Individual national consultancy on technical assistance to the Ministry of Health and Medical Industry of Turkmenistan (MoHMI) in introduction of IMCI program at scale

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services both for outpatient and in-patient care is inadequate and standards of provision of health services are outdated.

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 birth. At the same time, survival indicators suggest that there are some challenges with the quality and extent of timely newborn care.

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[1]. It is crucial for the country to make strategic efforts to integrate the 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 in selected districts of the country. However, its implementation was fragmented and not institutionalized. IMCI revitalization and implementation at the national level is a part of the Recently adopted Healthy Mother-Healthy Child-Healthy Future National RMNCH Strategy. With the Ministry’s request UNICEF and WHO support the revitalization of the IMCI approach to enable its scaling up at the national level. In 2020, with UNICEF support country has adopted IMCI guidelines for the management of childhood illnesses at the hospital (2013). In 2021, with the technical assistance of UNICEF, the Ministry of Health has developed a 5-year Road Map for the introduction of the IMCI programme at scale. The Road Map proposes 5 phase approach. The action plan proposes (a) improving case management skills of health staff (b) Improving the health system and (c) Improving family and community practices based on recent WHO/UNICEF global review findings. Currently, the Road Map is under the consideration of the Ministry for its endorsement. Within this technical assistance, the IMCI training package has been developed, with 52 trainers prepared. Currently, the package is available in Russian language. Its adaptation in Turkmen language is planned for this year.

Understanding an urgent need and the demand for the introduction of the IMCI approach and its implementation at scale the Ministry of Health requested to continue UNICEF support in the introduction of IMCI program at scale by strengthening the regulatory base and developing standards for the provision of pediatric services.

In March 2022 UNICEF CO initiated support to the 1st phase of the introduction of the IMCI programme at scale by developing the regulatory base and treatment protocols of most common childhood illnesses to enable its universal introduction and ensure the provision of quality MNH services at the PHC level. To support this work the Ministry of Health has formed a national working group responsible for introduction of the IMCI programme at scale.

[1] Cochrane review on IMCI (2016) quoted in WHO Report “Towards a Grand Convergence for Child Survival and Health”, November, 2016

How can you make a difference?

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

1. Work closely with the International Consultant and act as a liaison between the Ministry of Health IMCI working group and the International consultant.

2. Based on the results of the comprehensive review of current IMCI practices conducted in 2021 (facility-based and community-based IMCI) and analysis of the current legislative base assist the international expert and the working group in the development of a draft regulatory document to enable initiation of IMCI introduction.

3. Support in collection and analysis of data flow at PHC level and share it with UNICEF international consultant.

4. Support the development of the IMCI database and initiation of the monitoring and evaluation mechanism with the IMCI programme.

5. Support in the development of at least 10 Unified clinical guidelines and protocols to standardize management of childhood illnesses based on the IMCI approach at PHC facilities.

6. Support in Initiating opportunities in strengthening community components of IMCI in order to reach every child.

7. Assist in preparing a final report with proposed regulatory documents, clinical protocols, and suggested data flow.

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

• Advanced University Degree in Medicine, preferably with specialization in pediatrics with previous training in Integrated Management of Childhood training would be an 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;
• 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 Russian or Turkmen is a requirement.

For every Child, you demonstrate…

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

To view our competency framework, please visit here.

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.

2022-02-22 TOR_IMCI National Consultant for posting.docx