Coordinator for HIV Differentiated Service Delivery

Contract

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1. BACKGROUND

Differentiated service delivery (DSD) describes how services may be adapted to reflect the clients’ needs and preferences, as well as reduce the burden of care for healthcare workers. Such adaptations may be made across the cascade of HIV care from testing to virological suppression, including the adaptation of services to specific populations. DSD reflects the preferences and expectations of the various sub-populations while reducing unnecessary burdens on the health system. This approach involves the thorough assessment of PLHIV to determine the needed level of care and matching them to appropriate services. DSD also offers less intensive and less frequent services that are more easily accessible for people living with HIV (PLHIV) who are clinically stable on antiretroviral therapy (ART), thus reducing the barriers to treatment and care. DSD also involves the offer of innovative and targeted testing approaches. It refocuses health system resources on those who require more intensive care and follow-up. Similarly, it includes offering more intensive care for clinically unstable people and/or who present with advanced HIV disease.

Introduction

In 2016, the National AIDS/STI Control Programme (NACP) adopted the new World Health Organization (WHO) recommendations to treat all PLHIV with ART, regardless of immune status or clinical stage.

Among the recommendations adopted is DSD for PLHIV to improve HIV service delivery and fast-tracking of the HIV response. In line with these guidelines, implementing partners applied various service delivery models at the health care facilities, which included: innovative and targeted testing approaches such as index client testing and HIV self-testing, shifting of ART initiation from doctors only to include trained nurses and increase in ART refills to 3- or 6-month prescription. Ghana developed a comprehensive DSD operational manual in 2017 and that has since guided a phased scale up of DSD in Ghana.

In 2019 Global Fund grant resources were reprogrammed to support an HIV acceleration plan – DSD was the major underpinning principle of the acceleration plan. The implementation of the DSD based acceleration plan led to major gains and progress in the HIV programme for Ghana. However, much progress is still required as the country failed to achieve the 90-90-90 targets though on track to attain the 95-95-95 targets. The adoption and implementation of DSD is considered important for Ghana’s acceleration of progress towards the global goal of ending HIV by 2030.

The Global Fund has launched a series of Strategic Initiatives (SI’s) to support catalytic technical assistance activities with a direct link to grant activities (operationalization/implementation) from 2021 to 2023. Based on WHO recommendations, one of these SI’s concentrates on differentiated service delivery for HIV testing, treatment and advanced HIV disease. The GF DSD SI implementation covers ten priority countries, including Ghana.

The 3-levels of WHO (Headquarters, Regional Office and Country Office) support the GF DSD SI by providing technical oversight and quality assurance on policy, scale-up plans, performance, and accountability for results. The Ghana WHO Country Office (WCO) plays a vital role in engaging in the Global Fund grant processes as well as liaising with the MoH and other key stakeholders to adopt WHO DSD recommendations.

In 2021 the three levels of WHO worked together to support key stakeholders to successfully roll out the DSD SI in Ghana. Three technical assistance providers are supporting the country in the development of tools for the scale up of DSD, quality improvement of DSD at health facility level and virtual interventions for HIVST and PrEP. WHO country office support for coordinating the work of the three TA providers and various country level stakeholders has been essential to ensure that the agreed deliverables are aligned to WHO recommendations national guidance and lead to improved health outcomes for the population.

Considering the huge financial investments from the Global Fund, the importance of the successful implementation of the DSD SI and, workload associated to the coordination and technical assistance required, there is need for an additional human resource to focus on the coordination of the initiative at the country office.

1. DESCRIPTION OF DUTIES

Under the general coordination of the WHO Country Representative, the HIV/AIDS Technical Officer's supervision, the DSD for HIV coordinator will work to accelerate and strengthen the implementation of the DSD SI and other DSD support according to WHO recommendations. The DSD for HIV coordinator will work closely with the National HIV Control Program as well as other national stakeholders and be based primarily at the offices of the program.

