Individual International consultant to support the Ministry of Health and the Institute for Public Health of Montenegro on strengthening supportive supervision system in the field of immuniz

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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, the best start to life.

Immunizations are an essential health service that protect susceptible individuals from vaccine-preventable communicable diseases (VPD). Preventing a VPD outbreak not only saves lives but requires fewer resources than responding to the outbreak. Already declining immunization rates at global and country levels were further adversely affected by COVID-19. This was mainly due to the overstretched health services and physical distancing measures which have led parents to defer, postpone and/or reject routine childhood immunization. At the same time, frontline healthcare workers implementing immunization program were deeply involved in other important duties and responsibilities such as population wide COVID-19 immunization that took their focus from routine immunization tasks and duties. These challenges resulted in accumulation of individuals susceptible to vaccine preventable diseases and ultimately might lead to the resurgence of vaccine-preventable diseases. Montenegro is an upper-middle-income country with a total population of around 620 thousand (2011 Census). Despite its upper-middle status, Montenegro is faced with critically low and continuously declining immunization rates. Immunization coverage rates for first dose of measles, mumps, and rubella vaccine (MMR1) have been decreasing in recent years – from 90% in 2010 to 24% in 2020 and slightly above 18% in 2021,which is a critically low rate and one of the lowest in Europe and Central Asia region. This means that more than 80% of children born in 2020 were not timely protected from the most contagious vaccine-preventable diseases – namely measles. In addition, almost every sixth child in Montenegro has not been adequately protected from Diphtheria, Tetanus and Pertussis (three doses of DTP vaccine) in the first year of life (during 2020).In early 2020, Montenegro, with the support of the UNICEF Regional Office for Europe and Central Asia conducted a Root Cause Analysis of suboptimal immunization coverage at the sub-national level. Some of the main root causes identified were insufficient knowledge and skills of pediatricians when establishing immunization contraindications, lack of adequate interpersonal communication (IPC) skills for immunization, lack of motivation of immunization service providers for timely immunization, weak accountability of service providers for achieving immunization targets accompanied by nonexistent supportive supervision neither from peers – municipal coordinators nor from higher levels of program implementation, strong anti-vaccination campaign in media and social networks and weak nation-wide mechanisms for generating demand for immunization. Furthermore, according to a UNICEF supported nationally representative perception survey conducted in May 2020 which focused on health, 53% respondents agreed with the statement that vaccines should be avoided because they may cause other diseases and have unwanted effects (implying worsening of attitudes from Knowledge, Attitude and Practices survey conducted in April 2019 when 27% respondents agreed with the statement). Therefore, urgent actions were needed to ensure that the trend of declining immunization rates is reversed. In the past two years, with the support of the European Union, UNICEF has supported the Ministry of Health and Institute of Public Health of Montenegro with development of policies, training of health workers, conduction of media campaigns and massive recruitment through call backs of parents and strengthening of the vaccine management system in all 25 municipalities and 18 primary health care centers providing immunizations on the lowest administrative level. To build on those efforts, and due to its multidimensional role (increasing immunization uptake, immediate, integrated into routine services, adaptive to local context, etc.), the supportive supervision mechanism of frontline workers in all vaccine service delivery points for routine immunizations (18 primary healthcare centers and 4 health stations – Žabljak, Šavnik, Plužine and Petnjica) as well as in all epidemiological services across the country (providing immunizations in accordance with clinical and epidemiological indications) is seen as an excellent modality of enhancing immunization system both horizontally (municipal level) and vertically strengthening the national supervisory role of the Institute, providing the much needed support to colleagues at the lowest level of health care and improvement of the overall quality health services. The purpose of this assignment is to contribute to strengthening overall immunization system in Montenegro and to ensure that children and vulnerable groups in Montenegro are timely and adequately protected against vaccine preventable diseases through immunization services.The objective of the assignment is to assist the Ministry of Health and Institute for Public Health to ensure effective and efficient immunization services by defining, setting up and supporting implementation of supportive supervision model/system for primary health care level workforce in Montenegro.

How can you make a difference?

