Consultancy - to support integration of noncommunicable diseases (NCDs)

Contract

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1. Area of expertise :

Department: NMH

2. Background

The general purpose of this consultancy is to support integration of noncommunicable diseases (NCDs), including diabetes, in Primary Health Care (PHC) in the Eastern Mediterranean Region, focusing on patient empowerment and self-care management.

· The specific objectives are:

- To support the efforts on implementing the regional Therapeutic Patient Education (TPE) curriculum in the Eastern Mediterranean Region, including a Training of Trainers pilot in selected countries.

- To support evidence generation on diabetes comorbidities and complications in the Eastern Mediterranean Region.

- To provide technical support to integration of NCDs into PHC in Lebanon, including training and coaching, curriculum development/review, health literacy material development and testing, with focus on vulnerable contexts, in line with people-centred primary health care (PCPC) approach.

The WHO’s Global Action Plan for the Prevention and Control of Noncommunicable Diseases (NCDs) 2013-2020 recommends “empowering people with NCDs to seek early detection and manage their own condition better, and provide education, incentives and tools, for self-care and self-management, based on evidence-based guidelines, patient registries and team-based patient management including through information and communication technologies such as eHealth or mHealth”.

Therapeutic Patient Education for NCD:

Therapeutic Patient Education (TPE) is a structured, organized, person-centred learning process. It is defined as educational activities essential to the management of pathological conditions, managed by healthcare providers (HCPs), duly trained in the education of patients and designed to help a patient (or a group of patients and their families) to manage their treatment and prevent avoidable complications, while keeping or improving their quality of life. It is considered as a cornerstone and essential part of treatment and long-term management of NCDs in which it uses coordinated, patient-centred approach that is tailored to patients' needs, resources, environment, values and preferences. It allows patients to improve their knowledge and skills not only concerning their illness but also their treatment. It enables them to make informed decisions, cope with the daily routines of complex chronic illness, change their behaviour and monitor their illness on a daily basis. It brings a better quality of life, a greater therapeutic treatment compliance and a reduction in complications. Many health care providers, however, lack the skills to provide their patients with such an education giving that the training models currently focus on the biomedical aspects only.

Therefore, TPE training program for care providers is a necessity to acquire this skill and empower patients. It is also essential to identify the relevant multidisciplinary cadre in conducting the therapeutic education, the patient pathway, and the appropriate setting in which this can be incorporated within the primary care level. Developing a training program for TPE in the region that builds on existing initiatives and courses identified through a situation analysis is important to guide countries on implementing TPE as part of existing care models. Additionally, evidence-based TPE practice guidelines can also guide health care providers on the comprehensive approach and key components to conduct a well-structured TPE.

In the Eastern Mediterranean region, the knowledge about existing TPE programmes is limited. However, there is a large scope for implementing TPE programmes, as the burden of NCDs is growing dramatically and countries will need to encourage people to self-manage their conditions to improve outcomes and lessen the burden on the health system both in stable and humanitarian settings.

Complications and comorbidities:

Poorly managed diabetes can have severe consequences, as it significantly increases the risk of complications and comorbidities. Uncontrolled blood sugar levels can lead to damage to blood vessels and nerves, resulting in cardiovascular problems, kidney disease, and nerve damage. Additionally, the compromised immune system in individuals with poorly managed diabetes makes them more susceptible to infections and delayed wound healing, emphasizing the critical importance of effective diabetes management to prevent these detrimental outcomes.

Therapeutic patient education plays a crucial role in mitigating the risks associated with poorly managed diabetes. By providing individuals with diabetes the knowledge and skills needed to effectively manage their condition, educational programs empower patients to control their blood sugar levels, adhere to medication regimens, and adopt healthy lifestyle practices. Through targeted education, patients can better understand the implications of uncontrolled diabetes, enabling them to make informed decisions that contribute to improved self-care and reduced complications, ultimately enhancing their overall quality of life.

In the region, there is a noticeable lack of comprehensive data on comorbidities and complications related to diabetes. To effectively advocate for enhanced focus on these critical areas, gathering more detailed information is essential.

