Feasibility Assessment and Development of a Concept Note for a Telemedicine Initiative Supporting Frontline Regions in Ukraine

Organization: Norwegian Red Cross Closing date: 4 Sep 2026 Background The Norwegian Red Cross (NorCross), as part of the International Red Cross and Red Crescent Movement, works to protect life and health and support people affected by conflict, crises, and other humanitarian emergencies. In Ukraine, NorCross supports the Ukrainian Red Cross Society (URCS) in delivering essential health and protection services to vulnerable populations. The ongoing conflict continues to place significant pressure on Ukraine’s health system, particularly in frontline, hard-to-reach, and recently de-occupied areas. Damaged infrastructure, shortages of health personnel, disrupted referral pathways, medicine access barriers, and increased demand have reduced access to healthcare. These challenges particularly affect older people, persons with disabilities, internally displaced people, people with chronic conditions, and children requiring follow-up care. In many frontline communities, access to primary and specialist healthcare remains inconsistent. Insecurity, transport limitations, financial constraints, mobility restrictions, and lack of family support can further prevent people from reaching health facilities. Consequently, patients requiring regular follow-up or specialist advice may experience delays and interruptions in care. With Norwegian Red Cross support, URCS has established a strong humanitarian health platform through Mobile Health Units, Home Based Care, Mental Health and Psychosocial Support, Health Promotion and Disease Prevention, and community-based services. However, gaps remain in access to specialist consultations, continuity of care for chronic conditions, and referral and follow-up between community and higher-level health services. Telemedicine could help address these gaps by extending access to qualified healthcare professionals without requiring patients or health workers to travel in unsafe or difficult conditions. It can support remote consultations, triage, referrals, follow-up, and access to specialist advice, while complementing existing URCS services. Although several humanitarian actors have implemented or explored telemedicine initiatives, URCS has not identified an accessible and functional community-level telemedicine service in the target areas. The proposed initiative therefore seeks to assess the need and feasibility of establishing a safe, structured, and scalable telemedicine system for vulnerable populations in frontline, hard-to-reach, and underserved areas. Based on the assessment, a concept would be developed for a free service providing primary healthcare and selected specialist consultations, integrated with existing URCS health services and enabling seamless transition between remote and in-person care. Evaluation purpose and scope The purpose of the assessment is to develop a concept for a potential future telemedicine project. Given the enormous number of humanitarian response activities being implemented by multiple actors and the complex operational environment in which such a project would operate, a thorough assessment of the current and future situation on the ground is required as a prerequisite. The assessment will determine the feasibility, relevance, operational requirements, and potential added value of a telemedicine initiative designed to support frontline health posts and primary care clinics in conflict-affected areas of Ukraine. It will generate evidence to inform the development of a future telemedicine project and support decision-making on whether and how such an intervention – in a following phase – should be designed and implemented by the Ukrainian Red Cross Society (URCS) and other partners as appropriate. Also, the assessment will evaluate the intervention's potential for sustainability and scalability, identify the conditions required for successful implementation, and explore how the initiative can be designed to strengthen and complement the national health system while addressing the needs of populations living along the conflict's frontline and hard-to-reach or underserved areas. General Objective: To assess the need, feasibility and potential value of introducing a telemedicine support system for frontline health facilities in conflict-affected areas of Ukraine and develop a concept note for a potential development and implementation of such digital health intervention**.** Specific Objectives: • Assess health service delivery challenges that could potentially be addressed through telemedicine. • Identify priority clinical and operational use cases. • Assess demand, acceptability, and perceived usefulness among health care providers and higher-level stakeholders. • Evaluate Assess technical feasibility, including electricity and internet connectivity, hardware and software requirements, interoperability, and cybersecurity considerations. • Assess legal, regulatory, ethical, and data protection requirements. • Analyse operational and organisational requirements for implementation by the Ukrainian Red Cross. • Review existing telemedicine initiatives and identify opportunities for collaboration and integration into existing health care structures. • Elaborate a project concept for the development and implementation Assessment criteria: The assessment should evaluate the proposed telemedicine initiative against the following criteria: Relevance Extent to which the proposed intervention responds to identified health service delivery gaps and priority needs in frontline and hard-to-reach areas. Alignment with URCS, Ministry of Health priorities, and humanitarian health response objectives. Added value Degree to which telemedicine would provide benefits beyond existing health service