The selected consultant will perform desk review of all existing policy and legislative documents available in the local language. As needed, the consultant will contact relevant UNICEF staff and request additional consultation with government, IPH and primary health care center(s) representatives. Under the direct supervision of ECD Officer, the following tasks are expected to be completed by consultant: 1. Review all available relevant national strategic and other documents (laws, bylaws, rulebooks, guidelines, reports, analyses, EVM assessment data, immunization coverage data etc.) on immunization, and perform gap analysis of status of supportive supervision process in the country through series of meetings with national stakeholders in IPH/MoH and selected municipalities (primary health care centers or health stations). Gap analysis report should be delivered.2. Developing a step-by-step guide for supportive supervision of immunization process in the country both on municipal (local) and national levels. Step by step guide should include hardcopy checklists for both levels of supervision as well as online version of the forms in order to facilitate the implementation and become a starting point for development of online immunization supportive supervision program.3. Present to UNICEF, MoH and IPH first draft of deliverables listed above, gather inputs and incorporate them into deliverables and then prepare a second draft version of the guide.4. Develop final version of the step-by-step guide for supportive supervision of immunization process in the country both on municipal (local) and national levels together with a supportive supervision improvement plan including detailed work plan and activity timelines.5. Conduct face-to-face training for relevant health professionals including training national-level IPH immunizations related practitioners and pediatricians/municipal immunization coordinators. Training should cover supportive supervision principles, techniques, and introduce relevant tools (e.g., checklists, visiting plans, indicators, reporting, and filing systems). Coordination of logistics for training participants will be conducted with the assistance of the IPH and UNICEF CO.6. Prepare a proposal for national stakeholders that will lead to defining and regulating the supportive supervision process and its incorporation into the national immunization soft legislative framework. This includes drafting amendments of identified and corresponding national soft legislative – immunization rule book, national immunization guidelines, Ministry orders, the job description of municipal and national supervisors, and eventually any other documents, that will recognize and incorporate supportive supervision process as part of the legal duties and obligations of national stakeholders.7. Implement supportive supervision visit of national and municipal team of supervisors to at least three municipalities with the lowest coverages. Report on each of the visits should be provided.8. Recommendations for the next steps in establishing, introducing, and enhancing the supportive supervision model should be into the National Immunization Programme and possibilities for development of online dashboard where performance indicators of supportive supervision can be assessed, and municipalities may be provided feedback accordingly.

Deliverables: Output: Timeframe: Review all available relevant national strategic and other documents (laws, bylaws, rulebooks, guidelines, reports, analyses, EVM assessment data, immunization coverage data etc.) on immunization, and perform gap analysis of current status of supportive supervision process in the country through series of meetings with national stakeholders in IPH/MoH and primary healthcare level.

Supportive supervision Gap analysis report

By October 24th 2023 (home-based)

Develop a step-by-step guide for supportive supervision of immunization process in the country both on municipal (local) and national levels. Step by step guide should include hardcopy checklists as well as online version of the forms in order to facilitate the implementation and become a starting point for development of online immunization supportive supervision program.

Present to UNICEF, MoH and IPH first draft of deliverables listed above, gather inputs and incorporate them into deliverables and then prepare a second draft of the guide.

First draft of:

1. Step-by-step guide
2. Supportive supervision check lists
3. Power point presentation of the guide

By November 3rd, 2023 (Home based)

Develop and present to national stakeholders' final version of the step-by-step guide for supportive supervision of immunization process in the country both on municipal (local) and national levels together with a supportive supervision improvement plan including detailed work plan and activity timelines.

Final version of:

1. Step-by-step guide
2. Supportive supervision check lists
3. Power point presentation of the guide
4. supportive supervision improvement plan
5. detailed work plan and activity timelines
6. power point presentation of finalized guide together with workplan and timeframes .

By November 10th 2023 (home based)

Organize a series of meeting with stake holders and conduct a face-to-face training for relevant health professionals including training national-level IPH practitioners and pediatricians - municipal immunization coordinators. Training should cover supportive supervision principles, techniques, and introduce relevant tools (e.g., checklists, visiting plans, indicators, reporting, and filing systems).

Report on Training conducted in Podgorica with attendance lists and quantitative / qualitative assessment of the training.

By November 24th 2023

(Podgorica)

Implement training supportive supervision visit of national and municipal team of supervisors to at least three municipalities with the lowest coverages. Report on each of the visits should be provided.

Visits to three municipalities performed

3 reports on training visits to each municipality prepared and delivered

By December 1st 2023

(Podgorica – local travel)

Prepare a proposal for national stakeholders that will lead to defining and regulating the supportive supervision process and its incorporation into national immunization soft legislative framework. This includes drafting amendments of identified and corresponding national soft legislative – immunization rule book, national immunization guidelines, Ministry orders, job description of municipal and national supervisors, and eventually any other documents, that will recognize and incorporate supportive supervision process as part of the legal duties and obligations of national stakeholders.

Proposal for incorporation of supportive supervision prepared with draft amendments of soft legislation including amended Rulebook on conditions and methods of implementation of mandatory immunoprophylaxis and chemoprophylaxis against certain infectious diseases prepared

By December 8th 2023

(home based)

Prepare and present a final consultancy report.

