REQUEST FOR PROPOSAL (RFP) for

Baseline study for “Strengthening Village Health Councils (VHC)” Project in

Meghalaya

Closing Date for Submissions

December 18th, 2023, at 5:00 PM

I. INTRODUCTION & BACKGROUND

Lords Education and Health Society (LEHS), a not-for-profit organization works towards improving the quality
and access to primary healthcare services for underserved communities. The Organization is working on
primary healthcare models through a partnership with State governments, international agencies, and the
private sector by appropriately introducing promising healthcare innovations in the public health system in
order to build an equitable, innovation-led, and evidence-based quality healthcare system within easy reach of
the underserved population of Rajasthan, Madhya Pradesh, Delhi, Uttar Pradesh, Assam, Uttarakhand and
Meghalaya. WISH (Wadhwani Initiative for Sustainable Healthcare) is a flagship program of LEHS in India.
Since 2014, LEHS|WISH has been on an aggressive path of designing, piloting, and demonstrating practical
primary healthcare solutions through innovation and technology. LEHS|WISH take up the roles of Innovating,
Management, Monitoring, Advisory and Technical support for upgrading and scale-up of high quality rural and
urban healthcare programs through partnership with State government, international agencies and private
sector. LEHS|WISH’s 1000+ primary healthcare facilities cover a population of over 140 million and have
served over 21 million patients to date. LEHS|WISH envisages longer-term and systemic-level changes that
ensure a lasting impact on the underserved community. In 2022, the state of Meghalaya has come up with a
unique and innovative strategy to comprehensively address the demand side of health care in the name of
Village Health Councils (VHCs). They are elected community health institutions with the main objective to
enhance community engagement and improve health outcomes by fostering community participation in
ensuring good health for the citizens with the goal of improving health seeking behavior.
The TSU of LEHS|WISH is providing technical support to NHM, Meghalaya in various domain related to health
in general and strengthening VHCs in particular. Apart from generating health awareness by developing social
and behavior change communication (SBCC) and community sensitization through health education, the team
will develop innovative plans to ease accessibility, comprehensive capacity building of FLWs for quality
primary healthcare services while strengthening the VHCs to amplified the process. The major interventions
include the following;

 Landscaping of health seeking behavior.

 Prepare training need assessment (TNA) and training plans according to the TNA.
 Develop joint mentoring plan with health and other line dept.
 Identify challenges in VHCs and develop comprehensive plan for strengthening VHC’s involvement in
planned activities.

As a part of providing evidence based technical support, a detailed baseline study is planned for strengthening
Village Health Councils (VHCs) in Meghalaya.
II. PURPOSE AND OBJECTIVES OF THE STUDY

Village Health Councils (VHCs) is a unique initiative which is initiated recently to comprehensively address the
demand side of the health care that holds the potential of changing the entire landscape of health care

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delivery in the state. The baseline study proposes to establish the challenges facing the health care sector such
as poor health seeking behavior and intend to address the same with the help of locally acceptable measures.
Since VHCs are also in infantile stage, the study will help in identifying the key challenges for policy makers to
develop strategy and plan to strengthen the VHCs. Lastly, a proper scientific study will also help in identifying
the focus which is required for assessing the sustainability, scalability and adoptability of the intervention.
The objective of this baseline assessment is to assess the socio-economic and demographic factors of
communities which influence the utilization of health care services, current health seeking behavior of the
communities, existing status of VHCs and identify challenges to form a comprehensive plan for strengthening.
The study ambits to capture the potential/feasibility for sustaining its current interventions/solutions in the
future. The planned assessment will help in designing programme intervention strategy and will help in
formulating success indicators to monitor the programme intervention to achieve Universal Health Coverage
(UHC) by ensuring access to comprehensive health care services without suffering financial hardship which is
acceptable by all in Meghalaya through government systems and channels as per its strategic plan. In order to
achieve the ambitious goal, the baseline study have the following objectives

Community Level

 To explore the socio-economic and demographic factors which influence the utilization of health care
services in the state.
 To understand the demand dimension, the study will assess health seeking behavior of the
communities which includes affordability and accessibility of health care services

Facility Level

 To comprehend the supply dimension, the study will examine the health care infrastructure (physical
& human resources) of the state vis-à-vis the availability and quality health care provision.

