The first step of the planning process is to work with the donor to draft a scope of work. Drafting the scope of work begins with a series of conversations with the donor—and in some cases other local stakeholders—to shape the direction of the assessment, covering priorities, parameters, key stakeholders, potential challenges, and intended use of the findings. In some cases the donor may take on the task of drafting the scope, although more often, the organization tasked with conducting the assessment creates the first draft. This gives the donor something to react to, and a process of refinement follows.
1.1 Initiate Discussions with the Donor
Most assessments are conducted to generate information that can be used to make better decisions about how to allocate funds, design programs, or improve policies—with the ultimate goal of improving health outcomes. It’s important to understand the impetus for the assessment, from the donor perspective.
1.2 Identify Priorities and Issues
Determine why the donor wants to conduct an assessment, what the donor expects to achieve, and how the donor envisions using the findings. Use this opportunity to surface issues that could affect the process. Questions might include:
- Purpose—How will you use the findings? How do you envision other stakeholders will use the findings?
- Geographic focus—Should this assessment cover the whole country, or focus on specific geographic areas?
- Health domains—Are you interested in a broad assessment, covering a range of health domains, or do you have a priority in mind, such as HIV and AIDS or family planning?
- Technical areas—Are there technical areas that you are particularly interested in or concerned about? (Examples: health financing, service delivery, demand for specific products.)
- Potential issues—Is there anything we should be aware of as we begin the assessment? Contentious issues or reforms? Anything else that might affect the assessment process?
- Framing the assessment—Do you have any preferences with regard to structure for the assessment? SHOPS typically focuses on five interrelated elements: policy environment, health financing, service delivery, supply chain, and demand.
TIP ► Do your homework! It is important to investigate early on in the process whether any related assessments have been done and if so, make sure any relevant findings or issues inform the scope of work. And regarding potential issues that might affect the assessment, find out whether in-country approval (such as by an Internal Review Board) will be necessary.
1.3 Establish Basic Parameters
Conducting a private sector assessment is a significant undertaking in terms of time and budget. Ask about expectations in terms of the timeline—sometimes the donor is facing a hard deadline, for example, to submit a funding request or to inform a national strategic health plan. It is also important to confirm the level of funding available for the assessment, regardless of source. On average, an assessment takes about six months from start to finish, but previous assessments have ranged from three to nine months. Not surprisingly, assessments with broader goals and scope require more time and budget. While the basic approach has remained the same, implementation and outputs of private health sector assessments fall along a continuum—from assessments with a narrow scope (supported by a modest budget) meant to address a specific challenge, to a comprehensive effort (funded accordingly) intended to inform planned health reforms. Examples of the former include assessments focused on contraceptive security (Central Asian Republics, Jordan), as well as examining the role of the private sector in addressing the needs of populations most at risk for HIV and AIDS (Guatemala). Examples of the latter include the Kenya and Tanzania assessments, which covered multiple health areas, involved significant stakeholder engagement, and were jointly funded by USAID and the World Bank. Other completed assessments fall somewhere in between.
1.4 Identify Collaborators and Key Stakeholders
Understanding expectations around collaboration and country ownership is key. Collaborating, reaching consensus, and transferring skills takes time. Ask questions about process to determine how the donor expects you to conduct the assessment. Examples include:
- Who will take the lead on which tasks?
- To what extent is the Ministry of Health aware and supportive of the assessment?
- What other key stakeholders should be involved in the assessment process? Why do you want to include them—and in what capacity? How do you envision their level of participation?
These types of questions will help you design the assessment and identify any tasks or activities that may increase the time and resources required. Distill what you learn from these initial discussions to formulate the goal and objectives of the assessment.
1.5 Start Writing the Scope of Work
Next you’ll use what you learned to develop the scope of work. The main sections of a typical scope of work are outlined below. Expect some back-and-forth with the donor (and possibly other key stakeholders) before the scope is finalized.
Briefly describe the social, economic, and political context. Provide a broad overview of the health system including any recent reforms, and current health priorities to be addressed by the assessment. You may need to do a cursory desk review to complete this section. (Approx. 1,000 words.)
This is a succinct, high-level statement that describes what the assessment aims to achieve. (Approx. 30 words.)
What the assessment will accomplish; priority geographic, health, and/or technical areas should be reflected here. Format as a bulleted list (maximum 30 words per bulleted item).
- Assessment objectives usually begin with an action—provide, understand, assess, describe, identify, examine, review, suggest, recommend.
- Objectives generally focus on a specific group (stakeholders, providers, underserved populations), health issue (HIV and AIDS, maternal and child health, family planning), or technical area (health financing, supply chain, contraceptive security, etc.)
- Objectives may be framed in terms of the key elements recognized by SHOPS (e.g., policy environment, health financing) or other relevant structure.
This is an overview of how priority areas will be assessed, followed by a brief description of the assessment process. Include how the findings will be framed and used. This should follow the standard Assessment to Action approach. (600 words)
Duration, timing, and schedule
This section includes the period of performance, and the process for determining the schedule for each phase; and highlights key milestones and deliverables. You may include a proposed timeline for clarity.
List the deliverables that the assessment team will produce. At a minimum, deliverables typically include:
- Final scope of work
- Trip report
- Written report
- Workshop report (if applicable)
Provide a simplified budget for the donor to consider. The budget should include:
- Labor costs of team members and any consultants
- Other direct costs such as airfare, per diems (hotel and meals), visas, and local transportation
- Any costs for subcontracts (e.g., local research firms to help carry out data collection, or for local transport)
- Indirect rates, such as fringe benefits, overhead, and general and administrative costs (if necessary)
It is important to think of all possible costs when drafting the budget because the donor often uses your budget to commit funds—and making changes once the scope of work has already been approved can be difficult.
If known, specify the individuals who will be responsible for carrying out the assessment. In the event that not all members have been identified, include descriptions of the envisioned functions, roles, and responsibilities to complete the team.