Individual international consultancy on technical assistance to the Ministry of Health and Medical Industry of Turkmenistan (MoHMI) in development of a road map on introduction of IMCI progr

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UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. To save their lives. To defend their rights. To help them fulfill their potential.

Across 190 countries and territories, we work for every child, everywhere, every day, to build a better world for everyone.

And we never give up.

For every child, health

In the last 5 years, the Government of Turkmenistan has successfully developed and implemented a number of national strategies and programmes on reproductive, maternal, child and adolescent health, child nutrition and early childhood development.

Turkmenistan made considerable efforts in improving infrastructure at central level, while strengthening of PHC remains an urging priority. Home visiting (HV) is an integral part of the PHC system, providing universal access to health services. However, quality of provided services both for out-patient and in-patient care is inadequate and standards of provision of health services are outdated.

However, despite the efforts made, child mortality remains the highest in the ECA region with 42 per 1,000 live births and infant mortality being its major contributor with 36,3 per 1,000 live births. Neonatal mortality rate is at 23,6 per 1,000 live births (UN IGME, 2019). Country’s SDG targets to be achieved by 2030 are 12 and 25 per 1,000 live births for neonatal and under five mortality accordingly. Data on quality of care immediately after birth shows that the majority of newborns receive basic care upon their births. At the same time, survival indicators suggest that there are some challenges with the quality and extent of timely newborn care.

Thus, a need for strengthening capacity of health care providers remains one of the highest priorities. In 2014, with UNICEF support the country has developed a Road map on Strengthening the Home Visiting system and developed a Costing Tool for PHC HV System. The costing tool helped to understand that the current model is expensive compared to proposed models, and informed and suggested the most efficient approach.

COVID-19 pandemic affected availability and access to essential health services at PHC level due to most of the health staff being involved in management of COVID pandemic and physical distancing measures creating additional barriers to face-to-face counselling and home visiting. Despite of this challenge, the country continued to sustain routine immunization services. Considering the potential impact of the pandemic to the economy and to the family budget, with already high out-of-pocket expenditures (70%, 2016, WHO), the introduction of the state-guaranteed benefit package (SGBP) on maternal, newborn, child, and adolescent health becomes an urgent need.

During the past decade management of children with diarrhea and suspected pneumonia had worsened. Integrated Management of Childhood Illness (IMCI) is a key intervention for a holistic approach to the reduction of childhood mortality and morbidity through interventions that target the most common deaths in children under 5 years. Evidence suggests IMCI was significantly associated with a 15% reduction in child mortality when activities were implemented in health facilities and communities. It is crucial for the country to make strategic efforts to integrate Integrated Management of Childhood Illness (IMCI) approach in primary health care nationwide and to ensure continuity of quality care for sick children both in inpatient and outpatient facilities through the development and introduction of a national IMCI policy and guidelines, improved teaching of IMCI in pre-service and post-diploma training curricula for doctors and nurses, and development of sustainable supervisory support especially for primary healthcare providers.

Implementation of the IMCI approach was started in 2000 at selected districts of the country. However, its implementation was fragmented and not institutionalized. With the Ministry’s request UNICEF and WHO supports revitalization of the IMCI approach to enable its scaling up at national level. Last year, with UNICEF support country has adopted IMCI guidelines for management of childhood illnesses at the hospital (2013). IMCI revitalization and implementation at the national level is a part of the Recently adopted Healthy Mother-Healthy Child-Healthy Future National RMNCH Strategy.

Understanding an urgent need and the demand for introduction of IMCI approach and its implementation at scale the Ministry of Health requested UNICEF support in development of a road map on introduction of IMCI program at scale.

How can you make a difference?

The overall purpose of the assignment is to work in collaboration with the Ministry of Health in developing a country specific IMCI plan of action and tailored guidelines and tools to meet specific needs to health services and respond to the high infant and under 5 mortality rates. The assignment will inform country’s current situation in managing childhood illness, the barriers that impede a sustainable IMCI implementation and the steps in moving forward.

This assignment will provide a roadmap to the MoH on how to build capacity of the health sector to provide quality IMCI services at PHC facilities. Key deliverables will assist the government to approve and implement 5-year action plan, evidence based, high impact child survival interventions through IMCI and revision of the IMCI training package.

Scope of Work/ Work Assignments:

In cooperation with the MOH IMCI Task Force, the consultant will:

1. Conduct a comprehensive review of current IMCI practices (facility based and community based IMCI) and implementation to identify successes and gaps. This will include online interviews and discussions with stakeholders in government and partners from selected sites or clinics;
2. Identify gaps of health system component of IMCI through online focus groups discussions with specialists of urban and rural health facilities and relevant focal points of the MOH, identify opportunities to remove bottlenecks and possibilities to align IMCI with anticipated developments of leadership/governance, human resource, information/monitoring, communication, and essential supplies.
3. Identify opportunities to strengthen community components of IMCI in order to reach every child.
4. Develop a 5-year IMCI action plan which will encompass among other things (a) improving case management skills of health staff (b) Improving the health system (c) Improving family and community practices based on recent WHO/UNICEF global review findings.
5. Develop a clear monitoring and evaluation matrix for the 5-year IMCI action plan and finalize it upon MOHMI and UNICEF feedback.
6. Prepare a final report with scaling up recommendations, with finalized Action plan and M&E Framework.

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

• Advanced University Degree in pediatry with previous training in Integrated Management of Childhood training would be asset and/or Medical Doctor with experience in working in IMCI over the last 5 years.
• Undertaken work in revision, updating or development of policies, manuals and or guidelines previously;
• Minimum of 5 years of relevant professional experience in the one of above areas area with IMCI focus, in particular;
• Demonstrated experience in the Europe and Central Asia region a strong asset;
• Proven knowledge of United Nations human and child rights standards, UNICEF’s values and ethical standards; Cultural, gender, religion, race, nationality and age sensitivity and adaptability;
• Excellent command of English, both oral and written; working command of Russian or Turkmen is a strong asset.

For every Child, you demonstrate…

UNICEF's values of Care, Respect, Integrity, Trust, and Accountability (CRITA) and core competencies in Communication, Working with People and Drive for Results.

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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:

Mobility is a condition of international professional employment with UNICEF and an underlying premise of the international civil service.

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.