CHAI Overview 

The Clinton Health Access Initiative, Inc. (CHAI) is a global health organization committed to our mission of saving lives and improve health outcomes in low- and middle-income countries by enabling the government and private sector to strengthen and sustain quality health systems.  

CHAI was founded in 2002 in response to the HIV/AIDS epidemic with the goal of dramatically reducing the price of life-saving drugs and increasing access to these medicines in the countries with the highest burden of the disease. Over the following two decades, CHAI has expanded its focus. Today, along with HIV, we work in conjunction with our partners to prevent and treat infectious diseases such as COVID-19, malaria, tuberculosis, and hepatitis. Our work has also expanded into cancer, diabetes, hypertension, and other non-communicable diseases, and we work to accelerate the rollout of lifesaving vaccines, reduce maternal and child mortality, combat chronic malnutrition, and increase access to assistive technology. We are investing in horizontal approaches to strengthen health systems through programs in human resources for health, digital health, and health financing. With each new and innovative program, our strategy is grounded in maximizing sustainable impact at scale, ensuring that governments lead the solutions, that programs are designed to scale nationally, and that learnings are shared globally. 

At CHAI, our people are our greatest asset, and none of this work would be possible without their talent, time, dedication and passion for our mission and values. We are a highly diverse team of enthusiastic individuals across 40 countries with a broad range of skill sets and life experiences. CHAI is deeply grounded in the countries we work in, with the majority of our staff based in program countries. Learn more about our exciting work: http://www.clintonhealthaccess.org/  

Background 

In 2022, cervical cancer was responsible for 36.964 new cases and 20.708 deaths, making it the second most common cancer among Indonesian women according to the Global Cancer Observatory (GLOBOCAN). Almost all cervical cancer cases are linked to human papillomavirus (HPV) infection. Therefore, prevention strategies are essential to reduce and eventually eliminate the disease burden, including HPV vaccination as it remains the most effective intervention based on current research. Since 2016, Indonesia has introduced the HPV vaccine in selected areas and gradually expanded on a nationwide scale through school-based vaccination programs starting in August 2023. As of 2025, Indonesia has implemented a policy reform changing the HPV vaccination schedule from a two-dose vaccination to a single-dose in accordance with Ministerial Decree No.35/2025 issued by the Ministry of Health. The program targets 5th grade girls, as well as 6th grade and 15-year-old girls or those in the 9th grade of junior secondary school who have not yet received the vaccine. This accelerated expansion of HPV vaccination program aims to reach not only school-girls but also out-of-school (OOS), ensuring broader and more equitable coverage. 

CHAI has facilitated a pilot to quantify, identify, and reach the OOS girls, aiming to ensure they are reached alongside school-based programs, resulted in OOS reach strategy to be adapted to national technical guidelines. OOS are classified into two categories: 1) institutional based, including non-formal school such as Community Learning Centers/PKBM, religious schools, homeschooling, schools for children with special needs (SLB), which are more structured and easier to reach; and 2) non-institutional based or marginalized, such as dropouts and street children, who are more scattered and difficult to access. Reaching OOS strategies included: established a cross-sectoral and cross-program coordination platform to strengthen data identification and outreach; secured roles and responsibilities from relevant stakeholders to support effective service delivery; and shared inclusive IEC materials for broader sectors. The following areas exhibit adequate progress in the implementation of strategies and data collection, along with high HPV coverage.

Reaching out-of-school (OOS) presents challenges not only in programmatic side of identifying and reaching the target population but also significant financial implications. Additional costs are required to locate, engage, and vaccinate, which are not typically accounted for in school-based programs. The cost per vaccinated girl in OOS settings remains uncertain but is expected to be considerably higher than in school-based programs which raising important questions about cost-effectiveness, delivery feasibility, and long-term sustainability. There is an urgent need to analyze the cost of HPV service delivery to reach OOS girls. Generating estimates of the cost per service is essential to inform sustainable and inclusive immunization strategies. Without targeted approaches, this vulnerable group risks being left behind, undermining the goals of Indonesia’s National Cervical Cancer Elimination Plan (2023–2030). In response, CHAI is seeking a consultant with expertise in health economics and immunization-focused interventions to support this assessment. The consultant will be expected to extend the work into a costing assessment, using CHAI’s OOS intervention areas and approaches as the foundation for estimating the resources and costs needed to vaccinate OOS girls. 

