Individual consultant: Developing a comprehensive linkages and referral framework for AGYW in Mozambique

Consultant Medical & Health Programme & Policy

Contract

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Purpose of Activity/Assignment:

Undertake service mapping of cross-sectoral interventions for Adolescent Girls and Young women and their partners and develop a comprehensive linkages and referral framework for adolescents and young people in Mozambique.

Scope of Work:

Mozambique has the eighth highest HIV prevalence in the world and it is higher amongst adolescents and youth. Gender disparities are also pronounced in the HIV burden among adolescents and young people (10-24 years). Infection rates are hugely disproportionate in the 20-24 year age group (3.8% male and 11.8% female) and the 15-19 age group (1.6% male to 4.5% female) – effectively 3 times higher in women and girls (INSIDA). Around 4,200 adolescent girls and young women aged 15–24 years were infected with HIV every week in 2020. The HIV epidemic is highest in the Southern and Central provinces of the country (INSIDA) and is 70% higher in urban areas as compared to rural areas throughout the country.

Multiple factors exacerbate one another, creating multiple risks, many of them greater for adolescent girls and young women: Limited knowledge about HIV/SRHR, limited access to SAAJ services, poor quality of many SAAJ services, social exclusion, economic disadvantage, discriminatory and harmful cultural norms, various forms of sexual and gender-based violence including early and forced marriage, school drop-out rates, early and unwanted pregnancy, and drug and alcohol abuse.

Progress towards the 95:95:95 HIV targets has been mixed and is much slower among AYP relative to the adult population for both males and females. Whist the country has demonstrated improvement in numbers of HIV+ people on treatment (the second 90), surpassing the 95% mark, there are still only 71% of those with the HIV virus who know their status and this is less than 62% in four provinces of the central and northern regions (INSIDA). The situation is worse in the 15-24 age group with only 56% of HIV+ girls and as low as 45% of HIV+ men knowing their status. Although suppression of viral load has improved well in the country, amongst youth it is much lower, again indicating the need to redouble efforts at providing the right combination of services for youth. Increasing condom use amongst youth also remains a challenge and is lower for females. Amongst women of 15-24, the use of condoms amongst those with two or more partners in the last 12 months fell from 41%-30% between 2015 and 2021.

There is still a huge need to address the remaining structural, cultural, and behavioural challenges and barriers to reduce HIV incidence among adolescents and youth. To achieve the needed scale up of well-designed and effective programs that meet the HIV prevention needs of AGYW, we need to look cross-sectorally beyond the health sector and strengthen linkages and referrals across systems and sectors.

To enhance the quality and efficiency of AYP programming, the Global Fund has operationalized an Adolescent Girls and Young Women Strategic Initiative (AYP-SI). As a trusted partner on adolescent and HIV policy, data and programming, UNICEF is working with the Global Fund to provide technical assistance (TA) and strengthen Global Fund AYP grant implementation in priority countries. With the implementing partner and UNICEF, the requirement for TA in mapping AGYW interventions and strengthening linkages and referrals of cross-sectoral interventions for AGYW has been identified.

It is against this background that, in partnership with MOH, UNICEF is looking for a technical consultant to provide TA to the Global Fund AGYW Principal recipient (PR) and Sub recipient's (SRs), to support the AGYW interventions by mapping and strengthening linkages and referrals across services for a multi-sectoral comprehensive package for AYP, especially AGYW.

Goal: The purpose of this assignment is to support the Principal Recipient of the Global Fund in undertaking a mapping of cross-sectoral interventions and developing a comprehensive linkage, referral framework and system across services for AYP / AGYW.

Objectives:

• Map out services and interventions (geographical coverage, implementing stakeholders, existing packages) for AYP across different sectors with a focus on AGYW and their sub-populations and the various entry points (schools, community, health facilities etc.)

• Review the current official linkage and referral systems in place at district level, using project districts as the sample - at least 2 in each of the three regions of the country (6 in total). The analysis will particularly focus on the linkage and referrals made in different components of Viva+ and how these relate to official state referrals systems for ASRH as well as assess whether current levels of service coverage, utilization and referrals are adequate against the UNAIDS Size Estimates for Mozambique.

• Use quantitative and qualitative data, including existing outcomes and programme data and consultations with service users, service providers, project staff, Community Health Workers, and others, to also capture the experience of the implementation and effectiveness of these systems.

• Draw conclusions around variations between districts and between the project and services relevant to it and assess the project’s ability to ensure provision for AGYW and adolescent boys, through the various interventions of the project and the linkages between them.

• Identify service implementation modalities that are deemed most responsive to the needs of AYP especially AGYW.

• Provide recommendations on strengthening the current linkage and referral system and its implementation.