Report should include recommendations for the next steps in establishing, introducing, and enhancing the supportive supervision model as well as recommendations for manners of full integration of the supportive supervision process into the National Immunization Programme and possibilities for development of online dashboard.

(Report should be approved and accepted by UNICEF)

Final Report (approved and accepted by UNICEF)

PowerPoint presentation for national stakeholders

Final presentation meeting

By December 15th 2023

(home based)

The final consultancy report is considered once it's reviewed by the Ministry of Health and approved and accepted by UNICEF. All above-listed documents and reports shall be prepared in the local language. The final consultancy report is considered once it's reviewed by the Ministry of Health and approved and accepted by UNICEF.

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

- Master's degree in medicine, public health and/or epidemiology - PhD degree in medicine, public health, or epidemiology would be considered as an advantage; - At least 5 years of work experience in immunizations, especially in Effective Vaccine Management and Expanded Program of Immunizations Management, including experience in the development of national policy documents, standard operating procedures, supplementary immunization activities (SIAs) and other, including for different international agencies (especially UN); - Relevant work experience in developing and facilitating supportive supervision in the field of immunization. - Previous work experience with UN/UNICEF or other international organizations will be considered as an advantage. - Fluency in both local language and English is required. - Excellent writing skills, presentation skills, strong strategic and analytical skills. - Ability to work with different stakeholders. - Demonstrate integrity and high ethical standards. - Display cultural, gender, religion, race, nationality and age sensitivity and adaptability. - Profound knowledge of relevant WHO and UNICEF recommended guidelines, policies and position papers on immunizations - Familiarity with UNICEF’s mandate and goals - Excellent interpersonal and communication skills - Familiarity with results-based monitoring.

For every Child, you demonstrate…

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

To view our competency framework, please visit here.

Payment schedule: The payments will be made upon successful completion of the deliverables and submission of invoices as follows: a) 70% after November 28th and upon submission of final version of step-by-step guide for implementation of supportive supervision, supportive supervision improvement plan, detailed work plan and activity timelines, report on training supervisors, draft amendment of Rulebook and successful submission of municipality training visits and three reports on these visits, and b) 30% upon acceptation of the final report . UNICEF reserves the right to withhold all or a portion of payment if performance is unsatisfactory, if work/outputs is incomplete, not delivered or for failure to meet deadlines

Mandatory E-learning: Upon conducting the recruitment process and prior to the signing of the contract, the consultant will be required to complete the following online courses. All certificates should be presented as part of the contract. 1. Ethics and Integrity at UNICEF 2. Prevention of Sexual Harassment and Abuse of Authority (PSEAA) 3. Prevention of Sexual Exploitation Abuse (PSEA)

Before commencement of any travel on behalf of UNICEF, the Consultants and Individual Contractors must complete BSAFE (English) Course.In addition to above, any consultant or individual contractor who is issued a UNICEF email address must complete the following courses no later than 30 days after signature of contract: 1.Fraud Awareness; 2.General Information Security Awareness Course (only for consultants/individual contractors with a UNICEF email address). The above courses can be found on Agora through the following link: AGORA: Log in to the site (unicef.org).Course completion certificates should be shared and retained with the human resources unit of the hiring office.

Application procedure: The application shall consist of the following documentation: • Cover Letter detailing your interest and qualifications. • Updated CV, Resume or e-recruitment profile. • List of reference contacts: 4-5 reference contacts including 2- 3 of current/previous supervisors and 2-3 peers; • Lump sum financial proposal. • Proposed work plan – methodology of work, stakeholders list and timelines

Selection methodology: All applicants will be screened against qualifications and requirements set above. Candidates fully meeting all the requirements will be further evaluated based on the criteria below. The proposal will be evaluated against the following criteria: A) Technical criteria – Technical evaluation process / Maximum points: 70 1. Technical Criteria includes 1Desk review of applications (CVs, CL, work plan) as per below criteria: • Education: 10 • Previous experience: 20 • Proposed work plan: 30 • Other: 10

Only candidates who obtained at least 70% of points from the technical part (who will score at least 49 points) will be qualified for considering for financial proposal evaluation B) Financial criteria – evaluation of financial proposal - Maximum points: 30 The applicants are requested to submit their lump sum financial proposal consisting of a daily professional fee, number of days per deliverable, proposed travel costs for municipal visits and daily subsistence allowance (DSA) when applicable which will be paid up to a maximum of the official UN rate including other applicable costs. Reimbursement of travel costs / accommodation expenses will be based on lump sum.Financial scores will be calculated using the formula [lowest offer / financial offer of the candidate x 30].

UNICEF is here to serve the world’s most disadvantaged 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:

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.