Consultancy for Workload Indicators for Staffing Need (WISN)
Terms Of Reference (TORs)
Workload Indicators For Staffing Need (Wisn)
1. Company Information
Palladium is a global leader in the design, development, and delivery of Positive Impact - the intentional creation of enduring social and economic value. We work with foundations, investors, governments, corporations, communities, and civil society to formulate strategies and implement solutions that generate lasting social, environmental, and financial benefits. For the past 50 years, we have been making Positive Impact possible. With a team of more than 2,500 employees operating in 90-plus countries and a global network of more than 35,000 technical experts, Palladium has improved - and is committed to continuing to improve - economies, societies, and most importantly, people's lives.


Palladium is implementing the Rwanda Integrated Health Systems Activity (RIHSA), a three-year USAID-funded task order (72069620F00001) designed to support the Ministry of Health in strengthening Rwanda’s health system to provide quality health care for Rwandans while building the capacity of the Government of Rwanda (GOR) to move away from a donor-financed health system towards a self-reliant system. The project is aimed at achieving two major objectives.
I. Reduce financial barriers to health care through a mix of public and private interventions and provide tools for improved domestic resource mobilization and improved health care financing for the GOR.
II. Improve the quality of essential health services at national, facility, and community levels utilizing a health systems approach.

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Through a focus on financing and quality, RIHSA provides technical assistance to the GOR on various strategies, tools, and approaches that will allow Rwanda to sustainably fund its healthcare system and provide quality care at all levels. The Activity is implemented by a consortium led by Palladium International LLC (Palladium) in partnership with RTI International, the Council for Health Service Accreditation of Southern Africa (COHSASA), Zenysis Technologies, and Rwanda Agency for Accreditation and Quality of Healthcare (RAAQH).

3. Assignment Overview
Workload Indicators for Staffing Need (WISN) is an evidence-based planning tool used to estimate actual health worker staffing needs in health facilities and to provide health managers with a systematic way to make staffing decisions and manage their human resources. The Roadmap for scaling up human resources for improved health service delivery in the African Region 2012–2025 lays emphasis on the availability of sufficient numbers of qualified health workers in the right place as essential for the delivery of quality health services to the population1.

Thus, Palladium and the Rwanda Integrated Health Systems Activity (RIHSA) is supporting the MoH through a consultancy to conduct and develop a WISN study and a training of trainers (TOT) to provide findings and recommendations that will shed more light on the actual workload of existing health workers at health facilities in Rwanda, and identify issues of real gaps in staffing needs in terms of distribution, performance, and also of productivity of existing staff. A final report will allow facilities to identify HRH staffing needs and develop strategies to address staffing gaps, hence impacting the quality of healthcare services.


4. Objective
Palladium is seeking to hire a consultant or team of consultants to conduct a training of trainers on how to use the WISN tool for staffing projections and also to conduct WISN studies on a representative sample of 48 public hospitals across the country to identify staffing gaps based on workload.

5. Scope of Work
This assignment will specifically focus on the following activities:
1. Facilitate training of trainers (TOT) from the central level team on WISN to support facilities to use the WISN tool for staffing projections.
2. Facilitate WISN study at hospitals to identify staffing gaps based on workload.
3. Review the standard activities for each cadre: doctors (GPs, ENT, Gynecologist, Pediatricians, and surgeons), Nurses, Midwives, and allied health professionals (Pharmacists, Laboratory specialists, anesthetists, dentists, ophthalmology technicians, physiotherapists)
4. Review the customized WISN tool previously developed in 2019 and update in the current Rwanda context
5. Analyze findings and generate a report with recommendations for hospitals to improve the equities in health worker distribution.

6. Contract Type
This consultancy will be a fixed-price deliverables-based contract. Acceptance of the deliverables will be determined by the project’s Quality Improvement Director. Final approval will be required by the Chief of Party.

7. Expected Outputs/Deliverables
• A pool of 16 staff from MOH and HRH will be trained as Trainers to continuously provide support to health facilities on the use of the WISN tool.
• An inception report that includes the methodology of defining activity standards, and training materials
• A customized WISN tool that fits into the Rwanda context based on the selected cadre of health professionals to be used at district, provincial, and referral hospitals
• A detailed report of WISN survey findings and clear recommendations to support the future improvement of health worker distribution.

8. Expected Timeline
This assignment is expected to be implemented within a timeline of 5 consecutive weeks with an estimated level of effort of not more than 25 days, starting from the date the contract is signed.

Activities Timeframe/Deadline
1 Concept note on Workload Indicators in Staffing Needs in Rwanda 2 days
2 Inception report describing the approach to the training and study 2 days
3 Planning of training of trainers (TOT) and development of training materials 2 days
4 Training of trainers of 16 trainees 4 days
5 Protocol of WISN study 1day
6 Review WISN activity standards 1 day
7 Validation workshop of the WISN activity standards 1 day
8 Review the customized WISN tool used in 2019 in the current Rwanda context. 2 days
9 Conduct WISN study in hospitals 8 days
10 Data extraction from HMIS and HRIS reports and hospitals and data analysis using the WISN tool 2 days

9. Qualification and experience for the consultant(s)
• Holds a Master’s degree in Human Resources Management, public health, medical specialty, health policy, health services management, or any other health-related degree.
• Certified Trainer of Trainers (TOT) on Workload Indicator of Staffing Need (WISN).
• Extensive knowledge and experience in using the WISN tool and conducting WISN studies in different contexts.
• Experience conducting training indifferent countries or locations
• Understanding of health systems and human resource management

10. Application requirements
The application proposal must include:
1. A description of the applicant’s relevant capacity and past performance with regards to WISN, including a description of similar work undertaken by the consultant. Please include client references (name, position, and contact details) for reference.
2. Qualifications of the applicant should be notarized (academic credentials)
3. An updated CV (no more than 3 pages) with a brief description (half a page maximum) of the candidate’s past involvement or support to WISN.
4. Technical and financial proposal including the consultant’s proposed daily rate.