the Civil Engineer/Construction Specialist.
Deliverables and Timeframe
| # | Required Product | Frequency | Delivery date | Supervision |
| 1 | Status reports on the above mentioned repair activities. | Monthly | 5 calendar days after the end of the reporting month | CE |
| 2 | 4.1 Report on all relevant construction activities. | As required | As required | CE |
| 3 | 4.2 Reports as requested by the PEU and the Bank concerning the work progress. | As requested | As requested | CE |
Qualifications and Experience
Firm Experience
- Minimum Seven (7) years’ experience in structural/civil engineering related to government and non-government commercial projects
- Minimum Five (5) years’ experience with structural/civil engineering projects related to health facilities
Key Staff
- Team Leader
- Master’s Degree in Structural Engineering;
- Certificate in Project Management or a related field;
- Minimum (15) fifteen years professional and management working experience;
- Expert Experience in the construction industry (building construction and supervision);
- Structural Engineer
- Bachelor’s Degree in Structural Engineering, or Equivalent qualification;
- Minimum 5-10 years professional and management working experience;
- Working familiarity with the construction industry (building construction and supervision);
- CAD Specialist
- Associate Degree/Diploma in Architecture/ Engineering or equivalent
- Certificate in Autodesk or similar course
- Good command of Autocad drawing software or equivalent
- 2-3 years working Experience
Other support staff as deemed necessary, however scores will be calculated only for key staff.
Payments Schedule and Consultancy Conditions
The contract will be for a period of four (4) months plus three months’ advisory services.
| # | Required Product | Frequency | Delivery date | Percentage |
| 1 | Work plan & Inception Report | Once | 2 Weeks | 10 |
| 2 | 4.3 Design Solutions for each Facility – to include drawings etc. | As necessary | Two (2) Months after contract signing | 30 |
| 3 | 4.4 Bill of Quantity & Tender Document for Works | Once | Three (3) Months after contract signing | 40 |
| 4 | 4.5 Final Report | Once | After Complete repairs | 20 |