delivery mechanisms and telemedicine initiatives. Potential contribution to improving access, continuity and quality of care. Technical feasibility Availability and reliability of connectivity, power supply, equipment and digital health infrastructure. Compatibility with existing national digital health systems and interoperability requirements. Operational feasibility Availability of human resources, management structures, training capacity and support systems required for implementation and maintenance. Legal and ethical feasibility Compliance with Ukrainian regulations related to telemedicine, data protection, professional licensing and patient safety Sustainability Likelihood that the initiative can be maintained beyond initial donor support, including institutional ownership, financing and integration into existing health services. Scalability Potential for expansion to additional regions and populations without disproportionate increases in cost or complexity. Cost-Effectiveness Likely balance between required investment and expected health and operational benefits. Assessment domain: Health System & Service Delivery Analysis: Mapping of existing telemedicine solutions or interventions, including assessing functionality, usability, acceptability, types of frontline facilities, service packages provided, workforce composition, referral pathways, and specialist support needs. Telemedicine Use Case Analysis: Evaluating potential remote clinical consultations, specialist support (cardiology, pediatrics, family medicine), case discussions, mentoring, continuing professional development, MHPSS support for providers, and triage/referral support. Technical Assessment: Assessment of electricity, connectivity, digital health infrastructure, hardware availability, existing digital health platforms, interoperability requirements, and cybersecurity/information governance. Operational Assessment: Evaluation of human resource requirements, governance arrangements, training needs, support/maintenance requirements, scalability considerations, and cost estimates**.** Legal and Regulatory Assessment: Review of national telemedicine regulations, data protection requirements, professional licensing considerations, and clinical liability issues. Evaluation methodology The technical proposal (see below) should include an outline of a suitable methodology and appropriate data collection methods adapted to the purpose of the assessment. It is free to suggest any additional methodological approaches and data collection methods and questions that are not mentioned in the ToR. The consultant must adopt a consultative and participative methodological approach. The approach should consider the following elements: • Desk Review: Mapping of existing telemedicine solutions (or those under development), national policies, digital health strategies, telemedicine regulations, and existing assessment reports. • Stakeholder Mapping: Identifying key stakeholders across the health and digital health ecosystem, including Ministry of Health and regional health authorities, eHealth experts, telemedicine providers, PHC managers, frontline clinicians, URCS staff, clinical specialists, active international organizations, and other relevant digital health/telemedicine actors. • Field Visits & Key Informant Interviews: Conducting a targeted series of field visits and Key Informant Interviews (KIIs) with a representative range of stakeholders to assess local needs, existing solutions, implementation capacity, barriers, and potential use cases. KIIs will include, where relevant, Ministry of Health and regional health authorities, eHealth and telemedicine experts/providers, PHC directors and managers, chief physicians, frontline clinicians, IT focal points, URCS staff and Oblast Branch leadership. The number of KIIs will be determined based on stakeholder availability and the complexity of the assessment, rather than being limited to 2–3 interviews. • Patient/End-User Consultations: Where feasible, consultations with patients and other end-users will be included to assess the acceptability and practicality of telemedicine from the user perspective, including levels of trust in remote consultations, digital literacy and access barriers, patient preferences, perceived benefits and concerns, and overall willingness to use telemedicine services. • Stakeholder Consultations & Workshops: Collaborative sessions with URCS and relevant stakeholders to validate findings and prioritize potential use cases, discuss feasibility and added value, identify implementation requirements and risks, and jointly explore practical implementation options. The consultancy will take all reasonable steps to ensure that activities respect and protect the rights and welfare of communities, ensuring technical accuracy, transparency, and impartiality in alignment with the IFRC Framework for Evaluation and Fundamental Principles of the Red Cross and Red Crescent. Deliverables Deliverable 1: Inception Report (5–10 pages max) outlining methodology, stakeholder mapping, anticipated challenges, mitigation measures, detailed work plan, and data collection tools developed in close collaboration with URCS. Deliverable 2: Feedback Workshop with NoRC and URCS to present and discuss preliminary findings, conclusions, and recommendations prior to finalizing the report. Deliverable 3: Feasibility Assessment Report (10–20 pages max) summarizing background, methodology, findings, feasibility analysis, risk assessment, use cases, scenarios, cost considerations, and a clear Go/No-Go recommendation. Deliverable 4: Concept Note for a Telemedicine Implementation Project (2-page SMART concept note) providing the strategic foundation for future implementation and RFP development, subject to a positive Go decision: Proposed timeline (or schedule) Time Schedule