Case Study Documentation of Integrated TCV-MR SIA

Background

In March 2018, WHO recommended introducing typhoid conjugate vaccine (TCV) for infants and children over six months of age in typhoid-endemic countries. This new policy expanded access to typhoid vaccination in communities most impacted by the disease. Typhoid is responsible for nearly 12 million infections and between 128,000 and 161,000 deaths yearly.

The TCV recommendations were issued following a review of evidence on TCVs by WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization in October 2017. The group considered data on vaccine safety, efficacy, feasibility, and affordability, as well as growing rates of drug-resistant typhoid. Based on these discussions, SAGE recommended TCVs for children over the age of six months.

The WHO guidelines emphasized the use of typhoid vaccines to control endemic and epidemic typhoid. Where feasible, vaccine introduction was recommended to be accompanied by catch-up vaccination campaigns for children up to 15 years of age in endemic countries. Furthermore, the position paper recommended prioritizing TCV introduction in countries with the highest disease burden or a growing burden of drug-resistant typhoid.

Given the high burden of typhoid disease in Malawi, the Ministry of Health (MOH) and its partners commenced processes to introduce the TCV vaccine into the country to control the burden of the disease.

Since the onset of COVID-19 pandemic, most countries, including Malawi have experienced declining coverage in routine immunization. The country’s Measles-Rubella coverage has been significantly affected, and the occurrence of measles outbreaks in neighbouring countries further heightens the risk of measles- rubella outbreaks in the country.

Achieving optimal immunization coverage (≥ 95%) with 2 measles- and rubella-containing vaccine doses at all subnational levels while bridging immunity gaps in all age groups is crucial for the elimination of measles and rubella.

To reduce the burden of Measles–Rubella and Typhoid whilst addressing the immunization coverage gaps, the MoH and its partners have initiated processes to introduce TCV into Malawi and conduct Supplementary Immunisation Activities (SIAs) for Measles-Rubella to reach all zero- dosed under-immunized and unreached communities with these life-saving vaccines.

It is against this background that WHO would like to hire a consultant to provide technical expertise to document a case study on TCV/MR SIA.

Task/Assignment

In collaboration with the National EPI team, the consultant will conduct the following tasks:

1. Participate and lead the effective documentation of the entire implementation of the integrated TCV and MR SIA as a case study of an integrated approach of TCV vaccine introduction and MR supplementary immunisation activity.

2. 1. Participate and lead the documentation of all planning and implementation of coordination meetings with partners and all relevant stakeholders to monitor the preparedness of the integrated SIA.
3. 2. Participate and lead the documentation of all processes involved in the development of work plans and budgets, including resource mobilization for the TCV introduction and conduct of MR SIAs.
4. 3. Participate in and lead the documentation of all processes involved in the development of integrated national implementation guidelines, training manuals for introducing the Typhoid Conjugate Vaccine, and Measles–Rubella supplementary activities highlighting best practices, innovations, challenges and mitigating measures to address challenges.
5. 4. Support and coordinate the documentation of all preparation and implementation processes for the conduct of an integrated coverage survey for TCV and MR SIAs
   5. Support and lead the documentation of all monitoring and evaluation processes of the planning, preparation, and implementation of integrated SIAs, such as for immunization data collection, data analysis, interpretation, and the use of data for identifying gaps in immunization services and for advocacy and resource mobilization. All Innovations, best practices, challenges and mitigating measures to address gaps related to monitoring and evaluation activities should be effectively documented.

6. Lead the detailed documentation of strategies, innovations, approaches employed to leverage the integrated SIA as an opportunity to strengthen routine immunization.

7. 1. Document all key strategies utilised at the national and sub-national levels for delivering immunization services in communities with zero-dose and under-immunized children to improve access and uptake of immunization services, i.e., Periodic Intensification of Routine Immunization (PIRI), etc.

8. Document all processes used for the development of a Risk Communication and Community Engagement (RCCE) strategic plan and implementation in collaboration with the communication specialist/officer

   1. Document all processes, in collaboration with the EPI team, for the development of RCCE plan in collaboration with the communication specialist/officer highlighting all key strategies and activities and the justification for those strategies.
9. 2. Document all key interventions used for the development of locally suitable communication strategies and implementation action plans for improving access to and uptake immunization services for hard-to-reached, chronically under-reached populations.

Output and Deliverable

Output 1: Planning, preparing and readiness assessment of the TCV MR SIA in Malawi

1. 1. Comprehensive Report on overall micro-plan process
   2. Comprehensive Report on SIA monitoring (data collection plan and tools) and training materials
   3. Readiness assessment (conducted using TCV MR SIA readiness assessment tool) report

Output 2: Report findings and recommendations to MoH and WHO

1. 1. A comprehensive case study for possible publication in a peer reviewed manual on overall integrated SIA activity highlighting Key Strategies, Best practices, Results, innovations, challenges, mitigation measures and recommendations to MoH, Malawi and WHO.

The cases study should include a data analysis summary of the integrated SIA implementation process and results (vaccination coverage, vaccine and supply utilization, deployment statistics, and mop-up activities, etc.)

Qualifications, experience, skills, and languages

Education Qualifications

Essential: Postgraduate degree in a public health-related field

Desirable : Specific training in Vaccinology, Epidemiology, Data Management, Research, and Public Health Policy Development and Implementation.

Work Experience

Essential: At least 10 years of relevant experience in the field of vaccine-preventable diseases and public health Experience in planning and implementing supplemental immunization activities (SIAs) for TCV and or measles-containing vaccines, including direct support to national and sub-national levels.

Desirable: Experience working in the African Region on preparing for immunization campaigns; good understanding of specific challenges in Malawi or similar setting is desirable

Skills/Knowledge

• Management skills
• Demonstrated knowledge of immunization programs for routine immunization, new vaccine introduction, and conduct of Supplementary Immunisation Activities.
• Proficiency in the use of word processing and presentation software
• Proficiency with the MR SIA Readiness Assessment Tool

Languages and level required

Proficiency in English language is required (Read - Write - Speak)

Competencies

• Teamwork
• Effective communication
• Producing results
• Knowing and managing yourself