NCD integration: the case of Lebanon

Lebanon has been impacted by multiple crises, including a major economic crisis followed by a historic devaluation of the Lebanese pound, the COVID-19 pandemic and recovery from it, a cholera outbreak, the Beirut port explosion, and continuous civil unrest.

Efforts to integrate NCDs into PHC, with a focus on vulnerable contexts, are essential to address the growing burden of NCDs. Such integration aligns with the principles of People-Centred Primary Care (PCPC), emphasizing accessibility, equity, and quality service delivery. Tailoring interventions to meet the specific needs of vulnerable populations is crucial to address disparities in healthcare access and outcomes.

In Lebanon, the MOPH has integrated NCDs in the health service package at PHC centres. There are approximately 300 PHC centres that are part of the national MOPH network whereby they benefit from in-kind support such as essential medications and training, amongst others. As part of WHO support to strengthen the PHC system, WHO supported the MOPH in reviewing the basic benefit packages and developing the clinical algorithms of care for the most common conditions at PHC, conducting clinical chart audit to monitor the quality of care, as well as providing continuous capacity building for health care professionals. WHO is implementing a project on integrating PCPC approach in PHC. This project includes working closely with the PHC centres on identifying and reprofiling the core care team and providing training and on-the-job coaching, training nurses on the recently developed nursing curriculum, as well as establishing people participation groups. In addition, WHO has been implementing a project in central prisons, aiming at strengthening the prison health system, and improving access to health and mental health services, in line with the national essential packages of care used at the PHC level. Proposed interventions

We propose to recruit a senior public health expert to provide technical support for the integration of NCDs, including diabetes, in PHC in the Eastern Mediterranean Region. Specifically, the senior public health expert will support in the following areas:

· Support the implementation of the recently developed regional curriculum for Therapeutic Patient Education in selected countries, including the development of relevant technical and information, education and communication material, in close coordination with the EMRO expert working group on TPE.

· Conduct training workshops including training of trainers and coaching for health care professionals, with focus on NCDs at PHC in line with the PCPC approach and the TPE regional curriculum.

· Support the generation and compilation of data and knowledge on NCDs, with specific focus on diabetes complications and comorbidities.

· Support in coordinating NCD related activities with the working group.

3. Deliverables

The consultant is expected to do the following:

Output 1: Support the adaptation technical materials and curriculum for therapeutic patient education with a focus on Diabetes in EMR, in preparation for the pilot in selected EMR countries

- Deliverable 1.1: Support facilitation of implementation meetings at regional and country level.

- Deliverable 1.2: Develop material for country implementation, in close coordination with the Regional expert working group on TPE. This includes context adapted reference guide, facilitator guide, participant guide.

- Deliverable 1.3: Support capacity building activities in country, by facilitating the TPE Training of Trainers sessions in at least one of the pilot sites.

Output 2: Support data generation and compilation on diabetes comorbidities and complications in the Eastern Mediterranean region

- Deliverable 2.1: Conduct a desk review situation analysis on data availability and gaps of diabetes comorbidities and complications in the Eastern Mediterranean Region

- Deliverable 2.2: Prepare a report and manuscript on the status of diabetes comorbidities and complications in the EMR.

- Deliverable 2.3: Conduct situation analysis and review of the NCDs related strategies and plans in one EMR country, with a report including recommendations.

Output 3: Support the integration of the people-centred primary care approach in Lebanon, with focus on noncommunicable diseases with focus on vulnerable contexts

- Deliverable 3.1: Prepare and pilot health literacy materials including Information Education and Communication materials as well as training materials on NCDs, in line with PCPC approach, WHO guidelines, and vulnerable contexts.

Deliverable 3.2: Conduct qualitative interviews with PHC staff and beneficiaries and conduct thematic analysis around NCDs and PCPC at PHC to understand the continuity of care for PLWNCDs and prepare recommendations report

4. Planned timelines: (6 months – subject to confirmation)

Start date: 10/06/2024

End date: 10/12/2024

5. Qualifications, experience, skills and languages

Educational Qualifications:

-Essential : Master’s degree in nutrition and dietetics, public health or related field.

