Endgame Operational Research Study EOI Web form

Please fill out the form to submit all required Expression of Interest information.

STUDY TEAM

For each investigator involved with this study please provide name, title, and email contact. Please denote lead PI.

PI Name(s)*

Denote Lead PI and Co-PI(s) if applicable

PI and Co-PI(s) Email(s)*

PI and/or Co-PI(s) Telephone Contact*

Please list the preferred telephone contact number, and contact person's name

PI and Co-PI(s) Title(s) and Institution(s)*

PI Gender*

Male

Female

Prefer not to answer

Co-Investigator Name(s) and Contact

Please list the names, titles, institution and e-mail addresses for all co-investigators.

Implementing Partners*

Please list any collaborating institutions and provide a point of contact (name and email address) associated with each.

Country Engagement*

Describe the level of engagement, if any, you had with the national or sub-national NTD program and/or local researcher when developing this study proposal.

Government Funding*

Is the contracting organization for this project financed by the government?

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STUDY DETAILS

Study Title*

Country*

Where will this study take place?

Select or enter value

Disease Focus*

Using the listed abbreviations, please list all diseases on which this study will focus and check the corresponding check boxes below. If you select "Other Disease(s)" please specify the disease(s).

Leprosy

Loa-Loa / Loasis

Lymphatic Filariasis (LF)

Onchocerciasis (OV)

Schistosomiasis (SCH)

Soil Transmitted Helminthiasis (STH)

Trachoma (TRA)

Other Disease(s)

Thematic Area*

Please choose one. If more than one option applies, please make a note in the “Thematic Area Comments” section. If the Thematic Area is Diagnostics, list the diagnostic tool(s) to be evaluated in the "Diagnostics to be Evaluated" section.

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Thematic Area Comments

Diagnostics to be Performed (if applicable)

Diagnostics to be Evaluated (if applicable)

Primary Research Priority*

Please select the main research priority this study will address.

Select

Secondary Research Priority*

Please select which additional research priorities are applicable to this work (you may select more than one).

Select

Primary Research Question*

Secondary Research Question(s)

Has this research been implemented elsewhere?

(If yes, state where)

Background and Significance*

Please describe the problem, citing any evidence from previous research or program data. Approximately 1 page maximum. If you require more space, please attach a supporting document at the end of this form.

Methods*

For each research question listed above, please discuss the specific qualitative and quantitative methods and data collection tools to be used.

Study Site(s)*

Study Population*

Examples include, but are not limited to: Children, Adult Women, Adult Men, Nomads, Migrants, CDDs, the Disabled, the Elderly, Urban Slum Dwellers, etc.

Sampling Strategy*

Number of Primary Sampling Units

Total Sample Size

Please enter total number of people to be sampled (numerical figure).

Data Collection Method*

Electronic

Paper

Mixed

Electronic Data Collection Platform*

If this study plans to use electronic data collection, please list the platform (e.g.: ODK, REDCap, LINKS) and please note if NTD-SC support is needed.

Data Analysis Plan*

For each research question listed above, briefly describe the data analysis plan, what indicators will be used, and how results will be interpreted.

Study Deliverables*

Briefly describe the proposed study deliverables within your study timeline.

Research Translation, Implications and Next Steps*

Please describe the research translation and dissemination plan, including the following: impact of study outside country of interest, how the results of the study will be integrated into the country program, and if applicable, how the results of the study will be scaled up.

STUDY TIMELINE

Please note that from the time of proposal submission, it may take up to 14 weeks for the NTD-SC review and contract process.

Expected Start Date*

Expected End Date*

Duration in Months*

Limitations to Timeline

Please list any restrictions on the proposed timeline (e.g.: planned MDA, rainy season, holidays, etc.).

FINANCING

Estimated Budget*

Please include a total budget numerical figure only.

Budget Comments

Please provide a brief overview of the study budget.

Co-funder(s)

List co-funder(s), if any exist, and describe their contribution(s) to this study.

SUPPORTING INFORMATION

File Upload(s)

Please attach the following supporting documents:

Completed NTD-SC Budget Template * (click link to download; also available here). Please provide justification for all line items and demonstrate value for money.
Letter of support from the Ministry of Health
Protocol (draft ok)
Project Timeline
Additional documentation as applicable (additional background information, references, theory of change/conceptual framework, documentation of national per diem rates, etc.)

* Note: For budgets with a currency other than USD ($), please also submit a screenshot that shows the OANDA exchange rate used, as well as the date.

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