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Selecting an expert to provide consulting services

Terms of Reference for the selection of an expert / group of experts / legal entities for the provision of consultancy and training services in the context of the rational prescription of medicines


Name of the project Equity in health through social responsibility

Project code                                           415932

Application deadline                          04 January 2020


  1. General information

In 2019, the Swiss Red Cross started the implementation of the project “Health equity through social responsibility”, funded by the Swiss Agency for Development and Cooperation, which aims to strengthen health equity, transparency and social responsibility.

The project is implemented in partnership with the Public Association “CASMED” and the Public Association “HOMECARE” and is part of the national program, which supports the implementation of Universal Coverage with Health Services in Moldova (MD AUSS).

The project “Equity in health through social responsibility” complements the interventions of MD AUSS on increasing responsibility for patients and the population by establishing and / or supporting existing mechanisms of social responsibility in five pilot districts – Balti, Floresti, Soroca, Drochia and Edinet. These mechanisms at Community, local and national level aim to empower civil society and citizens to claim the right to health by holding medical service providers and authorities accountable.

The project sets out three objectives for improving quality, access and equity in health.

Objective 1 it refers to the provision of fair and quality medical services at all levels. The project aims to strengthen civil society and establish social responsibility mechanisms to monitor and improve equitable access and quality of health services. The involvement of civil society, together with patient groups and professional medical associations, through various social accountability mechanisms is a strong approach to holding health authorities accountable, which in turn provides feedback on consumers’ perceptions of the medical services provided.

Objective 2 of the project provides for the strengthening of the capacities of the National Medical Insurance Company (CNAM) to expand the coverage with medical services and become sustainable. Once social accountability mechanisms are operational and have an effect on quality care, confidence in the health system will increase, which will lead to an increase in the number of people insured in the system.

Objective 3 it refers to the protection of the population against poverty due to additional and informal payments in public medical institutions and expenditure on medicines. Social responsibility mechanisms will include monitoring additional and informal payments (for example, through questionnaires, or electronic patient feedback on the E-health platform or

  • Goal

Scopul constă în îmbunătățirea practicilor de prescriere rațională a medicamentelor, prin fortificarea capacităților instituțiilor medicale publice de a monitoriza și preveni fenomenul polipragmaziei.

  • Specific tasks and activities

Task 1): Analysis of the current situation related to the regulatory framework in force, the mechanisms and instruments existing in public medical institutions established for monitoring the rational prescription of drugs, the prescription of generic and compensated drugs, reduction and prevention of polypragmatism

Key questions:

  • What is the regulatory framework in force in the Republic of Moldova that concerns the monitoring and control of the rational prescription of medicines in public medical institutions;
  • What are the actions / practices undertaken at managerial level in public medical institutions to monitor the rational prescription of drugs and avoid polypragmatism;
  • To whom do the attributions of monitoring the rational prescription of medicines and the avoidance of polypragmatism in public hospital medical institutions and primary health care refer;
  • What are the main causes of polypragmatism;
  • What are the needs for strengthening the capacities of public hospital medical institutions and primary health care to reduce the risk of developing the phenomenon of polypragmatism, and the development of tools to control and prevent irrational prescription of drugs;
  • What is the target group needed to be trained to strengthen capacities in the control and prevention of polypragmatism in hospital and primary care institutions.

Within this task the following specific activities will be performed:

A methodology will be developed to accomplish this task. The methodology will include both a quantitative and qualitative research and analysis component. The methodology will include, but will not be limited to the application of questionnaires, focus groups, interviews, round tables. The methodology will be consulted and approved before being applied. As a result, an analysis report will be prepared. The report will contain conclusions and recommendations used for tasks 2-4.

Task 2)  Development of a training course/curriculum for the target groups

Based on the analysis performed, a training course / curriculum will be developed for the representatives of the hospital medical institutions and representatives of the primary health care institutions. The topics of the course will emerge from the results of the analysis, but will not be limited to this.

The training course will be consulted / approved at all methodological-didactic levels according to the existing procedure for the accredited courses for continuous medical training. The course will be institutionalized within the continuous training of medical workers by the continuous training entities.

Task 3)Based on the curriculum, a course support will be developed that will contain the necessary recommendations for the development of institutional mechanisms, tools and procedures for the control and monitoring of the phenomenon of prescription of medicines, both at the level of primary health care and hospital care.

The course support can be edited in a volume of 500-1000 copies as the case may be and will be distributed to the managers of medical institutions and to the persons responsible for monitoring / controlling the rational prescription of medicines from primary health care and hospital care institutions.

