1. INTRODUCTION

     About the Organization

Forum for Health Systems Design and Transformation, more popularly known as Health Systems Transformation Platform (HSTP), is a not-for-profit company licensed under Section 8 of the Indian Companies Act 2013, incorporated under the aegis of Tata Trusts. HSTP is an evidence-based research and implementation institution focused on strengthening public health systems across India, working in strategic partnership with state governments and national programs to translate research and analysis into actionable systemic improvements for public health and equity.

With a multidisciplinary team of public health experts, HSTP transforms research and analysis into actionable strategies, working in close partnership with state governments and national programs to advance health equity and improve population health outcomes. The platform creates a vital link between theory and practice, ensuring policies are forged from robust evidence and supporting health system reforms that respond to diverse societal needs.

HSTP has established formal MOUs and collaborates with governments in Odisha, Meghalaya, Karnataka, and Madhya Pradesh, addressing a range of priorities including strengthening urban primary health systems, digitizing healthcare delivery, developing long-term health investment strategies, formulating human resource policies, and building research capacity in health policy and systems. Beyond these state engagements, HSTP contributes to national initiatives such as the Government of India's National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD).

Samagra Urban Mother & Child Health Project — Supported by Infosys Foundation

The Samagra Urban Mother & Child Health Project, funded by Infosys Foundation, is implemented by HSTP with Karnataka Health Promotion Trust (KHPT) as the key local partner. The project seeks to develop an urban healthcare delivery model that improves RMNCH+A outcomes by strengthening Comprehensive Primary Health Care (CPHC) systems for vulnerable populations in urban Karnataka. Core strategies include community engagement, robust referral pathways, and digital health innovations for equitable, quality service delivery.

The project's primary goals are:

• Reducing out-of-pocket expenditure (OOPE) for health care among mothers, children, adolescent girls, and women in urban underserved areas.
• Increasing the proportion of mothers, children, and adolescent girls covered by affordable, accessible, and high-quality comprehensive primary health care. 

Samagra is a project spanning December 2023 to March 2027. Over its duration, the project aims to directly reach a minimum of 70,000 beneficiaries. The revised overall reach and selected beneficiary coverage targets are presented below: 

Table 1. Revised beneficiary coverage targets for the project period

2. SCOPE OF WORK

The purpose of this RFP is to identify an external agency to conduct a comprehensive endline evaluation for the project. A midline assessment of the Samagra Urban Mother & Child Health Project has been completed. The agency will review the baseline and midline assessment reports, tools, methodologies, and findings. To enable robust assessment of project progress and impact over time, the endline evaluation shall measure the same core indicators using comparable definitions and methodologies, unless modifications are specifically justified and approved by HSTP.

The evaluation findings will enable the project team and stakeholders to assess progress against baseline and midline benchmarks, determine the extent to which project objectives have been achieved, and generate actionable recommendations for scale-up, sustainability, and integration into health system policies and programmes.

Project Coverage

The project is implemented across four Urban Primary Health Centres (UPHCs) in Mysuru city. These UPHCs collectively cover 16 wards, representing approximately 24.6% of the city’s 65 wards, and serve a population of about 210,000.

HSTP and KHPT work together to implement the project, with close coordination to ensure consistent programme delivery across all intervention areas. 

Target Beneficiary Coverage

The evaluation shall assess achievement against the revised beneficiary coverage targets presented in Table 1 above.

1. Intermediate Outcome Metrics

1. Access to Care: Percentage of mapped vulnerable populations actively accessing quality-assured RMNCH+A services from target UPHCs.
2. Financial Protection: Percentage of vulnerable population holding health insurance who successfully availed inpatient/outpatient coverage.
3. UPHC Capacity & Quality: Percentage of target UPHCs with trained healthcare staff, adequate drug supplies, necessary consumables, and quality assurance mechanisms.
4. Maternal Care: Percentage of pregnant/lactating women receiving improved Antenatal Care (ANC) and Postnatal Care (PNC).
5. Social Benefits: Percentage of women successfully availing government social security and maternity benefit schemes during ANC/PNC periods.

       2. Impact Metrics

1. Out-of-Pocket Expenditure (OOPE): Quantifiable reduction in household healthcare spending among target urban vulnerable families.
2. Child Nutrition & Birth Weight: Measurable reduction in the prevalence of low-birth-weight infants and childhood undernutrition among children under 5 years.
3. Anemia Reduction: Reduction in anemia rates among adolescent girls (10–19 years) and pregnant women. 

