Consultant - Desk Review for SBI management in Nigeria

Background

We are an indigenous non-profit and non-governmental organization with a Head Office in Abuja and field offices across various locations in Nigeria. Our mission is to save lives, enhance the quality of life, and create opportunities for productivity, particularly for Nigerians living with or affected by HIV. Built on a foundation of strong core values, we are committed to innovation, inspiring leadership, and impactful partnerships.

Background

• The IMPAACT4HIV Project is a three-and-a-half-year multi-country implementation research initiative funded by UNITAID through the Aurum Institute, focused on improving access to comprehensive care for children living with advanced HIV disease (AHD) across six (6) African countries: South Africa, Mozambique, Democratic Republic of Congo (DRC), Côte d’Ivoire, Sierra Leone, and Nigeria.
• The project aims to develop and evaluate context-specific, cost-effective interventions that are co-designed with communities and policy actors to improve the uptake of, and strengthen AHD service delivery models; ensure a more diversified, responsive, and sustainable AHD commodity supply; and generate evidence to inform sustainable country-wide scale-up and transition, as well as support global advocacy to facilitate donor prioritization and inclusion of the pediatric care package in country health strategies.
• The Implementing Partner leads the consortium implementation in Nigeria, in collaboration with global and local partners.
• Advanced HIV Disease (AHD) remains a significant contributor to morbidity and mortality among people living with HIV, particularly due to increased vulnerability to opportunistic infections and severe bacterial infections (SBIs). Despite the availability of global guidance for AHD management, gaps remain in specific guidance for SBI diagnosis and treatment, particularly regarding empiric antibiotic use, availability of diagnostic tools, antimicrobial resistance (AMR) surveillance, and alignment with antimicrobial stewardship principles.
• The Project is thus conducting a situational assessment study to identify gaps and opportunities for improving the diagnosis and treatment of SBIs among people with AHD in Nigeria.
• The assessment will combine desk review and qualitative interviews to explore factors influencing SBI management, including guideline development, clinical practices, antibiotic stewardship, and opportunities for improvement.
• The desk review component will assess relevant policies, guidelines, programme documents, and scientific literature to determine existing recommendations, evidence gaps, and alignment with global frameworks, including the WHO Access, Watch and Reserve (AWaRe) classification.
• The Implementing Partner is therefore seeking a qualified consultant to conduct the desk review component of the assessment.

Purpose of the Consultancy

• The purpose of this consultancy is to conduct a comprehensive desk review of existing evidence, guidelines, policies, and programme documents related to the diagnosis and treatment of SBIs among people with AHD in Nigeria, covering both adult and pediatric frameworks, with a prioritized emphasis on pediatric and adolescent populations and, in conjunction with qualitative data, generate findings that will inform recommendations for improving SBI management practices.

Specifically, the Consultant will:

• Identify and review relevant national and subnational HIV, AHD, infectious disease, antimicrobial resistance, and treatment guidelines.

Assess the extent to which existing guidelines provide recommendations for:

• Diagnosis of SBIs among people with AHD;
• Empiric antibiotic treatment approaches;
• Use of microbiological and diagnostic tools;
• Referral and management pathways;
• Antimicrobial stewardship.
• Examine how bacterial epidemiology and AMR data are incorporated into SBI treatment recommendations.

Assess alignment of existing guidance with:

• WHO AHD management recommendations;
• WHO AWaRe antibiotic classification framework;
• Current antimicrobial stewardship principles.
• Review published and grey literature on SBI burden, pathogens, resistance patterns, and treatment practices among people with HIV/AHD in Nigeria.
• Identify gaps, inconsistencies, and opportunities for strengthening SBI diagnosis and treatment policies and practices.

Scope of Work

The Consultant will conduct a structured desk review covering:

• Policy and Guidelines Reviews.

Documents may include:

• National HIV treatment guidelines;
• Advanced HIV Disease guidelines;
• Opportunistic infection management guidelines;
• National antimicrobial resistance strategy documents;
• Standard treatment guidelines;
• Essential medicines lists;
• Laboratory guidelines;
• Infection prevention and control guidance;
• Relevant state-level policies and implementation guidance.

Program and Implementation Documents ReviewsIncluding:

• HIV program reports;
• AHD implementation reports;
• Facility assessment reports;
• Monitoring and evaluation reports;
• Partner program reports;
• Relevant technical briefs.

Literature ReviewIncluding:

• Peer-reviewed publications;
• Research studies;
• Surveillance reports;
• AMR studies;
• Relevant systematic reviews.

Methodology:

The consultant shall:

• Develop an inception report detailing:
• Review methodology;
• Search strategy;
• Inclusion/exclusion criteria;
• Data extraction approach;
• Analysis framework.
• Conduct document identification and retrieval through:
• Government repositories;
• Academic databases;
• International agency resources;
• Partner documentation.
• Apply a systematic document review framework.
• Extract information using an agreed data extraction template covering:

Domain

Information to Extract

SBI management guidance

Recommended diagnostic and treatment approaches

Antibiotic use

Empiric treatment recommendations

AMR integration

Use of resistance data in guidance

Diagnostics

Available recommended tests/tools

Stewardship

AWaRe alignment and antibiotic rational use

Implementation gaps

Barriers and opportunities

• Synthesize findings and develop recommendations.
• Validate findings with the study team and relevant stakeholders.

Institutional Inputs and Support from the Implementing Partner:

To facilitate the execution of this assignment, the Implementing Partner will provide the consultant with:

• Initial program implementation records, project briefs, and core stakeholder mapping.
• Formal introductory channels to the National Agency for the Control of AIDS (NACA), NASCP, and facility-level leads to simplify the collection of unpublished "grey literature" and state-specific implementation reports.
• Standard feedback loops and structured data-extraction review sessions with the IMPAACT4HIV technical team.

Key Deliverables and Timeline

The consultant is expected to complete the deliverables within 4 to 6 weeks from contract signing. Deliverables are structured around key verification milestones:

Deliverable Milestone

Content / Requirements

Target Timeline

Deliverable 1: Inception Report

Detailed methodology, finalized search protocol, specific inclusion/exclusion criteria, and finalized work plan.

End of Week 1

Deliverable 2: Document Inventory

A robust metadata repository of all retrieved and reviewed files (Title, Year, Source, Type, Relevance).

End of Week 2

Deliverable 3: Data Extraction Matrix

Populated matrix containing clear data points extracted systematically across all target domains.

End of Week 3

Deliverable 4: Draft Desk Review Report

Comprehensive technical narrative comprising the Executive Summary, Background, Methodology, Gaps, and Strategic Recommendations.

End of Week 5

Deliverable 5: Final Approved Report

A polished report cleanly incorporating all technical edits and review feedback from IP, NASCP, and project partners.

End of Week 6

Consultant Qualifications and Experience

Education

• Advanced Degree (Master’s or higher) in: Public Health; Epid