• Develop a referral and linkages framework for cross-sectoral interventions targeting AYP with specific modalities to optimize service uptake for AGYW.

• Provide recommendations for the national scale-up of the linkage and referral systems across different sectors.

Activities

1. Attend a kick-off call with UNICEF
2. Attend an inception meeting with PRs/SRs and key national partners and present a PPT outlining how you will meet this consultancy.
3. Develop Inception Report outlining the proposed methodology, workplan and tools.
4. Undertake a desk review of the latest literature on strategies, practices, policy and evidence on linkage and referrals for AYP in Mozambique and similar implementation contexts.
5. Gather and use appropriate quantitative data collection tools to inform the analysis of deliverables.
6. Conduct consultations and field visit to up to six districts with key implementers, including within the project Viva+, as well as other key informant interviews to understand experiences of the linkages and referrals, including bottlenecks, challenges and lessons learned with regards to effectiveness, appropriateness, and acceptability of current referral systems.
7. Use above interviews also to map current services, interventions and referral and linkages approaches for AYP/AGYW across different sectors, drawing on all the findings to support the cross-district comparative analysis, and the TOR elements of quality assessment and recommendations.
8. Using evidence generated from the above - literature review, data collection and quantitative and qualitative data analysis, UNAIDS subnational estimates to develop an optimal package of cross-sectoral interventions for AGYW and a multisectoral referral and linkages framework.
9. Develop and deliver a PowerPoint presentation (PPT), summarizing and circulating key findings and draft recommendations for feedback and validation from partners, including national-level stakeholders.
10. Based on validation meeting inputs, develop a final framework and updated system, including recommendations for national scale-up.
11. Develop a final report, in a format to be agreed with UNICEF, including key learning and lessons from the TA support provided, from the development of the work through to sign off process, to share for national and regional learning.

Deliverables and payments

Deliverable: 1

PPT and Summary minutes of Inception Meeting

Duration (estimated # days): 1 day

Timeline/Deadline: 10 July 2023

Deliverable: 2

Inception Report and tools

Duration (estimated # days): 4 days

Timeline/Deadline: 20 July 2023

Schedule of payment: 10%

Deliverable: 3

Field visit plan and conduct visit to at least two districts in each of region - central, south and northern provinces (6 districts in total)

Duration (estimated # days): 25 days

Timeline/Deadline: 31 Aug 2023

Deliverable: 4

Draft report of mapping report, desk review, data analysis, key findings and recommendations and summary PPT

Duration (estimated # days): 20 days

Timeline/Deadline: 30 Sept 2023

Schedule of payment: 60%

Deliverable: 5

Validation meeting & Final Report and updated PPT

Duration (estimated # days): 8 days

Timeline/Deadline: 20 Oct 2023

Deliverable: 6

Learning Report

Duration (estimated # days): 2 days

Timeline/Deadline: 31 Oct 2023

Schedule of payment: 30%

To qualify as an advocate for every child you will have…

• Minimum Qualifications required:

  Master

  Education: Advanced university degree in public health, paediatric/adolescent health, social sciences, epidemiology or related field

  Work experience: At least 5 years of professional experience at national and international levels, including field experience and expertise in HIV programming, adolescent programming or related field in Eastern and Southern Africa, is desirable

  Skills:

  a) A set of strong quantitative and qualitative analytical skills and a good understanding of translating research into policy and programmatic implementation

  b) Strong knowledge and experience in the development of frameworks, tools/materials

  c) Demonstrated ability to work across a range of partners, including national, sub-national and community-level stakeholders and partners to secure buy-in and ownership

  d) Technical field experience with data collection and pathway analytics would be an asset

  e) Demonstrated ability to work in a multicultural environment and establish harmonious and effective relationships, including with national-level stakeholders

  f) Experience working in Mozambique will be an asset

  g) Must exhibit the UNICEF Core Values of: Care; Respect; Integrity; Trust; and Accountability

  h) Language: Excellent English and Portuguese oral and written communication skills.

For every Child, you demonstrate…

UNICEF's values of Care, Respect, Integrity, Trust, Accountability, and Sustainability (CRITAS).

Consultants will be asked to stipulate all-inclusive fees, including lump sum travel and subsistence costs, as applicable.

Annex 3 - TOR Developing a comprehensive linkages and referral framework for AGYW in Mozambique a.docx

advantaged children and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, age, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, or any other personal characteristic.

UNICEF offers reasonable accommodation for consultants/individual contractors with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment.

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.

Remarks:

Consultants will be asked to stipulate all-inclusive fees, including lump sum travel and subsistence costs, as applicable.

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.

Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures, and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws.

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts.

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Added 1 year ago - Updated 1 year ago - Source: unicef.org