Consultants - National Rules on intrapartum care

Terms of reference for advice to update national rules on intrapartum care

Introduction:

Mozambique has made the commitments of the Sustainable Development Goals which, for maternal mortality, means reducing the overall ratio up to 70 maternal deaths per 100,000 live births, and with no country with a ratio higher than 140 per 100 million live births(LB) and, as for the neonatal mortality rate, it should not be higher than 12 deaths per 1000 NV.

Despite the remarkable progress made in the last two decades, data from the 2017 Census show that the maternal mortality rate still remains high (452 per 100,000 live births). The National Maternal Mortality Report indicates that themost common causes of maternal death are obstetric hemorrhages (especially from atony and uterine rupture), preeclampsia /eclampsia, puerperal infection, and unsafe abortion. On the other hand, there was no significant reduction in neonatal mortality (from 30 deaths per 1000 LB in 2011 to 29 in 2018), with the main causes of neonatal mortality being prematurity, neonatal asphyxia, and neonatal infections.

Most maternal and neonatal deaths are preventable and can be easily treated when the right care is provided at the right time by a qualified health professional working in a supportive environment.

The World Health Organization (WHO) in 2018 released the new Recommendations for Intrapartum Care, for a Positive Childbirth Experience, and the Guide to Care During Labor – "Next Generation Partogram". These recommendations provide an opportunity for the country to update national standards and the partogram, as well as to improve the care of women and their babies.

Thus, there is a need to Update the Standards of intrapartum care considering the latest WHO Technical Guidelinesin order to standardize the provision of quality care by the different levels of care.

Objective of the consultancy:

•The purpose of the consultancy is to review and update national standards for intrapartum care, including support for the process of adapting the new Guide to Care during Labour to the local context, to provide clinical guidance and up-to-date, evidence-based practiceson the care to be provided to the woman during labour and to the newborn during birth.

Expected product:

• Updated Intrapartum Care Standards for approval and printing;

• New Guide to Care during Labor " New Generation Partogram" adapted to the national context.

Activities to be carried out

•Present a schedule of activities to carry out the updating of intrapartum norms

•Incorporate the different revised sessions contained in the Intrapartum Care standards considering the WHO updates and recommendations and technical discussions.

•Finalization of the manual and care guide during labor including spell check to submit the printout.

•Support in the process of adaptation of the new Guide to care during Labor "partogram of the new generation"

•Facilitate a technical session with the maternal health WG for validation

Consultant qualifications:

Education:

•Medical specialist in Gynecology and Obstetrics or areas related to maternal health or social sciences

•Degree in Medicine in Post-graduation in Gynecology-Obstetrics

Professional Experience:

•Minimum proven experience of at least 5 years in the preparation of documents, strategies, Plans or Strategies for the Health sector;

•In-depth knowledge of national and international guiding documents and technical guidelines in the field of Maternal Health;

•It is desirable to have knowledge of the National Health System and the Maternal and Neonatal Health Programs

•Experience in Primary Health Care of at least l0 years.

Skills:

•Leadership skills , teamwork and communication with different partners

•Ability to produce sectoral policy and strategy documents

•Fluency in reading, writing and communicating in Portuguese and English.

Work methodology:

•The consultant will carry out the work in coordination of the DNSP - Department of Family Health of MISAU.

•The consultant should present the methodology and roadmap for product development. The different versions of the document should be presented to the Maternal and Child Technical Groups (neonatal component) for evaluation and discussion. It should also facilitate a technical session for validation. After the completion of the review and update of the materials, you should present the DNSP, for consensus according to the objectives of MISAU

Duration:

•The consultation is expected to last three 3 months, and should start in June, 2023.