-Desirable: PhD in one of the above fields.

Experience

Essential:

· 5 years’ working experience in nutrition and dietetics

· Experience working with self-management of diabetes

· Experience of developing educational material

· Experience of working in the Eastern Mediterranean Region

· International experience is mandatory.

Desirable:

· Previous working experience in vulnerable settings

· Previous working experience with WHO

Skills/Knowledge:

o Strong communication, interpersonal and organizational skills; training experience.

o Computer Skills: Good knowledge of the Microsoft Office including Word.

o Research skills (qualitative and quantitative).

o Training skills.

o Counselling skills.

Languages and level required :

· Excellent knowledge of English and French.

6. Location

Off site, with visits to health facilities in 1-2 countries

7. Travel

The consultant may be expected to participate in country visits and workshops related to the TPE pilot implementation.

All travel arrangements will be made by WHO – WHO will not be responsible for tickets purchased by the Consultant without the express, prior authorization of WHO. While on mission under the terms of this consultancy, the Consultant will receive subsistence allowance.

Visas requirements: it is the consultant’s responsibility to fulfil visa requirements and ask for visa support letter(s) if needed.

8. Remuneration and budget (travel costs are excluded):

a. Remuneration: Payband level - B

b. Expected duration of contract: 6 months

(Maximum contract duration is 11 months per calendar year)

9. Medical clearance

The selected Consultant will be expected to provide a medical certificate of fitness for work.

The selected Consultant will work under the supervision of:

Responsible Officer:

Medical Officer

Manager:

NMH Director

Additional Information

• This vacancy notice may be used to identify candidates for other similar consultancies at the same level.
• Only candidates under serious consideration will be contacted.
• A written test may be used as a form of screening.
• If your candidature is retained for interview, you will be required to provide, in advance, a scanned copy of the degree(s)/diploma(s)/certificate(s) required for this position. WHO only considers higher educational qualifications obtained from an institution accredited/recognized in the World Higher Education Database (WHED), a list updated by the International Association of Universities (IAU)/United Nations Educational, Scientific and Cultural Organization (UNESCO). The list can be accessed through the link: http://www.whed.net/. Some professional certificates may not appear in the WHED and will require individual review.
• For information on WHO's operations please visit: http://www.who.int.
• WHO is committed to workforce diversity.
• WHO has a smoke-free environment and does not recruit smokers or users of any form of tobacco.
• Applications from women and from nationals of non and underrepresented Member States are particularly encouraged.

· WHO prides itself on a workforce that adheres to the highest ethical and professional standards and that is committed to put the WHO Values Charter into practice.

• WHO has zero tolerance towards sexual exploitation and abuse (SEA), sexual harassment and other types of abusive conduct (i.e., discrimination, abuse of authority and harassment). All members of the WHO workforce have a role to play in promoting a safe and respectful workplace and should report to WHO any actual or suspected cases of SEA, sexual harassment and other types of abusive conduct. To ensure that individuals with a substantiated history of SEA, sexual harassment or other types of abusive conduct are not hired by the Organization, WHO will conduct a background verification of final candidates.
• Consultants shall perform the work as independent contractors in a personal capacity, and not as a representative of any entity or authority. The execution of the work under a consultant contract does not create an employer/employee relationship between WHO and the Consultant.

• WHO shall have no responsibility whatsoever for any taxes, duties, social security contributions or other contributions payable by the Consultant. The Consultant shall be solely responsible for withholding and paying any taxes, duties, social security contributions and any other contributions which are applicable to the Consultant in in each location/jurisdiction in which the work hereunder is performed, and the Consultant shall not be entitled to any reimbursement thereof by WHO.

• Consultants working in Switzerland must register with the applicable Swiss cantonal tax authorities and social security authorities, within the prescribed timeframes (Guidelines issued by the Swiss Mission are available at: <https://www.eda.admin.ch/missions/mission-onu-geneve/en/home/manual-regime-privileges-and-immunities/introduction/Manuel-personnes-sans-privileges-et-immunites-carte-H/Non fonctionnaires et stagiaires.html>

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Added 1 month ago - Updated 1 month ago - Source: who.int