Activities Deliverables Week 1-2 Initial meetings with URCS and NoRC to finalise scope and methodology. Desktop study: review of project documents, primary/secondary resources. Development of detailed inception report: assessment concept, team composition, schedule, methodology, and data collection tools. Inception Report Week 3-7 Mapping of relevant digital health initiatives in target region and stakeholders. Coordinate with local teams on field assessment & data collection. Conduct Key Informant Interviews (KIIs) with relevant stakeholders. Auditing of data collection proceedings. Interviews completed according to data collection plan Week 8-10 Analysis of collected data. Prepare draft evaluation report. Organise feedback workshop of initial findings, conclusions, and recommendations. Draft version of evaluation report & Feedback workshop Week 10 Address feedback with revisions in report where appropriate. Revise and submit final evaluation report. Final draft of evaluation report & suggested monitoring tools Week 11 Presentation of findings to URCS and NoRC leadership. Presentation of findings Week 11-12 Prepare concept note on following telemedicine project. Final draft of project concept note Evaluation quality and ethical standards The consultants should take all reasonable steps to ensure that the evaluation is designed and conducted to respect and protect the rights and welfare of people and the communities of which they are members, and to ensure that the evaluation is technically accurate, reliable, and legitimate, conducted in a transparent and impartial manner, and contributes to organizational learning and accountability. Therefore, the evaluation team should adhere to the evaluation standards and specific, applicable process outlined in the IFRC Framework for Evaluation. The IFRC Evaluation Standards are: Utility: Evaluations must be useful and used. Feasibility: Evaluations must be realistic, diplomatic, and managed in a sensible, cost-effective manner. Ethics & Legality: Evaluations must be conducted in an ethical and legal manner, with particular regard for the welfare of those involved in and affected by the evaluation. Impartiality & Independence: Evaluations should be impartial, providing a comprehensive and unbiased assessment that takes into account the views of all stakeholders. Transparency: Evaluation activities should reflect an attitude of openness and transparency. Accuracy: Evaluations should be technical accurate, providing sufficient information about the data collection, analysis, and interpretation methods so that its worth or merit can be determined. Participation: Stakeholders should be consulted and meaningfully involved in the evaluation process when feasible and appropriate. Accountability: Evaluations should be conducted ensuring the accountability by adequately documenting the evaluation process and products, aligning evaluation practice with an equity approach, and implementing the recommendations into actions It is also expected that the evaluation will respect the seven Fundamental Principles of the Red Cross and Red Crescent: 1) humanity, 2) impartiality, 3) neutrality, 4) independence, 5) voluntary service, 6) unity, and 7) universality. Further information can be obtained about these principles at: www.ifrc.org/what/values/principles/index.asp Evaluator(s) qualifications The evaluation should be conducted by an individual consultant or multidisciplinary evaluation team with demonstrated experience in digital health, health systems, telemedicine, and the Ukrainian health sector. Given the technical and strategic scope of the assignment, the evaluation team should collectively possess the following minimum qualifications and competencies: Academic qualifications: Advanced university degree (Master’s degree or equivalent) in public health, health sciences, health systems, digital health, health informatics, information technology, cybersecurity, economics, social sciences, or another relevant field. A PhD or equivalent advanced qualification would be an advantage. Evaluation experience: At least 5-7 years of demonstrated professional experience in monitoring, evaluation, health systems assessment, digital health assessments, or related research and consultancy assignments. Telemedicine and digital health: Demonstrated experience in assessing, designing, implementing, or evaluating telemedicine, digital health, eHealth, mHealth, or other technology-enabled health services, preferably including remote consultation models and integration with primary health care. Health systems expertise: Strong knowledge and demonstrated experience in health systems analysis, including service delivery models, primary health care, health workforce, referral pathways, patient access, quality of care, and institutional capacity. Telemedicine design and operational models: Demonstrated ability to assess and develop appropriate telemedicine service delivery and operational models, including workflows, roles and responsibilities, referral mechanisms, clinical governance, human resources, equipment, connectivity, and implementation requirements. Ukraine health sector experience: Demonstrated knowledge of the Ukrainian health system, including relevant health-sector institutions, primary health care structures, digital health developments, and the operating environment. Experience working with Ukrainian health authorities, health providers, or other relevant stakeholders would be highly desirable. Legal and regulatory expertise: Demonstrated understanding of the legal, regulatory, ethical, and data-protection requirements relevant to telemedicine and digital health services in Ukraine. Cybersecurity and data governance: Proven competence in assessing cybersecurity, patient data protection, information security, data governance, privacy, and