Task 4) Development / consolidation of the normative basis for avoiding polypragmatism and monitoring the rational prescription of medicines in medical institutions.

Based on the research conducted in Task 1, the normative gaps that need to be solved by proposing draft normative acts / regulations that would strengthen the mechanism of control and monitoring of rational prescription will be identified. of drugs and would reduce the phenomenon & nbsp; polypragmatism in medical institutions.

The elaborated documents will be submitted for discussion and consultation with key actors in the field (central authorities, managers of hospital and primary care institutions, etc.) in round tables, workshops. Subsequently, the documents will be submitted for approval to the Central Authority (MSMPS).

Sarcina 5) Instițuționalizarea mecanismelor de control și prevenire a polipragamziei și instruirea a cel puțin 200 de persoane din grupurile-țintă (asistență medicală primară și instituții spitalicești).

În cadrul instruirilor, audienților li se vor oferi cunoștințele și abilitățile necesare pentru a iniția procesul de dezvoltare și instituționalizare a mecanismelor și instrumentelor de prevenire a polipragmaziei. Astfel, procesul de instituționalizare va avea loc în paralel cu instruirea realizată din cadrul proiectului.

În urma realizării sarcinilor 1-5 vor fi obținute următoarele rezultate:

  • Un raport cu analiza situației, concluzii și recomandări cu privire la mecanismele și instrumentele existente în instituțiile medicale publice pentru prevenirea fenomenului de polipragmazie și prescrierea rațională a medicamentelor;
  • Un curs definitivat, acreditat și instituționalizat la nivel de instruire medicală continuă;
  • Un suport de curs aprobat;
  • Vor fi înaintate spre aprobare un set de acte normative necesare pentru fortificarea mecanismului de prevenire a polipragamaziei în instituțiile medicale;
  • Vor fi instruite cel puțin 200 de persoane din instituțiile medicale publice.

Deliverables and deadline


Task 1                                                                                Deadline

Analysis methodolgy                                                                January 2021

Analysis draft document                         February 2021

Submission of the final analysis document March 2021

Task 2                                                                                Deadline

Training curriculum developed, discussed and approved    Aprilie2021                                              

Task 3                                                                                Deadline

Course support developed, discussed and approved          August 2021                                                   

Task 4                                                                                 Deadline

Development / consolidation of the normative base            December 2022

Task 5                                                                                 Deadline

The trainings performed                                                             December 2022

The experts / group of experts or the contracted legal entity will report once every 6 months on the implementation of the Action Plan.

  • Payment. Payments will be made in accordance with the Operational Plan, after the Contractor and Beneficiary have signed the documents for the completion of the works.

6. Contracting period January 2021- December 2022.

7. Required experience, skills and competencies


  • Master’s degree or equivalent in medical sciences, economics or other relevant fields.


  • At least 5 years of relevant professional experience in the field of public health;
  • Knowledge of the health system of the Republic of Moldova;
  • Demonstrated experience in preparing analytical reports, performing of research, evaluations, analyzes in the field of public health (at least 3 references / reports);
  • Experience demonstrated by the trainer in the field of health;
  • Experience in the elaboration of the training course / curriculum ;
  • Excellent analysis and reporting skills;
  • Advanced skills in using Microsoft Office programs.

Spoken languages: Fluent knowledge of Romanian (written and verbal), Russian and English is an advantage.

Basic values:

  • Respect for diversity;
  • Integrity;
  • Professionalism.

Basic skills:

  • Responsibility;
  • Effective communication;
  • Inclusive collaboration;
  • Gender awareness and sensitivity.
  • Application File

Interested persons should submit the following documents / information to prove their qualifications:

  • Letter of motivation (explanation of how the applicant meets the qualification requirements), including links / information to similar tasks previously performed;
  • CV of key people involved;
  • The technical proposal for each task specified in the Terms of Reference, which will include a description of the vision of the tasks and tools used & nbsp; (eg focus group, interview, evaluation, office research, etc.), & nbsp; work plan, including the proposed deadline for deliverables;
  • Financial proposal, including the proposed fee (total amount and daily fee in Moldovan lei).

10. The decision-making process

Applications will be evaluated according to the appendix attached to the Terms of Reference.

  1. File Submission Instructions

Proposals should be sent to the following email address: no later than on 04 January 2020 (17.00), indicating the following reference “Provision of consultancy and training services in the context of the rational prescription of medicinal products”.

The “HOMECARE” Military Association reserves the right to request additional documents in case of need.

Incomplete applications or applications submitted after the indicated deadline will not be considered for evaluation. Only shortlisted candidates will be contacted.

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Uncategorized 21 January 2021