Consultancy to conduct Situational Assessment of Children’s Environmental Health ( Bhutanese National only)

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 has every child’s right to survive and thrive.

National consultant to conduct Situational Assessment of Children’s Environmental Health

How can you make a difference?

Purpose of Activity:

Climate change and environmental degradation threaten to reverse progress on child and adolescent survival, health, and well-being. Children worldwide face a host of environmental hazards, like pollutions from air water and food; exposure to toxic chemicals; unsafe infrastructure; and threats related to climate change. In 2021, UNICEF established the Healthy Environments for Healthy Children framework, which identifies the key hazards affecting child health and development globally. The framework emphasizes the dangers of lead poisoning in children and children’s exposure to lead pollution and its subsequent neurological, cognitive, and physical consequences. Emerging evidence demonstrates that not only climate but also environmental hazards from lead poisoning to plastic pollution pose a greater threat to children than previously understood.

Bhutan has witnessed unprecedented progress in child health over the last two decades in terms of reduction of child morbidity, mortality, and disability. For example, the infant mortality rate has dropped from 102 in 1984 to 30 per 1,000 live births in 2017 and the neonatal mortality has dropped from 21 per 1,000 livebirths in 2012 to 16 per 1,000 livebirths in 2017. The incidence of diarrhea reduced from 24 per cent to 5.2 per cent, while the incidence of pneumonia among children reduced from 15 per cent to 5 per cent in the same period. Chronic malnutrition (stunting) in children also reduced from 37 per cent to 21 per cent in 2015. The National Nutritional Survey,2015 reported high prevalence of anemia (43.8%) among children under. According to Population Housing Census data from 2017, the disability prevalence rate for Bhutan is 2.1 per cent, which corresponds to 15,567 people. This progress correlates with improvements in health systems capability and rising living standards for people in the country.

A strong primary health care approach accompanied by a preventive and promotive model of care focused on innovations, such as introduction of new vaccines, advancements in nutrition, sanitation and hygiene, high levels of institutional delivery coverage and enhanced health-seeking behaviors have improved the health outcomes of the population. The maternal and child health targets constitute some of the most important components of the National Key Result Area of the Ministry of Health and is aligned with the 13 Five Year Plan. Furthermore, Bhutan is also committed to the Sustainable Development Goals (SDGs) which has specific targets for maternal and child health.

While substantial progress in child survival has been made, child health remains a significant public health challenge with the epidemiological transition. There are areas which have not been covered much with child survival actions such as children’s environmental health. Children’s health and wellbeing remain vulnerable to the impacts of unhealthy environments and climate change in which they live. The Toxic Truth report indicated 24,975 children in Bhutan have been identified as having high levels of lead in their blood (BLL > 5 μg/dL). Compelling proof exists that lead causes learning problems, irreversible neurological damage, and behavioral changes in children. Continuing threats to children’s health and well-being in Bhutan is a bigger call to increase investment and efforts to realize every child’s right to survive and thrive.

To better understand the situation and generate evidence on the effect of climate and environmental hazards on children in Bhutan, it is imperative to conduct a country level Children’s Environmental Health (CEH) situational assessment. The findings would assess both the status of exposure to hazards and related disease burdens as well as also support in identifying what issues need to be prioritized urgently for addressing by the Government, UNICEF, and other partners.

Scope of Work

The purpose of this consultancy is to support the Ministry of Health and UNICEF to identify environmental health policy priorities and programme directions through evidence generation on the current situation and inform policy directions on the matter. The consultant is expected to conduct an in-depth country assessment on a range of environmental hazards and risk factors, and their impact on children and adolescents in Bhutan, including local research and studies as needed and facilitating stakeholder consultations. Children Environment Health (CEH) Assessment will support to design policies, programmes and interventions on CEH and contribute to the body of knowledge on children and be used to advocate for positive change for children, i.e. in mobilizing key partners in Healthy Environment and Healthy Children (HEHC) country programming. This activity is linked to output 2.3.12 under 2023 AWP

The specific scope and objectives of the consultancy are:

1. To generate evidence on the situation of environment health, specifically from an angle of child and adolescent health. Specifically, assess the overall situation of Children’s Environmental Health issues in Bhutan, with assessment of the health status, burden of disease trends and patterns; assessment of key environmental risks; and determination of the possible associations between the health status, burden of disease and environmental risks

2. To provide evidence-base for advocacy and source for public discussions on issues surrounding the situation of children with respect to the environmental disease burdens.

3. To provide programme and policy guidance and recommendations to guide the development of interventions addressing the children environmental health issues centering around Healthy Environment for Healthy Children.

The national consultant will be supporting the Health, Nutrition WASH section at the UNICEF Bhutan Country Office using technical note of the Country Assessment on Children’s Environmental Health as a guide, to undertake the following key tasks:

A. Design and carrying out an in-depth country assessment on a range of environmental and climate hazards and risk factors to child and descent health, including but not limited to heat stress, vector-borne diseases, air pollution, lead poisoning, toxic metals and chemicals, e-waste, pesticides, other key pollutants.