Objectives 

The consultant is expected to: 

1. Assess the cost of HPV service delivery to reach OOS girls in CHAI’s OOS intervention areas, including all associated components from preparatory activities to service delivery. This should cover the cost of full process reaching OOS girls for HPV vaccination, both for institutional based and non-institutional based (marginalized), with sample activities outlined below: 
2. Identification, including validation and synthesis of data sources (e.g., net enrolment rate/NER, civil registration) to estimate the size and distribution of eligible OOS girls. 
3. Community mobilization, including facilitation of coordination meetings with Provincial and District Health Office (PHO/DHO), Primary Health Centers (PHCs/Puskesmas); or multi-sectoral meetings with other relevant stakeholders. 
4. Information, Education, and Communication (IEC), including reproduction and distribution IEC materials to support awareness for OOS girls. 
5. Service delivery, including sweeping or outreach, vaccine pick-up, vaccine storage, vaccine injection, and vaccine per dose.    
6. Utilize the output of point 1 to develop comprehensive manuscript(s) on the cost of HPV delivery to reach OOS girls for scaling up HPV vaccination among OOS girls to other areas, with policy and program-relevant recommendation strategies. 

Deliverables 

Based on the objectives above, the contractor should complete the following deliverables: 

1. A technical proposal, outlining the work plan, timeline, detailed activities and annotated budget for conducting the costing assessment of HPV vaccination among OOS girls in three (3) selected areas where CHAI’s OOS intervention has been implemented: Bekasi City, Bandar Lampung City, and Bangka District. The proposal should demonstrate alignment with national immunization objectives and incorporate strategies for collaboration with relevant ministries and local health offices. 
2. A comprehensive final report written in English and Bahasa, consisting of the key findings from the analysis of the cost per fully vaccinated OOS girls for HPV. The report must include potential financing options and implications for sustainable implementation within the national HPV school-based vaccination program. 
3. Dissemination of key findings to relevant stakeholders (in-person or virtual, as agreed upon).  
4. Submission and publication of one or more manuscripts in reputable international journals, highlighting key findings from the costing analysis to contribute to national and global discourse on HPV immunization for OOS girls.   

Qualifications 

• Individuals/team (at least one research team member) with advanced degree/training in health economics, public health, public/health policy, or other relevant disciplines. 

• Experience in immunization program in Indonesia is an advantage. 

• Proven experience in conducting costing studies especially on immunization, Maternal and Child Health (MCH), or related public health intervention. 

• Proven experience in working with government institutions, such as Ministry of Health (MOH), Ministry of Ministry of Education (MOE) and Ministry of Religious Affair (MORA), Ministry of Social Affair, Provincial and/or District Health Offices (PHO/DHO), and PHCs. 

• Proven track record of conducting high-quality, evidence-based research with a focus on program evaluation and costing analysis. 

• Familiarity with the health systems and policy landscape in Indonesia, particularly immunization policies and strategies, including the HPV vaccination program and related public health initiatives. 

• Familiarity with immunization delivery systems, particularly school-based program and outreach strategies in LMICs.  

• Ability to effectively communicate complex technical findings to diverse audiences, including policymakers, program managers, and the public. 

• Strong presentation and writing skills in both English and Bahasa Indonesia. 

Applicant Requirements 

The proposal should be written in English and must include the following components: 

1. Research title 
2. Background and objectives 
3. Methodology 
4. Project timeline, with detailed activities 
5. Required supporting documents: 
6. Annotated budget, in Excel format 
7. CVs of key personnel, with at least one (1) sample of previous work, merged in a single PDF file 

Project Timelines 

The total expected duration of the assignment is around 7,5 months from 22 September 2025  to 30 April 2026. All reports must be finalized and submitted within this period.

Budget and Disbursement 

The projection budget estimate for this project is about USD 20,000, inclusive of consultant honorarium and expenses related to conducting the costing study and finalizing the reports. An additional amount of up to USD 8,000 is allocated for developing manuscript and submission to international journal publication. Payment will be disbursed by deliverables. The costs of the dissemination meeting will be covered by CHAI Indonesia. 

Application Submission 

Please submit your proposal no later than 10 September 2025, via email to indonesiaoffice@clintonhealthaccess.org and cc to smumtazah@clintonhealthaccess.org with “Proposal OOS Costing_Applicant’s Name” as the subject line. Only shortlisted candidates will be notified.