A Cost Effectiveness Study

Terms of References for Conducting a Cost Effectiveness Study

1. Background and rationale

CBM is a German international NGO committed to improving the quality of life of people with disabilities in the poorest countries of the world. In Guatemala, CBM has been working for more than 20 years with local implementing partners in the areas of health, inclusive education and community-based inclusive development. CBM intends to implement a project “Improved access to hearing health services, inclusive education and equal employment opportunities for persons with disabilities in Guatemala” implemented through the local partner organisations “Fundación Sonrisas que Escuchan” (SqE) and Fundal. The project aims to promote the development of inclusive communities in Sololá, Quetzaltenango, Zacapa, and Escuintla by improving access to hearing health services, inclusive education, and equal employment for people with disabilities.

As an essential component of the project, SqE plans to establish 4 audiology clinics in the rural departments of Sololá, Quetzaltenango, Zacapa, and Escuintla to provide quality hearing health care to mainly poor population groups with and without disabilities including hearing screenings of newborn babies, schoolchildren and elderly people. Furthermore, teachers and medical staff shall receive further training to early detect hearing impairments. Further details on the project will be provided in the project proposal documents.

It needs to be assessed whether SqE has sufficient administrative capacity to establish and manage the 4 audiology clinics independently and without the support of the private clinic CEDAF with which SqE has been closely interlinked in terms of personnel and finances. It furthermore needs to be evaluated whether the 4 audiology clinics will be able to break even and be sustainable when funding through the above-mentioned project ends. For this purpose, a cost-effectiveness study including an economic efficiency/ viability calculation based on reliable, realistic, and tangible data needs to be conducted.

This assessment needs to consider the realistically planned income for each of the 4 audiology clinics compared to the operational and staff costs of each of the clinics. It also needs to be considered that the audiology clinics will offer their services mainly to the most vulnerable population in these departments, including indigenous population, who cannot pay for the service or will only be able to make a small financial contribution. Furthermore, it needs to be assessed if there is an actual need among the direct target groups in the 4 rural departments for the services planned to be offered.

1. Purpose and overall objective

To carry out a cost-effectiveness study so as to provide evidence to CBM if the planned 4 audiological clinics in Sololá, Quetzaltenango, Zacapa, and Escuintla are based on an actual demand for audiological services by the target group in these regions and if they will be able work independently and sustainably after the project ends (end of 2025). This includes an assessment as to whether SqE has the administrative capacity to establish and manage the 4 audiology clinics in Sololá, Quetzaltenango, Zacapa, and Escuintla independently of the private clinic CEDAF and whether the 4 audiology clinics will be able to cover their costs and work in a profitable manner after the project funding ends, guaranteeing the sustainability of the clinics in the future.

1. Expected results

The Consultant is expected:

• To conduct a Cost-effectiveness study including an economic efficiency calculation of the 4 audiology clinics to be established in Sololá, Quetzaltenango, Zacapa, and Escuintla based on reliable, realistic, and tangible data to show if the clinics will be able to cover their costs and work profitably after the projects ends, putting into relation the planned revenue with the expected expenses (operating and personnel), for each of the clinics separately, also considering that the mostly poor target group will only be able to pay a small amount for the services received.
• To assess SqE’s administrative capacity to establish and manage the 4 audiology clinics in Sololá, Quetzaltenango, Zacapa, and Escuintla independently and without financial or staff support of the private clinic CEDAF.
• To carry out an assessment of the actual needs among the mainly poor direct target groups in the departments of Sololá, Quetzaltenango, Zacapa, and Escuintla in relation to the services to be offered in each of the audiology clinic to be established and provide respective figures to prove the need and demand for each of the clinics.

1. Deliverables, timeframe and duration

Deliverables:

• To provide a cost-effectiveness study report meeting ALL the above-mentioned expected results.
• To provide clear evidence-based results and recommendations in the framework of the study related to the above-mentioned expected results, particularly to the question of cost-efficiency/ profitability.
• To carry out the assessment in the below mentioned timeframe without delay.

Timeframe and duration:

• Max. 10 working days between 21st November and 7th December 2022.
• Meeting for briefing of consultant after contract signature.
• Submission of a draft report including the economic efficiency/viability calculation by 30th November 2022.
• Submission of the final report including the economic efficiency/viability calculation by 7th December 2022.

During the assignment of the assessment, the consultant is expected to closely coordinate with CBM International – Central America desk and CBM Asia & Americas’ Senior Institutional Funding Specialist.

1. Requirements

• Financial expertise and experience in economic efficiency calculations.
• Professionality and experience in conducting high-quality evaluations, viability studies, administrative assessments etc. for international NGO’s and providing respective reports.
• Fluency in Spanish, preferably native speaker.
• Excellent writing skills in English.
• Very good knowledge of the Guatemalan geography and context.

1. Place /location of Activity

Guatemala City as well as Departments of Sololá, Quetzaltenango, Zacapa, and Escuintla (at least Quetzaltenango and Sololá).

How to apply

1. Expressions of interest

Expressions of interest need to be submitted by 17th November 2022 (24hrs CST) to [email protected] including:

• Profile and CV of consultant
• Technical and financial offer

and should reflect in the subject line: “Cost efficiency study Guatemala”.