System Strengthening

 To assess the formation, composition and functioning of VHCs and identify challenges to form a
comprehensive plan for strengthening.

III. SCOPE OF THE STUDY

The baseline assessment will enable LEHS|WISH towards concretization of the Programme intervention, as
well as insights on bridging the basis of the gap in the evolving primary level community health care ecosystem
enabling the formulation of future VHC initiative strategies. The baseline assessment aims to understand the
attribution of the results around “4A” i.e., access, acceptability, affordability & accountability by assessing the
following:

 The socio-economic and demographic factors which influence the utilization of health care services in
the community
 The demand dimension, assess health seeking behavior of the communities
 Understand the existing locally contextualized awareness generation mechanism
 To comprehend the supply dimension
 The health care infrastructure (physical & human resources) of the state vis-à-vis the availability,
accessibility, affordability and quality health care provision.
 To assess the formation, composition and functioning of VHCs
 Identify challenges to form a comprehensive plan for VHC strengthening.

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IV. METHODOLOGY
The baseline assessment will adopt a sequential method applying desk research and quantitative research
followed by qualitative research as per the requirement of the assessment like IDI’s, KII’s, FGD etc, and other
related documents. The assessment team will examine the following
 Representatives of Government who are Involved
 Service providers & Beneficiaries
 Community-based household survey (according to Sample size)
 Desk Review: The assessment team needs to go through as much as possible large number of
important documents and data as, some documents related to the previous studies/literature, PIPs,
progress reports etc.
 Discussions/surveys with key service providers and beneficiaries and Field visits to all/sample project
sites
 Questionnaires: The team will use several questionnaires (as per the requirement and baseline
assessment conceptual framework) for survey responses concerning the future impact of the project.
Considering the below mentioned area of interest, there will be the flexibility of suggesting the target groups
and required sample size. The following section is area of interest, which can be altered as per the suggestion
of the research agency.
Sl# Area of interest / Domain Description
Utilization of health care services in
the state To explore the socio-economic and demographic factors
which influence the utilization of health care services in
the state.
1
To understand the demand dimension, the study will
assess health seeking behavior of the communities to
develop a locally contextualized awareness generation
mechanism.
health seeking behavior of the
communities To comprehend the supply dimension, the study will
examine the health care infrastructure (physical & human
2
resources) of the state vis-à-vis the availability,
accessibility, affordability and quality health care
provision.

The health care infrastructure To explore the information on formation, composition and
(physical & human resources) of the functioning of VHCs and identify challenges to form a
3
state vis-à-vis the availability, comprehensive plan for strengthening.
accessibility, affordability and quality
health care provision.

Health System Strengthening Explore the formation, composition and functioning of

4
VHCs and identify challenges to form a comprehensive
plan for strengthening.
A sequential mixed method (both qualitative and quantitative study) of design is required, which includes
quantitative assessment, analysis of data, and identify the questions for qualitative components. The major
focus of the study will be quantitative in nature and a qualitative study will be conducted to compensate for
critical factors that are non-quantifiable due to lack of information. The secondary data sources such as
reports published by the government and other agencies will also be incorporated into the assessment.
Facility assessment will be conducted on sample health facilities and secondary source of facility data can be

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linked for advance analysis to assess health facility level gaps across key areas such as human resources and
training status, infrastructure, availability of medical equipment, drugs, and supplies, service delivery etc. The
sample survey will be conducted among the specific target groups to understand the areas of interest
mentioned above. The target group of the survey is of

● At the household level: Following are the target groups at the household level.

o Household members above 18 years of age to understand the status of the utilization of
health care services, demand dimension, health seeking behavior of the communities,
awareness etc.

● At the Hospital: Facility assessment to assess the gaps in Infrastructure, HR and training, Drugs and
supplies, equipment, and data management systems
● Explore the capacity of health staff on maintaining core functions and serving the ongoing and health
care needs of their communities.
● At the Community-level: This will be assessed through a qualitative study among various stakeholders
including community members, providers, and community leaders to understand, assess and analyze
the KAP / behaviors of communities on health care seeking as well as the awareness on affirmative
action pertinent to health across HHs keeping vulnerabilities in mind. The effort is also to capture
opportunities, aspirations, and results of the health ecosystem, understanding enablers and disablers
thereby providing insights for informed decision-making for the formation, composition and
functioning of VHCs and identify challenges to form a comprehensive plan for strengthening.

