INVITATION TO TENDER: Development of a ‘Global Breast Cancer Training Package’ for primary care health workers

The Tropical Health and Education Trust (THET), with support from Sanofi, is seeking a Technical Partner to lead on the development of a Global Breast Cancer Training Package for primary health care workers, as well as support the training for our Master Trainers in Uganda and Zambia.  

About the Tropical Health and Education Trust (THET)  

THET works to create a world where everyone, everywhere, has access to quality healthcare. We achieve this by working through partnership to support the strengthening of the health workforce and the system within which it operates in several Lower- and Middle-Income Countries (LMICs). We use a model we call ‘Health Partnerships’, supporting long-term mutually beneficial partnerships between UK and LMIC health institutions (hospitals, NHS trusts, academic institutions, professional associations etc), to co-develop responses to locally identified priorities.  

Find out more at www.thet.org    

Need 

Globally breast cancer is the most common cancer among women. In the west, an estimated one in every eight women will develop breast cancer in their lifetime, recently overtaking lung cancer as the top-ranking malignancy in the general population. Although cervical cancer is the current leading cause of cancer related morbidity and mortality among women in sub-Saharan Africa, breast cancer is second, with an incidence rate of 33.8 per 100,000 women per year in the region1. Though incidence of breast cancer in sub-Saharan Africa is not as prevalent as in HICs, mortality is much higher with survival rates five years after diagnosis at a dismal 40% in sub-Saharan Africa, compared to over 90% in most HICs2. This high mortality can be attributed to breast cancer related disparities such as low breast health awareness, limited access to early diagnostic procedures and access to appropriate treatment sodalities. Many women are diagnosed with breast cancer at a late stage, where treatment is difficult and costly. This is especially exacerbated when access to quality breast cancer care is scarce. The late detection of breast cancer is in part attributable to limited knowledge on the benefits of early detection, scarcity of cancer screening and diagnostic facilities within the reach of communities, and poor breast cancer management among primary healthcare workers who lack the skills and knowledge to provide this care. 

Project Overview 

With the support of Sanofi, THET aims to address barriers to quality, timely and effective breast cancer care through a model of decentralisation that can be initially implemented in Zambia and Uganda, and then rolled out to other LMICs. Our decentralisation model involves addressing a series of breast cancer care components such as screening, diagnosis and referral, where appropriate, from highly specialised health professionals, such as surgeons and doctors in tertiary health facilities, to less specialised health professionals at the primary and community level3. By training health professionals at the primary level in breast cancer care, patients will be more likely to receive timely diagnosis and treatment, and oncology specialists in cities will have more time to dedicate to complex cases. Additionally, increased community awareness of breast cancer and the importance of screening and self-examination will minimise the number of cases that are presented late. This model will contribute to the reduction of morbidity and mortality for women with breast cancer, improving the survival rate after five years.  

This project will be implemented in two phases. The first phase will involve the development of a standard global training package for breast cancer care designed for primary and community health workers, with input from key institutions in Zambia, Uganda and globally. The second phase will roll this training out across the two countries through a variety of implementation methods, adapting the content to local contexts and to various cadres.  

Project Objectives 

• To develop a global breast cancer training package for Primary and Community Health Workers.  
• To support the MoH to decentralise breast cancer care by increasing HWs knowledge and skill in breast cancer awareness raising, diagnosis, and management, at the primary and community level.  
• To support the MoH in improving the quality of services at primary and community health level through supportive supervision and mentorship. 

 Scope of Work 

For the successful implementation of Phase I, THET seeks a technical partner over a period of 18 months. The technical partner is expected to have a health education background and a proven track record in developing educational resources for healthcare professionals. 

Key deliverables expected for a technical partner include: 

1. Development of a Global Cancer Training Package for Primary and Community Health Workers. The package shall include a full curriculum, training guidance and manuals, skill assessments etc.  
2. Conduct desk research, stakeholder mapping and facilitate collaborative discussions with experts in the region to ensure the training materials are of high quality, relevance and aligned with international/national standards. The Global Breast Cancer Training Package should be adaptable to different LMIC contexts.  
3. Support the Uganda Cancer Disease Institute and the Zambia Cancer Hospital to adapt and contextualize the breast cancer training package.  
4. In collaboration with THET in-house experts, adapt the training content for a user-friendly online tool.  
5. Develop robust mentorship and monitoring tools for the Master Trainers and Ministries of Health. This should include guidance on mentorship, how to conduct effective monitoring visits and relevant tools such as facility/area action plans.   
6. Facilitate the first Master Training and continue to support the master trainers as they cascade the training until contract closure.  
7. Collaborate with THET and Sanofi to establish a monitoring and evaluation framework to assess the effectiveness of training impact.  
8. Quarterly narrative and budget reporting to THET.  

THET will under this assignment support with: 

1. Overall management of the programme; including donor liaison.  
2. Coordination with the MoH and technical partners. 
3. Coordination of the training of master Trainers, ToTs and HCW.  
4. Providing support to the MoH and in-country key institutions to conduct monitoring and mentorship activities. 

Eligibility Criteria 

To be eligible for consideration as a Technical Partner, applicants should meet the following criteria: 

1. Registered as an academic institution, specialist hospital, or a recognised healthcare training institution. 
2. A strong background in healthcare, particularly in the field of breast cancer or non-communicable diseases (NCDs). 
3. Proven experience in developing healthcare training materials and curricula at primary and community health level. 
4. Demonstrated capacity to deliver training and mentorship programs and technical assistance. 
5. A commitment to the THET Principles of Partnership.  Principles of Partnership – THET 

Application Process 

Interested parties are invited to submit their applications, including the following:  

1. A detailed proposal outlining their approach, methodology, and timeline/ workplan for the project. 
2. A comprehensive curriculum vitae of key personnel involved in the project. 
3. A portfolio showcasing prior experience in developing healthcare training materials and delivering training and mentorship programmes. 
4. A budget proposal outlining the scope of each key activity. The budget available is £90,000, inclusive of travel, insurance and management fees. 

Evaluation Criteria 

Applications will be evaluated based on the following criteria: 

1. Demonstrated experience in healthcare education and training. 
2. Relevance of the proposed approach and methodology. 
3. Cost-effectiveness of the budget proposal. 
4. Capacity to deliver within the proposed timeline. 
5. Duration of Contract. 

The contract is expected to last for 18 months as per the elaboration below. It is expected that all training materials developed should be submitted and approved alongside an initial training phase of the master trainers. 

Submission Deadline  

Applications should be submitted to hrops@thet.org by midnight on 15th March 2024 with ‘Consultancy – Global Breast Cancer Training Package’ in the subject line. Applicants must be available for interview and assessment over the following two weeks. THET is an equal opportunity employer.  

The selected supplier would need to understand and adhere to THET’s Safeguarding policy which applies to the whole of THET including consultants, contractors and representatives of partners engaged in THET’s work.  The Safeguarding policy lays out the commitments made by THET, and informs staff and associated personnel of their responsibilities in relation to safeguarding. 

We look forward to receiving your application!