Individual Consultant for Review and development of a New 2022-2027 Rwanda Community Health Strategic Plan, Kigali, Rwanda, 3 Months

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Title: Review and development of a New 2022-2027 Rwanda Community Health Strategic Plan

Consultancy type: Individual Consultant

Consultancy Level: Middle

Duration: 25 October 2021 to 31 January 2022 (66 Working Days)

Location: Kigali

Purpose of Activity/Assignment:

To support development of a new Five year Community health strategic Plan, and set up priorities for the next upcoming five years, based on situational analysis findings, develop a new costed Five Year community health strategic plan document and M&E framework through consultative approaches

Scope of Work.

Individual consultant will conduct a desk review of existing documentation, interviews with staff from Government and key selected stakeholders, participate in different workshops and produce a draft of New community Health strategic plan document comprising evidence based strategies and appropriate M&E framework and budget to be presented to a designed steering committee, Community Health technical working group, Reproductive, Maternal, Newborn, Child and Adolescent Health Technical working Group (RMNCAH TWG) for review, inputs/comments, and consolidation. To a final Costed Community Health Strategic

Key development milestones.

1. Desk review of existing documentation including but not limited to the situation analysis, multidisciplinary model, Community health investment case, Community health program evaluation and subprogram strategies.

2. Participate in the organization and facilitate a 5 days’ workshop which is aiming at definition of priorities and conception of logical framework.

3. Translate the outcome of the workshop into a strategy document (writing of the strategy)

4. Organize consultations with key stakeholders (members of technical working groups, districts, civil society, private sector, and other social cluster sectors)

5. Develop a Monitoring and evaluation framework from the agreed logical framework.

6. Develop a budget of the strategic plan using evidence-based costing methodology.

Background.

Rwanda Community health started in 1995 and sustained capacity building of the CHWs through trainings and ensuring effective supply chain of tools, equipment, commodities and other consumables. By 2011, the number of CHWs had grown to 60,000. In May 2012, the Ministry of Health and Ministry of Local Government decided to remove the CHWs in-charge of Social Affairs in all the villages. The number of Community Health Workers (CHWs) was therefore reduced from 60,000 to approximately 45,000. Each village is meant to have 3 CHWs. One CHW, named Animatrice de Sante Maternelle (ASM), is in charge of maternal and newborn health and the other two CHWs consists in a Binôme. The Binôme is a male and female pair of CHWs who multi-disciplinary, polyvalent health agents are. In 2018, the 4th CHW in charge of health promotion was elected in each village located in urban and semi urban and currently Rwanda counts 58,567 CHWs countrywide. The range of services offered at community level by CHWs has evolved over time and so has its underlying policy, plans and implementation strategies.

The Government of Rwanda recognizes the problem of access to primary care is not only a health sector issue, but rather a multi-sectorial challenge that requires all sectors to work together in a synergetic manner to deliver a comprehensive health package – ranging from preventive to curative interventions with community participative .specifically, the community health package consists of the community case Management(CCM), Mother and New Born Health Program (MNH) Community Provision Family Planning(CBP) Community Nutrition Program(CBNP), Behaviour Change Communication (BCC),and Rwanda Community Management Information System(RHMIS). These programs are primarily devoted to the reduction of Maternal and Child Mortality. Additionally, the package includes the community Performance-Based Financing (C-PBF) through community Health Workers ‘cooperatives, both which aim to improve the quality of health care, while at the same time improving the communities welfare by way of creating income –generating projects.

In preparation for community health program reform the government of Rwanda designed a multidisciplinary (polyvalent) CHWs model comprising community health curriculum with fourteen(14) service programs including Maternal New Born Health, Integrated Community Case management (ICCM), Nutrition, Community Based Provision Family Planning(CBP/FP), Mental health, Non communicable disease(NCDs), First Aid, Drug management, Tuberculosis, Malaria, HIV, Behavior Change Communication (BCC), Emergency response to epidemics, Report Community health activities and crosscutting areas like Early Childhood Development (ECD), Adolescent Sexual Reproductive Health (ASRH), Water Sanitation and Hygiene (WASH) and Gender based violence (GBV).

In addition to the new model, Community health investment case has been developed with aim to explore how best to finance community health program. To this end, studies in review of different community Health Programme models in other countries to better understand the overall strengths and weaknesses of Community Health programs, with an emphasis on how different financing arrangements fare in terms of maximizing CHWs performance and ensuring financial sustainability. The studies found that financial incentives and stipends strongly impact the delivery of priority services and improve retention. Furthermore, several design features are also critical for long-term satisfaction and sustainability, such as how CHWs are trained, how they are recruited, certified, supervised, and remunerated.

Justification.

It is against the above background that the Ministry of Health in collaboration with UNICEF is seeking the services of international consultants with proven experience and expertise to review community health strategic plan which ended in 2018 and update it for upcoming 5 years from 2022 -2027. UNICEF will support Ministry of Health to recruit a qualified consultant to support development of a new costed Community Health Strategic plan. The consultancy is also expected to recommend a roadmap towards appropriate strategies to implement Community health multidisciplinary (polyvalent) model and investment case to achieve high quality community health services and financial sustainability.

Tasks/ Activities.

In view to the development of a quality Community Health Programme Strategic Plan which meets international standards and responds to emerging community health issues will require a consultant a skills and broad knowledge about community health program in general and specifically about the global health.