• The assessment is undertaken closely, and in collaboration with the Department of Public Health under the Ministry of Health, Department of Environment and Climate Change under the Ministry of Energy and Natural Resources, Khesar Gyalpo University of Medical Science of Bhutan (KGUMSB), UNICEF and relevant national authorities and institutions. This includes desk review of existing data, key informant surveys, conducting stakeholder consultations and a landscape exercise, supporting data collection, situational analysis, and report. The output document should include:

• Brief narrative country background information (demography, geography, socio-economic status, political & governance structure).

• Brief analysis of the country’s health systems: This includes identifying leading causes of morbidity and mortality in children, relevant sectoral capacities, and both existing policies and gaps in national frameworks, monitoring tools and technologies, health infrastructure, health budget and expenditure necessary to address climate and environmental hazards adequately. This can also include a summary of existing CEH programmes in the country.

• Enabling Environment & Context:

National and global environmental governance and signatories (whether Bhutan is signatory to any key global governance framework for climate and environmental actions)

Review Legislation related to chemicals

Provide an analysis with a deep understanding of the situation by analyzing the relevant environmental health policies and strategies, social and economic trends affecting them through a human rights, equity and gender and disability lens.

Existing CEH Polices & Programmes: Summary of existing CEH programmes, policies, framework and initiatives key findings and data/information gaps, following triangulation of all information.

• Analysis of Exposures & Environmental Hazards: Determine the extent of exposure of children to environmental and climate hazards: This will include assessing the child-specific health impacts of a range of hazards that are environmental (heavy metals, toxic chemicals, hazardous waste, other environmental hazards), climactic (excessive flooding, heat stress, drought, changing vector-born disease patterns) and a combination of the two (air pollution).

• Key Partners & Stakeholder mapping: Stakeholder and partnership mapping and analysis in the environmental and climate health space (Institutional arrangements), existence of inter-agency or inter-ministerial committee, including partnerships ranging from the public to the private, academia, NGO’s / CSOs.

• Conclusions and recommendations – Summarize the situation and assessment findings, and key gaps. Develop concrete recommendations on the identification of data or evidence gaps or policy programing or capacity gaps (regulation and acts relating to chemicals management). The recommendations should describe how to address these gaps and identify change strategies that could be effective (at policy level, programme level, community / individual level). The recommendations should also include any further analysis needed to better understand the CEH situation in the country.

B. Support the Ministry of Health and UNICEF with stakeholder coordination on environmental health issues, as part of the assessment process. Specifically, consultant will provide technical support, prepare, and facilitate stakeholder meetings, as well as documentation of consultations, meetings and workshops including determination of the capacity gaps. This includes supporting evidence-based advocacy and facilitating national and sub-national stakeholder meetings and consultations with experts, program focal persons from various organizations and Ministries as required.

Approaches and Methodology

The assignment will be carried out by a national consultant using the most current information/data available. Data and information gathering could be both primary such as through Key informant interviews and secondary, by literature or desk review of the previous relevant studies and projects in the past five years. In parallel, with secondary data gatherings, primary data gathering could be done such as training need assessment to understand the capacity gaps and consultation with government stakeholders to assess what CEH relevant to programmes of note are already being implemented. The national consultant will be required to develop a work plan outlining their detailed individual and joint responsibilities in the Inception report. Progress will be reported periodically to the Chief of Health and Nutrition Section who will monitor the progress, provide further directives and endorsement of the report.

The duration of the consultancy will be for 3 months spanning from August, September, October and November 2023 (equivalent to 60 working days) ( 60 working days)

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

Qualification:

• Minimum education certification for a master’s or post-graduate degree in Environmental Health, Public Health, Medical Sciences, Epidemiology, Health research or any other related disciplines

Experience:

• Minimum five (5) years’ work experience in the areas of public health, environmental health

• Demonstrated experience in design of studies and assessments, and conducting research related to the environment, environmental health, child’s health, pollutants and/or toxic metals

• Experience in capacity building, government relationship building, training and/or facilitation an asset

• Knowledge of research, monitoring, and evaluation methods, both quantitative and qualitative, and statistical methods and software

• Understanding of public health systems and policies related to environment and health in Bhutan.

• Excellent Communication and Presentation skills

• Drive for results, Works collaboratively with others

• Manages ambiguity and complexity

• Builds and maintains partnerships

Submission of Proposals and Evaluation Criteria

Proposal should include the following:

Consultant’s qualification and experience with detailed CV.

Approach and methodology that will be followed in executing the assignment.

A lump sum fee in local currency indicating a breakdown of professional fee for the anticipated number of working days/months, including fee for travel if local travel is required (per day basis)

Name(s) of collaborator(s) with CVs (if applicable) with their full curriculum vitae.

Reference to similar work (final products or links to previous work can be shared along with the proposal)

Submit the proposal online. No hard copies or through mail will be accepted. For any technical clarification contact Mr. Kinley Dorji, Health and Nutrition Officer @kidorji@unicef.org and for general information Mr. Laxmi Narayan Upreti @ lupreti@unicef.org

For every Child, you demonstrate…

UNICEF's values of Care, Respect, Integrity, Trust, Accountability, and Sustainability (CRITAS).

To view our competency framework, please visit here.

UNICEF is here to serve the world’s most disadvantaged children and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, age, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, or any other personal characteristic.

UNICEF offers reasonable accommodation for consultants/individual contractors with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment.

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:

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.

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts.