ANNEX-F

TERMS OF REFERENCE FOR INSTITUTIONAL CONTRACT

Title of the assignment

Nationwide Typhoid Conjugate Vaccine (TCV) campaign launching and SBC content design to create demand on Typhoid Conjugate Vaccine (TCV) for 9 months -15 years boys and girls in Bangladesh.

Purposes

The Government of Bangladesh has planned to provide the typhoid vaccine to all boys and girls aged 9 months to 15 years old in schools and communities across the country. This is a national campaign for providing TCV to all eligible children. This vaccination campaign will start on May 2025.

The main purpose of this assignment is to support the upcoming TCV Campaign for demand generation among communities. 

A creative agency will be hired campaign launching, event management and design/develop the Social and Behaviour Change (SBC) content (including audience specific message and materials) for community engagement and social mobilization to ensure highest coverage of TCV uptake during the campaign nationwide.

Location

Dhaka

Estimated Duration

6 months

Reporting        to           the Technical Supervisor of this assignment

Social and Behaviors Change Specialist, SBC Section, UNICEF Bangladesh

1.Background:

Enteric fever remains a public health concern in communities lacking sanitation infrastructure to separate sewage from drinking water. To bridge the gap until large-scale civil-engineering projects are implemented in high-burden countries, typhoid conjugate vaccine presents a promising disease-prevention technology. A new typhoid conjugate vaccine was prequalified by the World Health Organization in 2017 and is beginning to be introduced in countries around the world. To help inform vaccine introduction, the Surveillance for Enteric Fever in Asia Project (SEAP) conducts prospective enteric fever surveillance in Bangladesh, Nepal, and Pakistan. This supplement presents findings from Phase II of the study (2016–2019) on burden of disease, clinical presentation, the growing spread of drug-resistant strains, and policy and economic ramifications. These findings are delivered to support policymakers in their deliberations on strategies to introduce typhoid conjugate vaccine as a preventive tool against enteric fever.

In March 2018, WHO recommended TCV as the preferred typhoid vaccine because of its improved performance and suitability for younger children. WHO recommends the introduction of TCV be prioritized in countries with the highest burden of typhoid disease or a high burden of drug-resistant typhoid. WHO encourages routine administration to be accompanied by catch-up vaccination campaigns for children up to 15 years of age, where feasible and supported by data. Gavi, the Vaccine Alliance has provided financial support for eligible countries to introduce TCVs since 2018. Several countries have already introduced TCV into their routine immunization programs including Liberia, Pakistan, Samoa, and Zimbabwe. More than 36 million children have been vaccinated with TCV globally.

Bangladesh has a high performing immunization program, with the established capacity to set and achieve targets and deliver immunization services through well-structured network of service providers, monitor programme implementation and create evidence basis for design and implementation of corrective measures through the well-established surveillance system.

Meanwhile, Bangladesh made remarkable progress in child vaccination in the past 20 years. In 1999, 83.9% of all children are fully vaccinated from only 52% in 2001 as per coverage evaluation survey result conducted by third party. Pentavalent 3 dose validated coverage among children aged 12 months reached 93.4% in 2019 from only 77% in 2005 and Measles 1st dose coverage reached 88.3% from only 64% in 2001. In Bangladesh, where the greatest burden of enteric fever was found in children younger than 5 years of age, 30% of patients with laboratory-confirmed enteric fever were hospitalized, and hospitalizations lasted a median of 7 days.

The immunization programme in Bangladesh under the strong government ownership has made tremendous progress in recent years through maintenance of high national coverage levels and reduced drop-out rates. Reported immunization coverage rates and WHO & UNICEF coverage estimates have remained over 90% for more than ten years and more than 80% of children under 12 months of age are fully immunized.

The Global Burden of Disease Study estimates more than 9 million cases of typhoid and more than 110,000 typhoid-related deaths worldwide in 2019, largely concentrated in South Asia and sub-Saharan Africa.6 The majority of cases occur in South/Southeast Asia and sub-Saharan Africa. Data since 2000 show a reduced global burden of typhoid fever compared with the 1990s, though little consistency in trends has been observed in specific regions and countries, and typhoid fever incidence rates appear to have remained relatively stable in recent years.7 Enteric fever is a systemic infection caused by the human‐adapted pathogens Salmonella enterica serotype Typhi (S. Typhi) and Salmonella enterica serotypes Paratyphi A, B, and C. Typhoid and paratyphoid fever transmission occurs through ingestion of water or food contaminated with typhoidal Salmonella bacteria, with asymptomatic carriers playing an important role in contamination and onward transmission. Risk factors for typhoid fever include poverty; overcrowding; poor water, sanitation, and hygiene (WASH) infrastructure; and poor food handling practices. Recent estimates suggest 10.7% of the global population lives in extreme poverty (i.e., on less than US$1.90/day)8,with deficient WASH infrastructure, and approximately 1 billion people still practice open defecation.9 Ongoing surveillance studies estimate that 27% of typhoid fever cases requiring medical attention occur in children aged 0–4 years, of which a substantial proportion (∼30%) occur at ages below 2 years.10 Data from a recent meta-analysis also supports these findings, with estimates of the proportion of typhoid fever cases in those aged <5 years ranging from 14% to 29%, compared with 30% to 44% in those aged 5–9 years, and 28% to 52% in children 10–14 years of age. 11

This Terms of Reference (TOR) aims to support TCV campaign 2025 launching nationwide including develop and design of SBC materials to promote TCV vaccination and increase coverage. The successes and good practices gathered from the first phase will inform the development of messages and materials for different target audiences.

