CHW Service Package and training Guide Development consultancy

Contract

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UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. To save their lives. To defend their rights. To help them fulfill their potential.

Across 190 countries and territories, we work for every child, everywhere, every day, to build a better world for everyone.

And we never give up.

For every child, a champion

Madagascar faces major health challenges. Respiratory infections, diarrheal disease, malaria, malnutrition, maternal and neonatal mortality, poor hygiene and sanitation, and limited water infrastructure are a burden on Madagascar’s families, its communities, its health system, and the economy. With limited access to basic health services, every day 100 Malagasy children die primarily from common and preventable illnesses and 10 Malagasy women die from complications related to pregnancy and childbirth. The country’s high maternal mortality rate has essentially remained unchanged for more than two decades. Across Madagascar utilization of health services is low; over the past several years, use of health services has remained at about one-third, the key reasons being cost of and distance to services.

CHWs have long been recognized for their role in reducing mortality and morbidity, and in expanding access to health services in low-resource settings. CHWs play a critical role in linking their communities to the health system and often serve as the first point of care. They provide care that is culturally appropriate and cost-effective, while also encouraging the community to be more engaged in health results. Working in many of Madagascar’s 22 regions, 119 districts, 1579 communes, 17,485 fokontany (here “villages”), and 121,679 localities, many CHWs receive a small income from socially marketed products.

Despite significant progress towards achieving its Millennium Development Goals, Madagascar was unable to meet many of its targets. The Government of Madagascar has identified community health as a priority for improving health outcomes and is therefore updating its National Community Health Policy and Strategy. At the institutional level, Madagascar has a National Community Health Policy (PNSC) document in 2009 and updated in July 2017 which aims to improve the health status of the community through: (i) participation in socio-sanitary actions in the implementation of development programs and services and (ii) optimal access to an integrated package of promotional, preventive, curative, adaptation, emergency and monitoring activities. Several implementation documents have been developed including the National Strategic Plan for Strengthening the Community System 2019-2030 (PSNRSC, August 2019), Interministerial Decree 8014/2009 on Health Committees (CoSan); the 2018 Community Agents Package (PAC) Guide, the Community Activities Monthly Report (RMA); the Curriculum on Mobile Community Health (CommCare), etc.

The support for CHWs and their integration into health systems and communities are uneven across and within Madagascar; good-practice examples are not necessarily replicated and policy options for which there is greater evidence of effectiveness are not uniformly adopted. There is a need for evidence-based guidance on optimal health policy and system support to optimize the performance and impact of these health workers.

Purpose

The primary focus of the consultancy will be to review and develop an integrated national service Package and curriculum for the training of CHWs and their supervisors. The curriculum development is essential in continuing to institutionalize the CHW program, contributing to comprehensive healthcare delivery at the community level. This is an essential requirement to

ensure the sustainability of the National CHW program. Outputs from this consultancy will provide the foundation for sustainable community health interventions with an integrated approach. Additionally, the result will be a more comprehensive and coordinated national CHW program.

Methodology

The development of the Community health Package of service and training guideline will the standard WHO approach: review at national and regional level of the relevant literature on service package and community health, the assessment of the quality of the evidence including the assessment of the certainty of the evidence. The Training guide will incorporate key elements of supportive supervision and continuous monitoring and mentorship, data collection and supply systems. A Community health technical working Group, comprising a geographical representation across different constituencies (including policymakers, end-users of guidelines, experts, health professional associations, CHWs and labor union representatives) will guide the formulation of packages and training guide, with the support of a Steering Committee. Technical review workshops will serve as major platform for stakeholder engagement and validation of outcomes.

How can you make a difference?

The consultant will be expected to carry out the following tasks:

1. Support the MoH in the development of a comprehensive and integrated national Community Health Worker Package of Services and curriculum
2. Lead in the development of the CHW competency framework informed by the integrated approach of the National CHW Program.
3. Identify subject matter experts to develop training content of each module for consolidation and structuring by the consultant
4. Facilitate a multi-stakeholder consultation to include the CHW themselves to feed into the content, contributing to adaptations as per local social determinants and cultural practices
5. Develop modalities for pre-service training ( e-learning, theory, practical’s), competency based certification approach for CHWs who successfully completed pre-service training
6. Establish detailed plan and timeline for curriculum finalization and National CHW Program initial training schedule
7. Collaborate with DSSB/DFP and partners to facilitate pre-service training of CHWs i.e. develop training plan, rollout master and cascaded trainings using the approved curriculum
8. Coordinate activities relating to curriculum development and training (organization of meetings with MoH and partners, stakeholder engagement, etc) under the guidance of UNICEF from curriculum development to printing/dissemination
9. Facilitate complex multi-stakeholder conversations at both subnational and national levels to build consensus around the CHW package and multisectoral collaboration/coordination relating to the CHW program.
10. Lead in collaboration with MoH, partners, and internal UNICEF team the development, finalization, review, and assembly of facilitator guides, job aids, community based information system tools, supervision toolkit, and other curriculum materials to ensure consistency with CHW curriculum, national policy and MoH requirements while meeting MoH deadlines and in response to MoH needs
11. Support external relationship management in partnership with practice area lead, including regular communications and presentations.