Specifically, the WHO DSD for HIV Coordinator will support the national HIV implementors and DSD SI technical assistant (TA) providers (local and international) in the following:

Objective 1: Coordinate the DSD SI and support overall DSD activities in Ghana

• Activity 1.1: Support national DSD stakeholders’ meetings/workshops (in-person or virtual considering Covid-19 constraints) to ensure country dialogue on DSD and DSD SI for better alignment of DSD efforts, implementation progress and engagement of all key stakeholders. .
  • • Deliverable 1.1: Meeting slides, notes with key action points and review of meeting products.
• Activity 1.2: Support the monitoring of DSD SI implementation progress by tracking planned activities (country workplan), support the development of quarterly report updates and assist country participation in DSD SI events (e.g., Bi-annual meetings, webinars/workshops, etc.).
  • • Deliverable 1.2:
  • Deliverable 1.2.1: Updated quarterly reports on progress on the DSD SI implementation.
  • Deliverable 1.2.2: Slide decks (or other resources) from country presentations.
• Activity 1.3: Organize and convene the WHO periodic meetings to report the DSD SI implementation and coordination efforts.
  • • Deliverable 1.3: Meeting invites, agenda, slides, notes with key action points and review of meeting products.

Objective 2: Conduct situational and ongoing data analysis, technical assistance, produce supporting materials and publications:

• Activity 2.1: Support the dissemination of policies/approaches to accelerate DSD implementation, including alignment with WHO recommendations.
  • • Deliverable 2.1: Report/slide decks of meetings for policies and recommendations dissemination
• Activity 2.2: Support planning and facilitation of meetings and learning sessions with key stakeholders, share WHO resources.
  • • Deliverable 2.2: Meeting minutes with key action points and review of meeting products.
• Activity 2.3: Conduct and support monthly data collection, reviews, and detailed monthly analysis of DSD scale-up/implementation in coordination with ministry of health and other key stakeholders. This should include the systematic collection and reporting of GAM data pieces related to DSD and any enhanced DSD indicators.
  • • Deliverable 2.3: Produce monthly reports and present them in meetings and discussions.
• Activity 2.4: Provide technical and programmatic support, including reviewing national technical documents (aligned with WHO guidelines and national norms and policies) and DSD implementation tools
  • • Deliverable 2.4: DSD materials reviewed.
• Activity 2.5: Support the development of materials and publications on national experiences, best practices on DSD (and DSD SI).
  • • Deliverables 2.5:
  • Deliverable 2.5.1 Produce DSD overview slide decks for dissemination in meetings.
  • Deliverable 2.5.2 Produce materials that disseminate best practices (publications, case studies, technical briefs, web stories, etc.).

Objective 3: Provide technical support for the national scale up of Pre-exposure Prophylaxis (PrEP) and HIV Self-Testing (HIVST) in Ghana

• Activity 3.1: Participate in meetings of the National Technical Committee for PrEP and HIVST
  • Deliverable 3.1: Meeting Minutes

• Activity 3.2: Provide technical support for PrEP and HIVST implementation including trainings, supervision and monitoring and evaluation

  • Deliverable 3.2: Monthly reports on PrEP and HIVST activities

• Perform any other task of its competence assigned by the hierarchy.

2. REQUIRED QUALIFICATIONS

Education

Essential

• Higher level qualification or degrees in medical related fields,

Desirable

• Master’s degree in public health will be added advantage

Experience

Essential: At least 5 years of technical and programmatic experience working on HIV treatment and care in Ghana, experience on differentiated HIV treatment services and experience on HIV service delivery for underserved populations.

Desirable:

Expertise and experience providing technical support, and experience working with international organizations such as UN agencies, the Global Fund and other HIV actors, including the Ministry of Health and civil societies.

Skills

• Experience with technical writing, literature review, data synthesis and report writing. Good communication, presentation and coordination skills also needed.
• Demonstrated ability to work with experts at national and regional levels, and to establish and maintain effective working relationships with people. Excellent organizational skills.
• Other Skills (e.g. IT): Proficient in MS Office Software applications, data analysis and technical presentations.

WHO Competencies

• Teamwork
• Respecting and promoting individual and cultural differences
• Communication
• Ensuring the effective use of resources
• Producing results

Use of Language Skills

• Essential: Expert knowledge of English.
• Desirable: Intermediate knowledge of Local Languages.

REMUNERATION

• WHO salaries for staff in the Professional category are based on United Nations scales.