Consultant to Review and update of the Guideline for treatment and control of STI and the Strategic Plan for Prevention and control of STIs 2

Background

Sexually transmitted infections (STIs) are a major public health problem worldwide, affecting the quality of life and potentially causing serious illness and death. STI disease profoundly affects the physical, mental, and social well-being of children, adolescents, and adults worldwide.

Some STIs directly affect reproductive and child health by causing infertility, anogenital cancer, adverse pregnancy outcomes, fetal malformations and deaths, and general health abnormalities. In addition, they have indirect effects through their role in facilitating sexual transmission and acquisition of HIV, resulting in further suffering among people living with HIV.

More than 1 million sexually transmitted infections (STIs) are acquired every day worldwide, the majority of which are asymptomatic. Each year there are an estimated 374 million new infections with 1 of 4 STIs: chlamydia, gonorrhea, syphilis, and trichomoniasis. More than 500 million people aged 15 to 49 years are estimated to have genital infections with the herpes simplex virus (HSV)[1].

HPV infection is associated with 570 000 cases of cervical cancer in 2018, and over 311 000 cervical cancer deaths each year[2].

Almost 1 million pregnant women were estimated to be infected with syphilis in 2016, resulting in over 350 000 adverse birth outcomes including 200 000 stillbirths and newborn deaths[3].

STIs have a direct impact on sexual and reproductive health through stigmatization, infertility, cancers, and pregnancy complications and can increase the risk of HIV.

Drug resistance, especially for gonorrhea, is a major threat to reducing the burden of STIs worldwide.

The burden of STIs varies by region and gender, and the burden is greatest in resource-limited countries. The WHO African Region had the highest numbers of new cases of gonorrhea and trichomoniasis among women and men.

WHO's global health sector strategy on Sexually Transmitted Infections (STIs) 2016-2021, approved by the World Health Assembly in 2016, aims to eliminate STIs being a public health threat by 2030.

In 2019, WHO published estimates of new cases of chlamydia, gonorrhea, syphilis and trichomoniasis. Recent changes in the epidemiology of STIs and advances in the prevention, diagnosis, and treatment of STIs and HIV have necessitated changes in approaches to STI prevention and management. The most widely used approach in clinical settings is the syndromic management of STIs. In most resource-limited settings, syndromic management flowcharts remain the standard of care where laboratory diagnosis is unavailable or difficult to access.

In Mozambique, routine data from the National STI-HIV/AIDS Program showed that 998,289 cases of STI's were diagnosed and treated in 2020

Considering the changing epidemiological profile of STI and to improve the quality of management of people with STI symptoms by providing practical, recent, and evidence-based recommendations, in June 2021, WHO made available to countries the updated management guidelines for symptomatic STI cases.

The National strategic plan for the prevention and control of STIs 2018-2021 came to an end last year and the Guide for Treatment and Control of Sexually Transmitted Infections (STIs) dates back more than 15 years.

With the aim of strengthening the management of STI cases to guarantee the offer of high-quality services, based on simplified and standardized interventions and services that can be taken to the national scale and considering the outdatedness of both the strategic plan and the clinical guideline, the Ministry of Health, through the National Program for STI-HIV/SIDA intends to revise its plan.

Deliverables

Three deliverables are expected namely:

Undertake situational analysis of Sexually transmitted infections in Mozambique. This product, should be achieved during the first month of the work after the signature of the contract and the main tasks are:

Comprehensive desk review that includes the Mozambique STI data analysis desegregated by Syndrome, sex, and age.

interview with key stakeholders on STI

Produce the report on the situation analysis

Promote meeting with STI Technical Working Group (TWG) for discussion, harmonization, and validation of the situation analysis report.

Updated Sexually transmitted infections (STIs) Action Plan

Updated National STI Guideline

These two deliverables will have to be worked on simultaneously and will take two months after the situation analysis report approval the main tasks are:

Review the new WHO STI guidelines and recommendations on the approach to STI at different levels of the health system

Propose the approaches to be implemented in Mozambique by the level of care and considering the capacity of the country

Elaborate on a proposal of issues to be modified in the current plan, based on WHO recommendations

Develop the proposal of issues to be modified in the current clinical guide based on the new WHO STI Guidelines and national capacities

Promote a meeting with the STI Technical Working Group (TWG) for discussion, harmonization, and validation of the proposal for updating the guideline and the Action plan.

Updated diagnostic and treatment algorithms and flowcharts for STIs. This activity depends on the approval of the updated guideline and will be carried out within one month of the guideline approval the main tasks are:

Design the new STI diagnostic and treatment algorithms and flowcharts, as approved in the guidelines

Promote meeting with STI Technical Working Group (TWG) for discussion, harmonization, and validation of the proposal of STI diagnostic and treatment algorithms and flowcharts.

Qualifications, experience, skills, and languages

Educational Qualifications

Essential: Advanced university degree in medicine with master’s in public health and/or related equivalent social sciences

Desirable: Ph.D. or Post-graduate degree/specialty in public health.

Experience: At least 5 years of progressive experience in the development of Health-related Strategic Plans.

Essential: At least 5 years of progressive experience in the development of Health-related Strategic Plans.

In-depth knowledge/experience of working with the matter related to Sexually transmitted infections (STIs).

Demonstrated experience in collaborating with different stakeholders in STIs, HIV, Key populations, and Viral Hepatitis.

Experience with technical writing, literature review, data synthesis, and report writing.

Experience in working with the Ministry of Health in a developing country.

Desirable:

Experience in international organizations such as the UN system, the Global Fund, and other

Skills/Knowledge

Good analytical, planning, and organizational skills

Ability to manage stress and time

Excellent knowledge of Microsoft Office.

Good communication, presentation, and coordination skills

Languages and level required

Very good command of the Portuguese language (advanced level)

Working knowledge of the English language (intermediate level)

Technical Supervision

The consultant will work under the supervision of the focal point at the National Program for STI, HIV, and AIDS control in the Ministry of Health

Once a week, whenever possible will meet the WHO STI, HIV, and Viral Hepatitis Technical officer (Nurbai Calú – [email protected] ) to update the progress of the consultancy

Location

Duty station: Maputo, Mozambique at National Program for STI, HIV, and AIDS control – MoH (address: Av. Eduardo Mondlane nº 1008, Maputo) and in the WHO Mozambique Country Office (address: Rua Beijo da Mulata Nr 73, Sommerschiel, Maputo)

Travel - If travel is involved, full medical clearance is required

No travel expected