The contracted consultant will be required to design evidence-based strategies appropriate for implementation within the following key Rwandan context.

1. Implementation of integrated services (multidisciplinary model) considering:

• Recruitment of younger and replacement of ageing CHWs
• Transition plan from the current new community health programme model
• Training, career paths and certification
• Appropriate packages of interventions and numbers of CHWs in Urban and rural areas.
• Deployment of CHWs in community with emphasis on population density, burden of disease and geographical accessibility.
• Implementation of trainings through E-learning
• Community health legal framework
• Social marketing of community health services to improve uptake of services

2.Quality of community health services /Performance enhancement considering:

• Monitoring and evaluation framework
• Mentorships and supervision
• User experience, Patient voice and satisfaction
• Competent community health care and systems
• Replacement/replenishment strategy for community health Supply chain (equipment, tools, commodities) appropriate supply chain of supplies/medicines
• Digitization
• Program Evaluation (contribution analysis)

3. Considering Sustainable funding:

• Implementation of recommendations from investment case
• Monetary incentives /Fixed and affordable incentives
• Performance Based Financing
• Initiation of Basket funding and mobilization approaches targeting private sector
• Monetary incentives /remuneration or fixed salaries
• Motivation, satisfaction and retention of CHWs
• Non-Monetary incentives
• Sustainable cooperatives
• Retirement of CHWs and related packages
• Economic evaluations of the program
• Costing

Overall Objective.

To develop a Community health strategic document containing priorities of the 5 coming years from January 2022.

Specific objectives:

• To set up priorities for the next upcoming five years (January 2022 to December 2027), based on situational analysis findings.
• To develop the community health strategic plan document and M&E framework through consultative approaches (desk review, key informants, focus group discussions)
• To do the costing of the community health strategic plan
• To present first draft of community health strategic plan to the steering committee and TWGs (Community, RMNCAH) for guidance, inputs, and validation of the final Community Health Strategic Plan to be consolidated and approved by Rwanda Biomedical center (RBC)/Ministry of Health (MOH).

Scope of Work.

Individual consultant will conduct a desk review of existing documentation, conduct interviews with key informants from MOH, RBC, Health facilities, community health workers, community representatives and as many stakeholders as possible, present, participate and take notes from different consolidation workshops, meetings and sessions to produce a final Community Health Strategic plan document. The development of M&E framework and budget of strategy will require specific sessions with concerned community health experts and focal points to make necessary reviews, inputs and integration of comments and inputs to a final document.

A contracted consultant will undertake the following specific tasks:

• Desk review of existing documentation including but not limited to the situation analysis of the new multidisciplinary community Health Programme model, Community health investment case, Community health program evaluation and subprogram strategies.
• Participate in the organization and facilitate a 5 days’ workshop which is aiming at definition of priorities and conception of logical framework.
• Translate the outcome of the workshop into a strategy document (writing of the strategy)
• Organize consultations with key stakeholders (members of technical working groups, districts, civil society, health facility managers, community representatives, health providers, private sector and other social cluster sectors)
• Develop a Monitoring and evaluation from the agreed logical framework.

• Develop a budget of the strategic plan using evidence-based costing methodology.

  Key deliverables.

1. Inception report presented to and validated by the Community Health program, steering committee (to be established by RBC and MOH), Community Health Technical Working Group and RMNCAH TWG – and approved by the Community Health Desk lead.
2. Write a preliminary strategy document with logical framework from the community health program workshop, draft narrative document of the Community Health Strategy comprising situational analysis, strategic objectives, result matrix (outputs, interventions, activities, indicator matrix, budget programs and implementation plan for the strategy)
3. A draft Community Health Strategic plan integrating inputs from TWGs (Community Health, RMNCAH) and steering committee including detailed budget of the strategic plan using evidence-based methodology and tools, Monitoring and evaluation framework,
4. A final Community Strategic plan document Validated by: the Community Health program focal points, Steering committee, Community Health TWGs, RMNCAH TWG, and consolidated with inputs from MoH and RBC focal points – ready for approval qualified government institutions/forums.

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

Education

The candidate should have a Masters’ Degree in Health-related areas.

Knowledge/Expertise/Skills required:

• At least 5 years- of professional experience in development and design of health policy and strategic plans with a proof of at least 3 examples prepared for developing countries
• Proof in conducting similar exercises, analytical and planning skills in developing health related strategies, policies and other strategic documents. Experience in the development community Health Strategic Documents will be an added value.
• Experience of working in similar settings like Rwanda.
• Experience in Working with UN systems will be an asset.
• Fluency in English with excellent writing, analytical and communication skills. French will be an asset

For every Child, you demonstrate…

UNICEF's values of Care, Respect, Integrity, Trust, and Accountability (CRITA) and competences: Demonstrates Self Awareness and Ethical Awareness, Works Collaboratively with others, Builds and Maintains Partnerships, Innovates and Embraces Change, Thinks and Acts Strategically, Drive to achieve impactful results, Manages ambiguity and complexity, Nurtures, Leads and Manages People.

How to Apply

Interested candidates should send their cover letter explaining what makes them suitable for this consultancy.

Only successful candidates from the technical evaluation exercise will be contacted and requested to submit their most competitive Financial Proposal.

UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization.

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:

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.