Expected Deliverables

Deliverables outlined below, to be due on a timeline to be agreed at the start of the contract. A time-bound work plan for the deliverable in Table 1 below will be developed by the consultant in the 1st week of the assignment.

TABLE 1. Deliverables

Deliverables

Working days

Payment Schedule

1. Inception report (after Desk Review of key documents- national strategies and policies, secondary data and 2018 Guide PAC, and Key informants’ interviews) that present the Community Health landscape analysis in Madagascar

12 days

10%

2. Review the ongoing work on development of Guide PAC and develop an evidence-based package of community interventions along the continuum of care

7 days

15%

3. Present data and package of interventions for review/discussion with key stakeholders at national stakeholder workshop

1 days

4. Development of guidance for CHW preservice training that should include: CHW selection criteria, Pre-service training duration, Competency domains for the curriculum for pre-service training of CHWs, Modalities for pre-service training ( e-learning, theory, practical’s), Competency based certification approach for CHWs who successfully completed pre-service training and training Plan

30 days

20%

5. Development of guidance supportive supervision and continuous monitoring and mentorship of CHWs: appropriate supervisor-supervisee ratio allowing for meaningful and regular supports

10 days

15%

6. Review existing tools and develop guidance for Data collection and use for Community health interventions: how CHWs will collect, collate and use health data on routine activities, including through relevant mobile health solutions, minimizing the reporting burden and harmonizing data requirements; ensuring data confidentiality and security; equipping CHWs with the required competencies through training; and providing them with feedback on performance based on data collected.

10 days

15%

7. Review existing supply systems for community health inputs and drugs and develop strategies for ensuring adequate availability of commodities and consumable supplies, quality assurance, and appropriate storage, stocking and waste management; integration in the overall health supply chain; adequate reporting, supervision, compensation, work environment management, appropriate training and feedback, and team quality improvement meetings.

30 days

15%

8. Present CHW preservice training curriculum, supportive supervision guide, data collection and Use tools and supply system strategies for validation at national Community health Technical working group meeting

5 days

10%

To qualify as an advocate for every child you will have…

Academic qualification

• An Advanced university degree (Master’s or higher) in public health, pediatric health, family epidemiology, or community health related sciences is required.
• A minimum of Eight (8) years of relevant professional work experience at the national and international levels in the area of planning and management and/or in relevant areas of maternal neonatal and child health care, experience working with community health programs, training material development and training facilitation is required.
• Good experience in Monitoring and evaluation or management information systems at country level will be an asset
• Prior relevant experience in health/nutrition program/project development and management in any UN system agency or organization is an asset.
• Experience working in a developing country is considered as an asset.
• Relevant experience in a UN system agency or organization is considered as an asset.
• Fluency in English is required. Knowledge of another official UN language (Arabic, Chinese, French, Russian or Spanish) is an asset.

Languages - Written and spoken fluency in both French and English (English desirable, French required)

For every Child, you demonstrate…

UNICEF's values of Care, Respect, Integrity, Trust, and Accountability (CRITA) and core competencies in Communication, Working with People and Drive for Results.

The UNICEF competencies required for this post are...

• Strong analytical, negotiation, oral and written communication skills
• Effective presenter including ability to adapt the message and visual aids for multiple audiences to deliver concise, impactful presentations of primary health care interventions.
• Effective facilitator with proven ability to engage and train a group of individuals at national level and for front line health workers as well
• Ability to work in a multi-cultural environment

Evaluation criteria

The application package must include: 1. A letter of motivation for the application 2. A detailed CV 3. A technical proposal (understanding of the Terms of Reference, methodological approach, timeline, etc.) for the service delivery. 4. Copy of the most relevant diplomas and certificates. 5. Total financial proposal (fees) for the completion of the tasks, submitted in a separate file and established according to the following model:

The selection of applications will be made on the basis of the criteria of the standard UNICEF selection matrix.

Administrative issues

The consultant will work under the supervision of the Health Specialist, Health Systems Strengthening who will be responsible for the general coordination and scheduling and in close collaboration with the Chief of Health. Weekly meeting will be held between the consultant and its supervisor t TOR for Community Health Package and training Guide Version 1.pdf TOR for Community Health Package and training Guide Version 1.pdfo discuss progress and adjustments. The Madagascar Health team will provide inputs along the different processes and will be consulted. The consultant will be provided with a desk office but will be using his/her own personal computer. The regular office hours will apply to the consultant. The payments will be made subject to the submission of progress reports.

To view our competency framework, please visit here.

Click here to learn more about UNICEF’s values and competencies.

UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization.

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.

Remarks:

Mobility is a condition of international professional employment with UNICEF and an underlying premise of the international civil service.

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.

Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures, and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws.