KEY POPULATION RESEARCH AND ADVOCACY

TERMS OF REFERENCE
Community Assessment of the Quality of Service Delivery of HIV Testing and Sexual Reproductive Health among Sex Workers in five countries- Bangladesh, Cambodia, Indonesia, Myanmar, and Vietnam

ORGANIZATIONAL BRIEF
Asia Pacific Network of Service Workers (APNSW), a regional network of sex workers established in 1997, is a common platform for member organizations in Asia and the Pacific. It has registered as a Foundation in Thailand with a regional Secretariat based in Bangkok. The Secretariat is chiefly responsible for planning, implementing, coordinating, networking and communicating with the member organizations. It represents over 34 members from 23 countries across the Asia-Pacific Region. The purpose of APNSW is to protect and advocate for the Human Rights of Sex Workers by upholding their voices, empowerment and meaningful participation at the national, regional and international platforms. APNSW is playing a pivotal role to ensure human rights and improve the quality of lives of sex workers by means of evidence-based advocacy, networking, capacity building, research and policy development and reforms. APNSW is a Sub-Recipient of a regional Global Fund Grant - Key Population Research and Advocacy (KPRA) which is implemented and managed by Save the Children as Principal Recipient. Through this grant, APNSW will conduct a Community Assessment of the Quality of Service Delivery of HIV Testing and Sexual Reproductive Health Services in five countries – Bangladesh, Cambodia, Indonesia, Myanmar, and Vietnam.

BACKGROUND
In Asia the HIV epidemic is concentrated among key populations-men who have sex with men (MSM), people who inject drugs (PWID), female sex workers and their clients, and transgender women. Programs addressing prevention and HIV testing and treatment needs of key populations are variably implemented across countries.

Sex workers are disproportionately affected by HIV Globally; female sex workers are 13.5 times more likely to acquire HIV than other women of reproductive age1. In Asia and the Pacific, the likelihood is even higher; women in sex work are 29 times more likely to be living with HIV than other women of reproductive age2. Sex workers are at particular risk of HIV transmission due to social and legal factors, and they are often stigmatized, marginalized and criminalized by societies. In the region, there is a lack of legislation and policies protecting sex workers who may be at risk of violence from both state and non-state actors such as law enforcement, partners, family members and their clients (UNAIDS Global HIV and AIDS Report).
Accessibility, availability and acceptability of comprehensive and quality HIV services among sex workers are low. Less than half of the female sex workers in the region know their HIV status. It has ranged from 6% in Pakistan to 72% in India, and between these extremes are observed 38% of sex workers in Indonesia, 41% in Vietnam and 46% in Myanmar who knew their HIV status. Consistent condom use by sex workers is low in many countries (UNAIDS 2016- Asia and the Pacific, Female Sex Workers). Evidence-based interventions by the community are proven to be most effective when they address the legal and social barriers that affect sex workers.
1 UNAIDS (2013). UNAIDS HIV and AIDS in Asia and Pacific
2 Baral and others (2012) “Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis”, The Lancet Journal of Infectious Diseases.

In 2016 there was a paradigm shift in the approach to HIV from controlling the epidemic to ending AIDS reflected in the UNAIDS Fast-Track Strategy 2016-2021.3 A bold call to action, it has ten Fast-Track targets of which target one is to the reach 90-90-90—90% of people living with HIV know their status, 90% who know their status are receiving treatment, and 90% on treatment are virally suppressed; and target six is that 90% of key populations have access to combination prevention services. Community led and driven responses are
essential for scaling up prevention and treatment services for meeting these targets by 2020.

The WHO in 2016 updated its Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations.4 New recommendations are provided for ARV treatment, service delivery, Pre Exposure Prophylaxis (PrEP) as an important prevention strategy, addressing critical enablers, and using community as an integral part of the response to increase access and reach members of key populations that are not only at high risk but also those at medium and low risk who often serve as a bridge to the general population.

The role of community in prevention and testing is central for countries in Asia to meet the Fast-Track targets and end AIDS in the region. But in most countries there are very limited initiatives on community-based testing and community monitoring on the quality of service delivery to encourage testing and improve treatment access, retention and viral load suppression. The KPRA gathers evidence for community led prevention and testing services amongst key populations.

The project is envisioned to strengthen community capacity to improve access to quality HIV prevention, testing, treatment, care and support services among key populations. One focus of this work includes female sex workers, building evidence and engaging in strategic advocacy for the purposes of improving quality of HIV prevention and care services for sex workers in Bangladesh, Cambodia, Indonesia, Myanmar and Vietnam. For this, a national level assessment is to be conducted of policies, laws, legislation and other barriers, as well as community based testing, that affect access to HIV services, including HIV prevention and testing, treatment and other services associated specially for sex workers. This work also is to include an assessment of quality of services including community led and driven responses of sex workers.

PURPOSE
The overall purpose of this study under the project is to build evidence for advocacy on improved quality of HIV prevention, care and support services for sex workers in Bangladesh, Cambodia, Indonesia, Myanmar and Vietnam. This work is to be achieved through assessment of national level policies and programming; quality of HIV testing and counseling; STI examination, diagnosis and treatment; sexual and reproductive health services at community and health facilities; and building capacity of the national teams.

We are looking for a research consultant who will develop a data entry, perform data analysis, and provide an overall guidance on data analysis (key indicators and dummy tables) to national consultants for the 5 country community assessment. The consultant will work closely with a regional research consultant who will support the writing of the national reports and regional report for this 5 country community assessment. The research consultant will also work closely with five national consultants, one from each country.

3 UNAIDS (2015). UNAIDS 2016-2021 Strategy on the Fast-Track to end AIDS. UNAIDS. Geneva.
4 World Health Organization (2016). Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations: 2106 Update.
WHO. Geneva.

TASKS, TIMELINE AND DELIVERABLES
16 consultancy days During the period of 27 April 2019 – 30 June 2019 (or equal to a package of USD 4000)

1) Develop a data entry which include value checks and skip patterns, and a user-friendly instruction on how to enter, manage and perform data quality control for data for of the KPRA research in Bangladesh, Cambodia, Indonesia, Myanmar, and Vietnam
- estimate 2 days
2) Oversee and provide necessary technical support in data cleaning, data entry and analysis of the community assessment in in Bangladesh, Cambodia, Indonesia,
Myanmar, and Vietnam
- estimate 2 days
3) Develop an analysis plan and dummy tables in coordination with APNSW Regional Research Consultant and APNSW team
- estimate 2 days
4) Based on the guidance from the APNSW Regional Research Consultant and APNSW
team, combine all five country data sets into a regional data set, and produce
findings’ tables and graphs for each of five countries, and five countries as a whole
- estimate 10 days

EXPECTED DELIVERABLES
1. A data entry which include value checks and skip patterns and a user-friendly instruction on how to enter, manage and perform data quality control for data for of the KPRA research in Bangladesh, Cambodia, Indonesia, Myanmar, and Vietnam;
2. A brief report of technical supports for 5 countries,
3. An analysis plan and dummy tables of key findings,
4. A regional data set which contains data from all 5 countries,
5. A set of key findings’ tables and graphs for each of five countries, and the region.

SKILLS AND QUALIFICATION REQUIRED
• A Bachelor’s (Master’ preferred) degree in public health, statistics, epidemiology or related field, is required.
• At least 2 years of Experience in developing data base and performing survey data analysis.
• Experience working with key populations and key population related research is highly desired
• Knowledge of HIV and the epidemiological situation of key populations including sex workers in Asia and the Pacific region is desired.

To Apply
Interested candidates should send a cover letter and résumé via email to snantaza@apnsw.info

Please indicate “Application: Research Consultant” in the subject of email.
The call will be open until 25 Apr 2019. Only selected candidates will be contacted.

Job Email id: snantaza(at)apnsw.info