Consultancy to support the implementation of the Telemedicine Programme in Primary Health Care, Pristina, Kosovo 1244, 40 days

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Title: Consultancy to support the implementation of the Telemedicine Programme in Primary Health Care Type of engagement: International Consultant Duty Station: Pristina Duration of assignment: 40 working days

Purpose of Activity/Assignment:

The health sector in Kosovo faces many challenges in meeting the health needs and delivering quality health services. This is more emphasized when it comes to vulnerable groups, such as rural populations, children, elderly, and marginalized communities i.e. Roma, Ashkali and Egyptian communities. Indicators for many health outcomes for the most marginalized communities are significantly worse than those of the general population, indicating deep inequities in access to quality health services. The COVID-19 pandemic has further widened the gaps in the provision and funding of health care by putting additional strain on the already weak health system. Health services in Kosovo are provided through the network of health institutions organized in three levels: primary, secondary and tertiary health care. The public network of Primary Health Care (PHC) facilities consists of 429 institutions; each of 38 municipalities has a Main Family Medicine Center (MFMC) as the main unit, and Family Medicine Centers (FMC) and Family Medicine Ambulances (AMF) as sub-units. The PHC in Kosovo provides health services based on the concept of family medicine and is led by the principles of promoting, preserving and improving the health status for all.

Although PHC serves as a first contact of people with the health system, the overall utilization of the PHC services remains low. The data on outpatient visits in public facilities data shows an average of two (2) visits per inhabitant. As a result of the disruptions caused by COVID-19 in health systems globally, the utilization of remote digital platforms as a means to provide and access health services through increased significantly. Telehealth and telemedicine, especially for follow-ups with patients were recommended by the World Health Organization as a way of maintaining essential health serviced during the COVID-19 pandemic. In Kosovo, some of the services, such as the Home Visiting programme for maternal and child health, switched to remote modality of functioning. As indicated by the assessment done by UNICEF at the time, parents continued to rely on the Home Visiting programme, even when it was delivered over phone.

This showed that, although telehealth cannot entirely replace the importance of the in-person visits, it has a significant potential for reaching more households, especially in those remote areas where in-person contact with health providers could be more difficult.

Kosovo's experience with telehealth and telemedicine dates back to 2002, with the establishment of a Telemedicine Center as part of the Kosovo University Clinical Center. Later, in 2006, the telemedicine program was expanded to the secondary level, with 6 Regional Telemedicine Centers established in the regional hospitals of six municipalities: Gjilan, Prizren, Gjakovë, Pejë, Mitrovica and Skenderaj. The network was then expanded to two other regional hospitals in the municipalities of Vushtrri and Ferizaj, covering all public institutions of the secondary health care. The Ministry of Health is committed to expanding the telemedicine program to PHC and other services, such as mental health centers and prison health services, thus covering all three levels of health care. In March 2022, the Ministry of Health established a Working group for the expansion of telemedicine to PHC, made-up of members from the Ministry of Health, PHC and the Telemedicine Center. This Working group will work on the introduction of the telemedicine program in PHC and its

integration with the Telemedicine at secondary and tertiary level, with the aim to improve the quality and accessibility of health care services in Kosovo.

In line with its programme priorities, UNICEF is supporting the Ministry of Health and PHC institutions in increasing the accessibility and quality of maternal and child health services at PHC through the digitalization of services. Within this objective, this assignment will assess the institutional needs for the introduction of the telemedicine in PHC and provide recommendations for implementation of telemedicine in PHC for uses of the Home Visiting programme and other PHC health services.

Scope of work:

Under the overall supervision of the UNICEF Health Officer, the international consultant will conduct an assessment of the national capacities for implementation of Telemedicine in Primary Health Care, recommend actions for implementation and provide technical support to the Working Group. The consultant will be supported by the Working Group through provision of documents and information to inform the assessment and the plan for implementation of telemedicine in PHC.

Within the scope of this assignment, the key expected outputs are:

  1. Conduct a needs assessment for the implementation of the telemedicine in PHC and a rapid review of the implementation of telemedicine in secondary and tertiary level of the health care system.
  2. Review the policy and legal framework for implementation of the Telemedicine Programme in Primary Health Care and provide comments for the revision of current legal and policy framework to enable functionalization of telemedicine in PHC.
  3. Develop a plan with concrete steps and technical specifications of required hardware and software for the implementation of telemedicine in PHC.
  4. Provide technical support to the Working Group established by the Ministry of Health for implementation of Telemedicine Programme in Primary Health Care.

Tasks/Milestone: Develop the inception report with the proposed methodology of the assessment, workplan and timeline Deliverables/Outputs: Inception Report developed Timeline: 30 September 2022, 5 days

Tasks/Milestone: Review of the legal framework and provide recommendations for revision of the legal framework to enable introduction of telemedicine in PHC. Deliverables/Outputs: Desk review developed Timeline: 15 October 2022, 6 days

Tasks/Milestone: Conduct field work to PHC and secondary and tertiary level, as well as other stakeholders for the needs assessment and rapid review. Deliverables/Outputs: Data collection and analysis completed. Timeline: 30 October, 10 days

Tasks/Milestone: Conduct a workshop with the established working group to draw practical suggestions on implementation of telemedicine in PHC. Deliverables/Outputs: Agenda and the workshop presentation developed in consultation with UNICEF team. Timeline: 30 October 2022, 3 days

Tasks/Milestone: Submit the first draft of the needs assessment for implementation of the telemedicine in PHC. Deliverables/Outputs: Needs assessment report drafted. Timeline: 15 November, 3 days

Tasks/Milestone: Consolidate the recommendations and inputs from the working group and submit the final document of the needs assessment. Deliverables/Outputs: Final document submitted Timeline: 30 November, 3 days

Tasks/Milestone: Informed by the needs assessment, develop a plan with concrete steps and technical specifications of required hardware and software for the implementation of telemedicine in PHC. Deliverables/Outputs: Plan submitted Timeline: February 2023, 5 days

Tasks/Milestone: Provide any technical assistance to the Ministry of Health and the working group with concrete recommendations for implementation of telemedicine in PHC, as requested. Deliverables/Outputs: Conduct meetings with MoH officials and members of the working group and submit recommendations on telemedicine. Timeline: September 2022-March 2023, 5 days

Minimum Qualifications required: Masters Enter Disciplines: Medicine, medical sciences, public health, health informatics, health management, or other fields related to e-Health.

Knowledge/Expertise/Skills required: - An advanced degree in the field of medicine, medical sciences, public health, health informatics, health management, or other fields related to e-health. - At least 7 years of work experience in the programs and projects in the field of telemedicine and/or digital health. - At least three 3 years of experience with project management and implementation, particularly in the development of the telemedicine services on a country level. Previous experience of similar assessment is considered an asset. - Excellent working knowledge of the English language

Added 4 months ago - Updated 4 months ago - Source: unicef.org