associated risks within digital health or health information systems. Health information systems and interoperability: Experience assessing technical infrastructure, digital platforms, health information systems, interoperability, data exchange, connectivity, hardware/software requirements, and integration with existing health information systems. Costing and financial analysis: Demonstrated experience in cost analysis, resource requirements, budgeting, and financial modelling for health or digital health interventions, including assessment of implementation and recurrent costs. Sustainability and scalability: Demonstrated experience assessing institutional, financial, technical, and operational sustainability, as well as the potential for scale-up and integration into existing health systems. How to apply To get the complete tender package including detailed ToR, Please send an email to zubair.ahmad.keen@redcross.no by 26.Sep.2026 Proposals will be ranked according to how they fulfil the three following requirements: • Team qualifications (40%) • Methodological approach (35%) • Price (25%) Interested candidates should submit their application material by 04.Sep.2026 to: • Hassaan Zafar – Regional Support Manager, Europe region, Norwegian Red Cross, hassaan.zafar@redcross.no • The “TECHNICAL PROPOSAL” and “FINANCIAL PROPOSAL” Shall be submitted in separate emails • The email containing the “TECHNICAL PROPOSAL” shall have the subject below: SUBJECT: 4008.001 RFP 001- TECHNICAL PROPOSAL The proposal shall be submitted with the following attachments: • Annex 1 General Terms & Conditions for Services – accepted • Annex 2 Requirements/ Terms of reference - acknowledged • Annex 4 Supplier Registration Form – acknowledged • The email containing the “FINANCIAL PROPOSAL” Shall have the subject below: • SUBJECT: 4008.001 RFP 001 - FINANCIAL PROPOSAL • The proposal shall be submitted with the following attachments: • Annex 3 Pricing template – filled, signed, and stamped • The financial proposal must be signed and stamped clearly indicating the name of the person authorized to sign. • The proposals shall be submitted to the email hassaan.zafar@redcross.no • Failure to follow instructions may lead to disqualification. Application materials should include: • Curricula Vitae (CV) for all members of the team applying for consideration. • Cover letter clearly summarizing your experience as it pertains to this assignment, your daily rate, and three professional references. • A brief description of your firm or institution (for applicants other than individual contractors). • Technical proposal not exceeding five pages expressing an understanding and interpretation of the TOR, the proposed methodology, and a time and activity schedule. • Financial proposal itemizing estimated costs for services rendered (daily consultancy fees), accommodation and living costs, transport costs, and any other related supplies or services required for the evaluation. • Two examples of an evaluation report most similar to that described in this ToR. Application material is non-returnable, and we thank you in advance for understanding that only short-listed candidates will be contacted for the next step in the application process. According to Norwegian tax law, Norwegian Red Cross can only enter consultancy contracts with companies registered as legal entities with their respective tax authorities. For individual consultants, temporary employment contracts are signed. Contracted consultants shall sign the Norwegian Red Cross “Standard Procurement Terms and Conditions” and the “Code of Conduct for Corporate Social Responsibility for Suppliers to the Norwegian Red Cross”. Consultants are responsible for buying their own travel and health insurance. NoRC security regulations must be followed, including signature of proof of life and acknowledgement of risk. A security briefing will be provided prior to departure and upon arrival in country. Field Security Rules will be shared prior to travelling. The consultancy firm needs to ensure that the individuals who will travel to Ukraine have the necessary visas to enter the country. Consultants are responsible for their travels themselves both nationally and internationally. Qualitative and quantitative research: Proven experience designing and implementing qualitative and quantitative data collection, including stakeholder interviews, key informant interviews (KIIs), focus group discussions where appropriate, surveys, data analysis, and triangulation of findings. Stakeholder engagement: Demonstrated ability to engage effectively with a broad range of stakeholders, including Ministry of Health representatives, eHealth/digital health experts, telemedicine providers, primary health care managers, frontline health workers, Ukrainian Red Cross Society staff, programme partners, and patients/end-users. Concept and strategic development: Demonstrated ability to translate assessment findings into practical recommendations, implementation options, and a structured concept note for a potential telemedicine intervention. Red Cross/Red Crescent experience: Knowledge and experience working with the International Red Cross and Red Crescent Movement or National Societies would be an advantage. Communication and reporting: Excellent analytical, report-writing, presentation, and communication skills in English. The ability to communicate complex technical findings clearly to both technical and non-technical audiences is required. Local language: Working knowledge of Ukrainian and/or Russian would be an advantage, particularly for stakeholder consultations and engagement with health providers and patients/end-users. Teamwork and independence: Demonstrated ability to work independently, manage an evaluation assignment effectively, and collaborate as part of a multidisciplinary team.