Research on “Determining the causes of child road deaths and injuries in Lebanon”

BACKGROUND INFORMATION

According to the Institute for Health Metrics and Evaluation, road crashes are the leading cause of death for adolescents (10-19) worldwide, and the 4th leading cause of death for children age 5-9.  Road crashes also have a serious impact on children in Lebanon – according to data from 2016, transport injuries were the 6th leading cause of death for children 5-14 years old.  The causes of children’s deaths and injuries on the road are numerous, including:

• Children are hit by vehicles when crossing or walking alongside busy roads
• Children are injured or killed when they are traveling in cars involved in crashes; their injuries are more severe because they are not wearing seatbelts or using car seats
• Children are injured or killed while riding motorcycles along with an adult; often these children are not wearing helmets

While there are numerous causes of children’s deaths and injuries on the roads, it is unknown which causes are most frequent and severe, because this data has not yet been compiled, analyzed and reported in Lebanon. 

RESEARCH SCOPE AND PURPOSE

The purpose of this research is to determine the greatest causes of children’s road crash deaths and injuries by reviewing hospital records.  By determining what the greatest causes are, Save the Children, as well as other road safety actors, can better design programs that specifically address the most serious causes.

Research will be conducted in 15 hospitals in Lebanon in 5 of the largest cities:  Beirut, Tripoli, Jounieh, Saida, and Zahle.  Data will be collected for three years:  2015, 2016 and 2017 – this is the period following enactment of Lebanon’s robust traffic law, law #243 (which forbids children under 10 from sitting in the front seat, and requires children under 5 to ride in car seats.)

RESEARCH QUESTION AND SUB-QUESTIONS

Research Question

According to hospital records, what are the greatest causes of children’s road crash deaths and injuries in Lebanon?

Sub-Questions (to be refined with the researcher/s during Inception Phase)

• What is the number of road crashes child injuries and fatalities during the past three years disaggregated by age, cause of death/injury, mean of transportation and type of trauma?
• How should we categorize the causes of injuries? (e.g. not wearing seatbelt, not using car seat, being hit by car, head trauma due to motorcycle crash, pedestrian)
• What will be the criteria for selection of hospitals?
• Do the causes of children’s death and injuries by road crash differ between the different 5 cities? If yes, How?
• Is there a relationship between children’s cause of road crash death and injuries and their age group and/or gender?
• How do hospitals register the cause of death by road crash in their records? What are the challenges faced during this process, if any?
• What are the different road safety awareness campaigns/initiatives implemented in these 5 cities since 2015?
• Are there georgraphic locations near which crashes more often occur (such as schools, hospitals, markets, etc.)?
• Are there time periods during the day in which crashes occur more often?

METHODOLOGY

• In partnership with Save the Children Lebanon (SCL), obtain letter of support from Ministry of Health to work with hospitals and review records
• Develop criteria for selection of 15 hospitals for inclusion in research
• Coordinate with and obtain support from hospital directors
• Work with hospital staff to understand injury recording and injury coding system
• Access hospital records (paper based and/or electronic) to determine how injuries are recorded
• Access hospital records (paper based and/or electronic) to search for injury codes (specify which injuries are required)
• Develop system for categorizing injuries by cause
• Determine protocol and level of uncertainty acceptable for attributing certain injuries to specific causes, if cause not explicitly recorded
• Compile and categorize all causes of children’s (under 18) road crash injuries and deaths for the 2015 – 2017 period.  
• Note on potential methodology:  The consultant/firm may need to check the ER records compared to the doctors report on the causes of injury. Case studies will help showcase the alignment between the ER report (trauma arriving to the ER), and the Dr’s follow-up reports. Case studies could also be linked with the police records to be able to identify the causes of the injury/death (i.e. no helmet on motorcycle, no seat belt, speed, pedestrian, etc).   

RESEARCH FOLLOW-UP AND LEARNING

SCL follows-up all research and evaluations with a management response, and its implementation is subsequently tracked. This will include the documentation of key learning which will be shared with the relevant SCL teams on the local country level as well as the regional and global SCL levels.  In Lebanon the results of this research will be used to inform the upcoming design of child-focused road safety programming. Additionally, the research will be shared with the donor, the FIA Foundation, Save the Children US, and the Global Road Safety Partnership.

RESEARCH PRINCIPLES

The views expressed in the report shall be the independent and candid professional opinion of the evaluator. The research will be guided by the following ethical considerations:

• Openness and transparency of information given to the highest possible degree to all involved parties
• Public access to the results when needed unless in the case of confidentiality restrictions
• Broad participation of the interested parties to be involved where relevant and possible
• Reliability and independence: the research should be conducted such that its findings and conclusions are correct and trustworthy
• Child-sensitiveness, Child participation and gender sensitiveness

COORDINATION AND MANAGEMENT OF THE RESEARCH

The research is managed in country by the Country Director and MEAL Manager– they will coordinate with the Global Road Safety Partnership for some technical guidance.

The consultant should include coverage of travel costs in the estimated proposed budget.

The consultant should expect to meet with the Country Director and MEAL Manager as regularly as needed during the start-up period (approximately 6 weeks) and then once hospital research has begun, approximately once a month for brief updates and discussion on any challenges faced.

DELIVERABLES AND REPORTING DEADLINES

The research team will submit three reports and three presentations to the Country Director and MEAL Manager:

• Inception report: Following the desk review and prior to beginning of the field work, an inception report will be produced subject to approval by SCL. This report will detail a draft work plan with a summary of the primary information needs, the methodology to be used, and a work plan/schedule for the field visits and major deadlines. With respect to methodology, the inception report will include a description of how data will be collected and categorized – however, this categorization system may be revised once the collection process has begun, based on stronger understanding of hospital records. It should also include the draft of the final report outline (i.e. Table of Content). 

Once the report is finalized and accepted, the research team must submit a request for any change in strategy, methodology or approach to the Country Director and MEAL Manager.

• Draft report: A draft research report will be submitted to the Country Director and MEAL Manager who will lead the revision process and provide feedback within two weeks of receipt of the draft report. Quantitative and qualitative data collected and analysis developed should be annexed to the draft report.
• Final report: The Final Research Report (estimated 15-25 pages) should include a 1-2 page executive summary that summarizes the key findings. Tools used for data collection and analysis should be annexed to the draft report.

All material collected (excluding confidential hospital records) in the undertaking of the research process should be lodged with the MEAL Manager prior to the termination of the contract.

Presentation of findings:

• At the end of the field work and after submission of the draft report, the research team will present preliminary findings to validate and prioritize learning at the SCL Lebanon level
• After submission of the Final Research Report, the research team will provide a final presentation for relevant stakeholders

TIMEFRAME

The research is scheduled to start in October with up to 6 weeks for preparatory work (approval from Ministry of Health, selection of hospitals and meetings with hospital directors), while the data gathering work in hospitals may take up to 3 months.  A draft report is expected to be submitted by February 10, 2019 and finalized by March 15, 2019.

The Researcher is expected to provide a suggested timeline and work plan for the study based on these scheduling parameters and in keeping with the scope of the research question.

In event of serious problems or delays, the Researcher should inform the MEAL Manager and Country Director immediately. Any significant changes to review timetables shall be approved by the MEAL Manager and Country Director.

RESEARCH CONSULTANT TEAM

SCL seeks expressions of interest from people with the following skills/qualifications and expertise:

• Ability to read, analyze, and effectively categorize hospital patient records as needed to undertake this study effectively
• Experience working with the Ministry of Health and/or hospitals in Lebanon would be preferred
• Sound and proved experience in conducting research, particularly utilization and learning focused research and projects’ evaluations.
• Expertise in quantitative data collection techniques

EVALUATION CRITERIA

Essential Criteria:

- Bidder’s registration in Lebanon: submit copies of company registration and Tax Certificate if applicable; or a permission from the relevant authorities to trade in that market (in case of individual consultants)

- Bidder’s confirmation of compliance with the attached Conditions of Tendering, Terms and Conditions of Purchase, Anti-Bribery and Corruption Policy, Child Safeguarding Policy and IAPG Code of Conduct .The bidder should Read and sign T&C in Bidder response document

Technical & commercial criteria:

 Technical Criteria (60%)

- Bidders proofs of expertise in similar tasks, at least 2 letters of reference from government bodies or International or Local organizations within the last 2 years, as well as 2 relevant research papers within the last 3 years (10%)

- Quality of proposal (level of effort/details put into proposal and level of understanding of assignment scope). (20%)

- Methodology (approach) and the extent to which the proposed sample covers all concerned stakeholders). (10%)

- Demonstrated experience working with the Ministry of Health and/or hospitals in Lebanon (10%)

- Candidate profile (the strength and relevancy of the candidates’ academic background and technical and evaluation expertise). (10%)

Financial Criteria (40%)

-Total Price: Bidder’s prices demonstrate an economically advantageous position for SCI. (40%)

APPLICATION PROCESS AND REQUIREMENTS

Interested researchers or research firms are required to submit their proposals in addition to evaluation criteria documents in a sealed envelope by the deadline of August 10th, 2018 to the following address:

1st Floor, Sodeco Square Building, Bloc B, Achrafieh, Beirut.

The proposal should include:

• Outline of research framework and methods, proposed time frame and work plan
• A short description highlighting any past experience working with the Ministry of Health and/or hospitals in Lebanon
• Proposed research budget and proposed payments schedule aligned with deliverables schedule
• CVs of each team member
• At least 2 letters of reference from government bodies, or international/local organizations within the last 2 years
• At least 2 relevant research papers written within the last 3 years
• the methodology, the CV(s) of the consultant(s), and their respective rates per day;