SAMPLING METHODOLOGY:

● Health Facility Survey: The sampling unit of this survey i.e., health facility will be selected
proportionately based on the number of health facilities available in each district/block of the state
while considering distance of the facilities from district/block headquarters. To ensure a comparable
report, the sample of this survey will be drawn from the selected blocks of household survey
mentioned above.
● Household Survey: The proposed sampling unit i.e., household, will be selected on the basis of multi-
stage stratified random sampling method. The sampling frame of the study is the 5,48,059 households
(4,30,573 rural & 1,17,486 urban) of the state as per Census of India, 2011. In the first stage, the state
will be clustered into three zonal regions based on similar districts according to languages and
communities viz., Khasi Hills, Garo Hills and Jaintia Hills. In the second stage, the selection of primary

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 sampling units (PSUs) which is the corresponding blocks of the zonal cluster will be carried out with
probability proportional to size (PPS) for both rural and urban blocks. It is expected that the research
agency will come up with cost effective sample size number including sample size distribution.

No. of Households* No. of Blocks

Zonal Cluster
Total Rural Urban Rural Urban
Garo Hills** 2,06,207 1,82,370 (88) 23,837 (12) 17 4
Khasi Hills 2,75,824 1,87,117 (68) 88,707 (32) 17 6
Jaintia Hills 66,028 61,086 (93) 4,942 (7) 5 1
Meghalaya 5,48,059 4,30,573 (79) 1,17,486 (21) 39 11
Source: Census of India, 2011; * Figure in parentheses are percentages; **Garo Hills to be 40%
oversampled as this will be a pilot area

 QUALITATIVE INTERVIEW: The qualitative part will be implemented after the analysis of quantitative
data. The findings that emerged from the quantitative analysis will be used for designing qualitative research.
This part should be able to answer How? Why? Questions.
V. SUMMARY OF THE STUDY
a. EXPECTED OUTCOME/OUTPUT
● Provide a locally contextualized landscape on knowledge gaps, needs, problems and barriers with
respect to health seeking behavior down to the village level.
● Identify key challenges facing the health care system in terms availability, accessibility, affordability
and quality health care from both demand and supply perspectives.
● Identify key challenges in VHCs and provide a comprehensive strategy to strengthen and well define
key performance indicators (KPIs) for all VHCs.
b. KEY TARGET POPULATION

The baseline assessment is planning to cover the following target population to collect information (IRB
required)

● Health care providers (different levels as per requirement)

● Administration (Govt. officials)

● PRI members

● Community members

● Community Groups / CBOs

c. GEOGRAPHICAL AREAS OF THE STUDY:

The baseline assessment exercise is planned to conduct in whole state of Meghalaya. The state has 11 districts
(health district), 39 Blocks and around 7000 villages. The PSUs of the assessment will be in these 39 Blocks of
the State. So it is expected that the research agency will propose a cost effective sample size along with
sample distribution plan for both quantitative and qualitative assessment.
VI. FINDINGS AND RECOMMENDATIONS
The baseline findings will be core contributions from the research agency which will foster organizational
knowledge and improves performance. The purpose of this whole assessment exercise is to summarize the

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specifics of how they are formulated and subsequently made available for organizational learning, develop
Programme strategic planning using the various systems/diversity processes in support of results-based
management.

VII. SCOPE OF WORK

It is expected that the selected agency collaborates with LEHS | WISH, and brings technical expertise to
demonstrate high-quality and cost-effective methods of data collection. The specific scope of work is
summarized below but is not limited to:
 Designate a dedicated team to work closely with LEHS | WISH
 Designate dedicated experts for baseline assessment
 Develop study design and protocols
 Finalize the assessment/information collection tools including the questionnaire and schedules for all
relevant stakeholders (Health facility staff and beneficiaries etc.)
 Desk research of available project-related documents.
 Design integrated data collection (mobile / tablet-based) tool, analysis
 Design manuals
 Investigator’s manual, Supervisor’s manual, Data capture manual (mobile/tablet), etc.
 Data quality assurance manuals, highlighting data quality indicators and data quality monitoring and
review mechanism.
 In-house/Hire data collectors and train them on the manuals developed.
 Study to be approved by Institutional review board (IRB)
 Data Collection& Analysis
 Finalization of the report/timely Submission of final report to LEHS | WISH.
 Real-time sharing of clean data sets.

