Consultant -EENC

Contract

This is a No grade contract. More about No grade contracts.

Band C level

1. Purpose of the Consultancy: To provide technical support to the MoH to introduce EENC – “the first embrace” component - in one early implementing hospital in the West Bank

2. Background

In Palestine, where the neonatal mortality rate is 9,4 deaths per 1000 live births, neonatal deaths account for two thirds (66%) of deaths in children under the age of five (14,2/1000)[1]. In the West Bank, according to the most recently published findings, the neonatal mortality is higher than in Gaza - for the first time ever – and has not significatively improved over the past decade. One half of neonatal deaths occurs in the first day of life, mainly from complications related to prematurity, birth asphyxia, and infection, as well as birth defects[2].

International evidence suggests that there are several opportune moments during which prevention of newborn deaths is possible through provision of high-quality routine care during labour, delivery and the immediate postpartum period.[3] Additional deaths can be prevented through simple actions for prevention and care of preterm, low-birthweight babies and sick newborns. Hence, the focus of attention needs to include not just the time after birth, but also the time during labour and delivery. Hence, even where a high proportion of births are attended by skilled health professionals, there is a need to ensure that quality essential care is provided during all these critical moments.

In the West Bank, past studies have shown that health workers often use outdated and harmful clinical practices during and after delivery which increases risk for newborn morbidity and mortality[4],[5],[6],[7]. CS rate in the WB is high and has alarmingly increased over the last decade[8].The risk of death associated with caesarean sections (CS) was found to be six times higher than the risk associated with normal delivery[9].

To redress this challenge, in 2017 the ministry of health in Palestine has endorsed the Every Newborn Action Plan[10]. One main focus of the plan is on improving the quality of care at health facilities - where 99,9% of all deliveries occur - using early essential newborn care (EENC)[11]. Implementation of EENC involves coaching health facility staff on appropriate childbirth and immediate newborn care practices using adult learning methodologies. Subsequently, a quality improvement approach is used to address contextual factors that influence practice such as local policies, reorganization of work spaces, health worker roles, sequencing of tasks, and availability of supplies and equipment.

Planned steps

1. Alia Hospital, Hebron; Medical Complex, Ramallah; Rafidia Hospital, Nablus have been identified by the MoH, where clinical coaching should begin. One of them will be selected to be targeted during 2021, while the others will follow.

• Potential to become centers of excellence (CoE)
• Can facilitate coaching in all hospitals over time

2. Conduct first EENC clinical coaching for key staff at the targeted hospitals (5-days: coaching of facilitators)

• Select staff for coaching from obstetrics, pediatrics, neonatology, midwifery (about 12 per hospital)
• External WHO facilitators
• Develop 6-month plan of hospital activities

3. Form a EENC hospital team in each implementing hospital

• 6-12 members from obstetrics, pediatrics, neonatology, midwifery
• Formally endorsed by hospital manager
• Oversee hospital EENC introduction and scale-up, including procuring supplies and planning coaching

4. Scale-up EENC coaching for key staff in implementing hospitals (2 days: coaching of staff)

• Done by EENC facilitators and supported by the national consultant
• Keep database of staff coached and written and practice scores

5. Update newborn policies, protocols and plans (in tandem with clinical coaching)

• Adapt, approve and introduce EENC clinical pocket guide (In agreement with the new National Neonatal Protocols)
• Modify hospital standing orders and work guidelines as needed
• Develop annual plans for EENC scale-up after initial introduction

6. Introduce EENC quality improvement approach in implementing hospitals (2 days)

• 3-6 months after first coaching when a high proportion of staff in early implementation hospitals have been coached
• External WHO facilitators
• EENC facilitators collect practice and systems data with checklists; and use of data for identifying gaps and taking actions to address gaps
• 1-year plan of activities developed, including regular self-monitoring

7. Evaluate progress at the end of the year (5-7 days)

• Conduct EENC Annual Implementation Review (AIR)

  3. Planned timelines

Start date: 1st July 2021

End date: 15 November 2121

See the proposed activity framework attached

4. Work to be performed

Output 1**: Collect baseline data on quality of childbirth care in the West Bank**

Deliverable 1.1: Conduct data analysis and Report assessment findings on quality of care in the targeted hospital

Output 2: Conduct EENC clinical coaching

Deliverable 2.1. Conduct clinical coaching targeting 8-12 facilitators and 10-15 staff ((Module 2)

Output 3**: Conduct EENC quality assurance coaching in the targeted hospital**

Deliverable 3.1. Form a EENC hospital team

Deliverable 3.2. EENC quality coaching and process conducted with hospital team (Module 3)

Output 4: Advice the MoH on developing program supports for improving quality of EENC

Deliverable 4.1: Technical support on reviewing and updating newborn policies, protocols and plans

Deliverable 4.2: Technical support on reviewing and updating MoH indicators for routine data collection systems

Output/Activity

Tasks

Timing

Consultant support

Field Visit (FV)

Remote support (RS)