      Evaluation Agency Responsibilities 

The selected agency will be responsible for:

• Designing and conducting mixed-method quantitative and qualitative assessments using both primary and secondary data sources.
• Including all intervention areas in the evaluation (16 wards under 4 UPHCs in Mysuru).
• Surveying vulnerable population groups including a representative sample of mothers, children, adolescents, and health facility staff. The agency shall propose an appropriate sample size and sampling methodology that ensures statistical validity and representation across project intervention areas and beneficiary groups.
• Developing and applying appropriate methods to assess key outcome indicators such as ANC/PNC uptake, immunization coverage, health insurance enrolment, health expenditure, utilization of services and community engagement outcomes in terms of functioning Mahila Arogya Samitis (MAS) and self-help groups (SHGs). 
• Analysing innovative project pilots, including Arogya One kiosks and digital health systems integration.
• Conducting stakeholder interviews and focus group discussions with community facilitators, frontline health workers (FLWs), and health officials to gather qualitative insights on implementation and impact.
• Reviewing and synthesizing findings from the baseline and midline assessments and conducting comparative analysis to see changes in key project indicators over the project period.

       3. KEY DELIVERABLES 

The selected agency shall produce the following deliverables: 

• Inception report detailing the evaluation design, methodology, survey plan, sampling framework, and data collection tools.
• Field data collection monitoring and validation reports documenting progress, coverage, and quality assurance measures.
• Cleaned and anonymised datasets with accompanying documentation, including a codebook, ensuring data integrity and protection of participant confidentiality.
• Draft endline evaluation report presenting findings, thematic analysis, lessons learned, and actionable recommendations for stakeholder review and feedback.
• Final endline evaluation report incorporating feedback received from HSTP and relevant stakeholders, including a comparative analysis of baseline, midline, and endline findings, indicatorwise trends, and an assessment of the project’s contribution to observed changes.
• Presentation of key findings and recommendations, and facilitation of dissemination workshops to support their uptake.

The agency shall ensure compliance with ethical standards, including informed consent, data protection, and confidentiality, throughout all phases of the evaluation.

4. ELIGIBILITY AND QUALIFICATIONS

The proposing agencies should demonstrate the following capacities and experience: 

• Established track record in evaluating urban health projects in India, particularly in reproductive, maternal, newborn, child, and adolescent health (RMNCH+A).
• Proven expertise in designing and conducting mixed-methods evaluations, integrating quantitative and qualitative approaches.
• Experience in conducting large-scale household and community surveys, including sampling design and survey implementation.
• Experience in qualitative data collection and analysis, including in-depth interviews, focus group discussions, and participatory assessments.
• Demonstrated ability to lead and coordinate multidisciplinary evaluation teams.
• Established systems for data quality assurance, management, and validation to ensure reliable and credible findings.
• Strong stakeholder engagement skills to work effectively with community members, health service providers, and government officials.
• Technical and analytical expertise to produce high-quality evaluation reports, presentations, and actionable recommendations.
• Capacity to adhere to ethical standards in research, including informed consent, confidentiality, and data security. 

       5. PROPOSAL SUBMISSION REQUIREMENTS

Technical Proposal

The technical proposal should include:

• Clear understanding of the Samagra project context and evaluation objectives.
• Detailed proposed evaluation design and methodology, including data collection and analysis approaches.
• Details of the proposed team, including the roles, qualifications, and relevant experience of key personnel.
•  A work plan showing key activities and timelines, with all deliverables to be completed by 31 January 2027. 

Financial Proposal

• An itemised budget covering all costs of the evaluation, with applicable taxes shown separately.
• A brief explanation of the proposed costs and the assumptions used to prepare the budget. 

6. TERMS AND CONDITIONS 

•  HSTP reserves the right to accept or reject any or all proposals without assigning any reason.
• The selected agency will be required to enter into a formal contract with HSTP before commencing the evaluation.
• The selected agency must maintain the confidentiality of all project data, findings, and reports during and after the evaluation. These must not be shared or published without prior written permission from HSTP. 

      7. PROPOSED EVALUATION TIMELINE

The endline evaluation, including submission and acceptance of the final report and all deliverables, must be completed by 31 January 2027.

The agency shall submit a detailed work plan covering inception, tool development, data collection, analysis, report writing, stakeholder consultations, and dissemination. The work plan must allow sufficient time for HSTP to review the draft report and for the agency to incorporate feedback before final submission.

Table 2. Key evaluation milestones and deadlines