VIII.DELIVERABLES AND TIMELINES

A list of deliverables with the timeline is shared in this section. Please note that you need to consider the
discussion points which are elaborated in different sections of this RFP. The agency should be able to have a
dedicated team for this work. The research agency is expected to provide detailed timelines. The baseline
assessment will be completed in 3 months of the signing of contract and the final report to be submitted.
Please find Annexure-A for specifying activities and timelines. The research agency is expected to provide
detailed timelines.
IX. REQUIRED QUALIFICATION OF THE AGENCY
 Expertise in health research and surveys especially experienced in large-scale evaluation design, large-
scale facility surveys, etc.
 Strong in quantitative and qualitative research methods and health system research.
 Profound knowledge and experience of public health programs and government health care system of
the state.
 Understanding of public health issues and current policy scenarios as related to the implementation of
primary health care, patient quality care, etc.
 Experienced team members with proven experience in public health research, medical research,
evaluation surveys, etc.
 Demonstrated agility and flexibility in change management and motivation in larger collaborations.
 Research organization registered as Private Ltd company and has sound business records.
X. PROPOSAL SUBMISSION GUIDELINES (Not more than 16 pages)
 Introduction (one paragraph)

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  Objectives, technical approach, and methodology (Maximum two pages)
 Project deliverable timelines (Refer Annex: A)
 Project management approach including quality management of field data collection and headquarter
dedicated team (One page)
 Activity-wise timelines (One page)
 Project team staffing (CVs of key personals who will continue till the study completes not more than 3
pages)
 Company/Organization overview with details of similar projects done in the last 3-5 years (max 4-5
pages)
 Detailed and itemized price (In a separate excel file with formulas, one page).
 At least 3 copies of knowledge products developed by the organization and are in public domain
(shareable).
 Mandatory enclosure
 Please submit the following as enclosures or attachment with your quotation. Bidders must provide all
the information requested below. Quotations that do not provide the required information and
certificates, or do not follow the submission requirements may not be reviewed.
 Company Profile, testimonials, reference (NGOs).
 GST registration certificate.
 PAN registration.
 TAN registration.
 Audited Financials for last three years (3 pages).
 Income Tax Return for last three years.
 Cancelled cheque.
 Copy of registration documents/certificate and most recent renewal as a legal entity.
 Research organization registered as Private Ltd company and has sound business records.
XI. EVALUATION CRITERIA

Technical and financial proposal will be scored in the ratio of 80:20.

XII. PROPOSAL (TECHNICAL & FINANCIAL) RESPONSE INFORMATION

All payments will be aligned against deliverables. All inquiries and requests for information affecting this study
must be submitted no later than 11th December 2023 through the following e-mail id. Inquiries and response
to inquiries will be shared with all. LEHS|WISH will not compensate agencies for their preparation of a
response to this RFP. A pre-bid meeting may be conducted on 13th December 2023 depending on the
queries/interest received by LEHS|WISH

All responses to this study must be received no later than 18th December 2023. The proposal should be
submitted only through e-mail in PDF format addressed to CEO, LEHS|WISH Foundation in the below-given e-
mail id:

rfp@wishfoundationindia.org

Only shortlisted organizations will receive an acknowledgment and will be called for personal interactions-
presentation / negotiations. Organizations that do not hear from us within two weeks from the last date of
submission of the proposal may assume that their application has not been successful.

ANNEXURE A: DELIVERABLES AND TIMELINES

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 Sl. No. Activity details*
1 Desk research completed
2 All manuals (indicators, data quality, supervisors, etc.) are ready
3 IRB submission, presentation and approval
4 Mobile/tablet-based application ready with real-time data-sharing protocol/mechanism
5 The survey team hired and trained
6 Data collection complete
7 Clean data shared
8 Desk research findings shared (meeting)
9 Quantitative and qualitative findings shared (meetings)
Submit all final products (both hard copy and soft copies of facility survey data, codes, final
10 report and manuals)
*Based on broad activity, micro planning needs to be prepared

Please mention RFP – “Strengthening Village Health Councils (VHC)” Project in MeghalayaMRF-108 on
the subject line of email

***

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