1. West Bank: EENC around time of birth

   Collect baseline data on quality of childbirth care in the targeted hospital

   - Preparation: Coordination and advocacy meetings with MoH and H managers and staff

- Data collection

-Analysis and reporting

Jul-Aug

FV RS (2 days)

FV (2 days)

RS (2 days)

Conduct EENC clinical coaching in the targeted hospital

- Clinical coaching

- Preparation and follow up: Communication, coordination, advocacy

Aug

FV (5 days)

FV RS (3 days)

Conduct EENC quality assurance coaching in the targeted hospital

- QA coaching to EENC Hospital teams. Small teams of 3 people – combined with facility reviews and actions to address gaps. Use national facilitators

- Preparation and follow up: Communication, coordination, advocacy

Oct

FV (2 days)

FV RS (3 days)

Advice the MoH on developing program supports for improving quality of EENC

- Review existing policies, guidelines, plans, propose modifications, share draft with MoH and H teams, participate to discussions, review and edit final drafts

- Review hospital impact indicators, currently available routine data, assess quality and gaps, recommend way forward

Aug-Nov

FV RS (10 days)

FV RS (10 days)

N of days: 39

- Qualifications required:

1. Medical degree with advanced degree (masters or Doctorate degree) in Public health or other relevant field

- Experience required:

1. At least 10 years of experience in developing country settings
2. At least 10 years of practical experience supporting country and health facility level planning, implementation, scale up, monitoring and evaluation of maternal, newborn and child health programmes

Desirable: Working experience in West Bank and Gaza or middle-eastern countries.

- Skills / Technical skills and knowledge:

1. Expertise in the gathering, analysis and use of epidemiological data – particularly in the area of maternal, newborn and child health
2. High level technical skill in core areas such as programme planning, management, monitoring and evaluation
3. Experience in planning and facilitation of meetings and workshops; writing and development of tools, methods and guidelines; publications in RMNCH topic areas; and advocacy and discussions with senior country staff about programme financing, policy and advocacy.

- Language requirements:

1. English language; expert level required for reading - writing – speaking

• Competencies

1. Communicating in a credible and effective way
2. Producing results
3. Ensuring effective use of resources
4. Building and promoting partnerships across the organization and beyond
5. Moving forward in a changing environment

7. Place of assignment

a. Remote support: review and development of reports, policies, guidelines; data analysis and reporting; technical backup and follow up on technical issues.

b. Field work in West Bank and Gaza: visits to hospitals; observations and interviews with mothers and staff; observations of clinical practice and of facility systems; facilitation of review meetings and planning; clinical coaching in delivery room and surgical theatre settings.

In case travel will not be possible, remote support will replace field visits. In this case, methods and tools will be developed accordingly, to allow replacing remote activities to be effective.

10. Financial offer and detailed cost and budget breakdown – consultant days (see specified n of days in the table below)

Total estimated consultant cost: 39 days x 460 US$ = 17,940 US$

Travel costs - 2400 US$ (800 x 3 trips)

Payment terms:

The total payment amount will be divided in two instalments as following:

a) The first instalment: 50% of the total value of the contract will be paid by the end of August 2021 upon the delivery of report by the consultant illustrating the achievements and progress.

b) The second and last instalment: 50 % of the total value of the contract will be paid by the end of the period of contract in November 2021 upon delivery of a final report by the consultant.

The consultant will report to Public Health Officer, Health Systems, P5, WHO oPt

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's workforce adheres to the WHO Values Charter and is committed to put the WHO Values into practice - https://www.who.int/about/who-we-are/our-values
• 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

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[1] Palestinian Central Bureau of Statistics, 2021. Palestinian Multiple Indicator Cluster Survey 2019-2020, Survey Findings Report, Ramallah, Palestine.

[2] Validation of UNRWA survey findings on Infant Mortality in Gaza: Summary of Main Findings, August 2016.World Health Organization (WHO), Ministry of Health (MOH), UNWRA

[3] Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L, Lancet Neonatal Survival Steering Team. Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet 2005;365:977–88.

[4] Wick L, Mikki N. Childbirth in Palestine. Reported practices and evidence-based guidelines. Birzet University, 2004

[5] Wick L, Mikk N, Giacaman R, Abdul-Rahim HF: Childbirth in Palestine. Int J Gynaecol Obstet, 2005.

7 H.Bitar S, Narrainen S, ‘Shedding light’ on the challenges faced by Palestinian maternal health-care. Midwifery 2009

[7] H.Bitar S, WickL. Evoking the Guardian Angel: Childbirth Care in a Palestinian Hospital. Repr. Health Matters 2007

[8] The WHO states that no region in the world is justified in having a caesarean section rate greater than 10–15 percent

[9] Abdo SA, JarrarK, El-Nakhal S. Report on Maternal Mortality in Palestine, 2010

[10] Every Newborn Action Plan: Strategic Action Plan for neonatal care in Palestine 2017-2019.

[11] Health Annual Report Palestine 2018, PCBS, July 2019

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Added 2 years ago - Updated 2 years ago - Source: who.int