Background

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that was first recognized in Wuhan, Hubei province, China, in December 2019. The COVID-19 pandemic has unprecedented effect on the health and socio-economic status of the world population. The official number of 509 confirmed cases and 21 deaths was released by the government on 11^th May, 2020. Since then, there has not been any other updates, but the country is said to have experienced both the first and second wave of the pandemic, and is most likely entering into the third wave. In the early days of the pandemic, the government of Tanzania had taken strong measures to combat the pandemic, that included closure of schools, restricting gatherings, providing health education to citizen to take necessary precautionary measure including washing of hands with soap and running water, wearing of face masks and observing physical distancing.

Recently, the 6^th government has stepped up its efforts to address the COVID-19 pandemic. The President of the United Republic of Tanzania formed a special committed to re-look into the whole issue and provide recommendations on how the government should address the pandemic. Several measures have been put in place since then including steeping up and encouraging citizen to abide to all precautionary measures, and it has allowed UN agencies to bring into the country COVID-19 vaccines for its staff. Other measures include exploring the possibility of local production of the vaccine, in addition to initiating importation of the vaccines for its citizens.

Although the country is yet to experience increased number of COVID-19 admissions in health facilities, the government has provided a warning on the possibility of experiencing a third wave of the pandemic which is said to be due to virulent Delta variant of the virus. Based on what has happened in India, and in the neighboring countries, where increased number of severe cases has been observed, leading to shortage among others of supplies such as oxygen and ventilators to save the lives of severe COVID-19, it is imperative that advance preparations are made to address and short falls that may result due to constraint health system.

Nutrition International (NI) has taken bold steps to ensure its staff safety and security in the last one year. Work from home (WFH) has been implemented globally over the last one year. NI also approved COVID-19 emergency funding to avail basic preventive measures such as provision of Personal Protective Equipment (PPE) for its staff. Furthermore, NI has a plan to implement home-based care approach to ensure the safety and wellbeing of its staff in case the health system becomes overwhelmed and fail to provide services due to hospitals being overcrowded.

2. Rationale of recruiting a consultant physician/firm

The anticipated increase in number of severe cases of COVID-19 in Tanzania could be beyond the capacity of COVID-19 treatment centers in the country. On the other hand, shortage of life saving medications and equipment will be a serious challenge for the country to save the lives of with severe cases of COVID-19. In line with its principle of investing on its staff, NI will provide support for staff affected by COVID-19, including assist in home-based care in case of health service failure through hiring a medical practitioner or a firm to provide emergency home based care clinical and counselling services to affected NI staff and their immediate family members. It might involve prepositioning of oxygen concentrator and other commodities, as necessary. The purposes of recruiting consultant physician include:

· To avail clinical services to severe cases of COVID-19 at home in the absence of functional health system.

· Arrange ambulance and critical care service when moving staff to hospitals or other centers is required.

3. Specific duties and responsibilities of the consultant physician

3.1. Provide lifesaving clinical services for severe cases of COVID-19

3.1.1. Provide lifesaving medications such as IV fluids, antibiotics, antipyretics and corticosteroids. The consultant physician is responsible coming up with a list of essential medicine/supplies as per the country’s COVID-19 Treatment protocol; and o procure and avail these lifesaving medications.

3.1.2. Administer oxygen to severe cases at home as per the national guideline. Oxygen concentrator will be provided by NI.

3.2. Provide medical and nutritional counseling services for the patient and families

3.2.1. Provide nutrition and home-based care counseling to the patient and families remotely and physically as needed.

4. Key Deliverables and timeline

S/No

Deliverables

Timeframe

1

Monthly update report including treatment outcomes of patients to the Country Director or his/her designee.

Report on each case managed within 3 days of providing care.

2

Simplified home-based care protocol including use of oxygen concentrator.

August 2021

5. Qualifications of the consultant

The consultant physician should have a Medical Degree (MD) degree and specialty in internal medicine or infectious diseases from a recognized university. He/she should be certified clinician (with practicing license) and have not less than five (5) years’ experience of providing clinical services in Tanzania.

6. Reporting and working hours

The consultant physician shall report to the Country Director weekly. He/she shall work on call basis as needed based on the availability of patients.

7. Duration of consultancy service and contract Period

The consultant will be engaged on need basis.

8. Selection/Remuneration

The consultant physician or firm will be recruited based on competition. The consultant shall prepare and submit a technical proposal (based on the above objectives and scope of work) and financial proposal (based on cost of consultation/patient and cost of medicines and supplies for COVID-19 treatment) to NI as instructed in section 9 below.