2.Objectives, Purpose and Expected Results

Provide technical and event management support to the Directorate General of Health Services (DGHS) and the Ministry of Health and Family Welfare (MoHFW) to launch Typhoid Conjugate Vaccine (TCV) campaign at national and divisional level.

Design and develop Social Behavior Change (SBC) content (messages and materials) for different target audiences based on the field findings as well as secondary data review including social listening.

1. Purpose:

This assignment is to support the upcoming TCV campaign by creating demand among target populations (girls and boys), teachers, parents, and other key stakeholders, including the general population nationwide through the development of SBC materials and assistance to MoHFW in conducting the launch event.

It is expected that the SBC messages and materials will help to address misconceptions about TCV at the community level, increase the knowledge of key target audiences (fathers, mothers, teachers, and adolescent girls), and create demand to optimize vaccination coverage during the campaign.

4.Deliverables:

1. Report of the quick perception survey to understand people’s views on TCV in urban and rural area of the country.
2.  Message and materials development workshop ( 2 days) with different stakeholders. At least 50 participants from GoB, UNICEF, WHO, creative agencies, religious leaders and media personalities.
3. All the SBC materials must be field-tested and submitted to the IEC Technical committee for review and approval.
4. Organize and Manage a National Launching Event for National TCV Campaign in Dhaka preferably in BCIC/Hotel Sonargaon/any other suitable venue. At least 300 participants of which 90 participants will attend from district and divisional level.
5. Support in decorating divisional level launching event.
6. Develop call for action videos for with best practitioners, health and information ministers, DG, DGHS and Health Secretary and other celebrities. Total 7 AV bites for 30 second each. These AVs will be use in national, private television channels and social media.
7. Develop two 60 seconds PSA on TCV campaign including field test. This will include script development, shooting, editing, music, artists payment.
8. Desing and develop vaccine card, planners, infographic.
9. Design, editing of five factsheets for different target audiences i.e. religious leaders, teachers, LGIs, 
10. Design poster and banner for Chittagong hill tracts and plain lands.
11. Design three manuals/guidelines i.e. health workers guideline, training module, volunteers guideline and reporting formats.
12. Design one brochure for para workers on “How to engage Communities for HPV vaccination.
13. Design 5 social media posts for before and during campaign

Tasks

Deliverables

Timeframe

(15 days)

Submission of inception report

1 week after signing the contract

Conduction of a quick perception survey of the community n urban and rural area on TCV

1-2 week

Conduction of Messages and materials development workshop (2 days)

3rd week and 4th  week

Design poster and banner for Chittagong hill tracts

Final design of posters (2) and banners (2) for hill tracts

4th week

Design one brochure for para workers on “How to engage Communities for TCV vaccination.

Final version of scripts, quick field test with report and final version brochure.

5th week

Organize IEC Technical Committee meeting to get approval for all message and printing material content.

Meetings held at the ministry of Health & Welfare to approve all the materials and messages developed.

Incorporate feedback and re submission for final approval

5th week

Develop two 60 second PSA on HPV vaccination campaign including field test

Final version of scripts, quick field test with report and draft version of PSA.

6th week

Organize IEC Technical Committee meeting to get approval for all audio-visual materials

Deliver PSA with a pen drive for 40 television channels

7th week

Develop call for action videos for with best practitioners, health and information ministers, DG, DGHS and Health Secretary. Total 7 AV bites for 20 second each. These Avs will be use in national, private television channels and social media.

1. Video bites/call for action by honorable health minister -Duration 20-30 seconds
2. Video bites/call for action by honorable information minister-Duration 20-30 seconds
3. Video bites/call for action by DG and Secretary, DGHS-20 seconds
4. Video bites/call for action by DG and Secretary, DGHS-20 seconds
5. Video bites/call for action by adolescent girl who received HPV vaccine in the first round – Duration 30 second
6. Video bites/call for action by religious leaders (male and female) – Duration 30 second
7. Video bites/call for action by parents (father and mother) – Duration 30 second

7-8 week

Design 5 social media posts for before and during campaign

Final design of social media post

9th week

Organize two talk show

Two talk show in private TV channels, will cover renowned doctors and celebrities.

10th week

Support in decorating divisional level launching event

Venue decoration with backdrop, festoons, sound system, banner and photography.

12th week

Organize launching event of HPV vaccination campaign in a standard venue in Dhaka.

Venue decoration, invitation card, backdrop, sound system, banners, festoons video & still, master of ceremony, invitation card distribution, photography including speech writing for the chief guest and special guests

13th week

Organize launching event of HPV vaccination campaign in a standard venue in 8 divisional city

Venue decoration, invitation card, backdrop, sound system, banners, festoons video & still, master of ceremony, invitation card distribution, photography including speech writing for the chief guest and special guests

13th week

Provide additional support during campaign when necessary

Revision of messages and materials need based (to address rumors, mis information)

14th week

Submission of final report

Final report with all the final design with a soft copy

7 days after completion the task

     5. Reporting requirements

1. Inception Report within 7 days of signing the contract.
2. Pretest report of messages and materials after approval of the designs.
3. Final Report within 1 week upon completion the task.
4. Soft versions of all the materials.

6.Payment Schedule

7.Qualification requirement of the company/institution/organization