International Consultancy: Enhance knowledge, skills and technical capacity building of national breast-feeding counselors through consultation, workshop and training

Consultant Medical & Health Programme & Policy

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International Consultancy: Enhance knowledge, skills, and technical capacity building of national breastfeeding counselors through consultation, workshop, and training

Background

Successful completion of this assignment will contribute to the objectives of planned activity 2.3. of Health and Nutrition capacity building on Infant and Young Child Feeding (IYCF).

Based on a DHS study in 2000, at least 90% of Iranian children under the age of six months were breastfed (not exclusively). However exclusive breastfeeding rate among these children was less than 44% and the figure dropped to 27% by 2004. However, according to the 2010 DHS study, the rate increased to 53.3%. Additionally, the same study estimated the probability of continued breastfeeding up to the age of 20-23 months at 51%. The review of these reports indicates that despite the progress made, 50% of Iranian children under the age of 2 years are deprived of breastfeeding in its true sense both in the early months and in childhood.

Considering the above situation, both Ministry of Health and Medical Education (MoHME) and UNICEF felt the immediate need to improve breastfeeding counseling by enhancing the capacity and skills of the Breastfeeding Counsellors (BC). To achieve this goal, training breastfeeding counselors at the field level has significant importance. Training ToTs and using the drop-down process to train field-level service providers, may be an appropriate approach to achieve the goal. Based on MoHME request, training of trainers will be possible through an international consultant who has vast knowledge in this field. The consultant will share knowledge through the facilitation of the ToT workshop, consultative meetings, and sharing experiences. S/he will conduct role play as well as review available reports to find the existing situation before conducting training and consultation which will contribute to performing a targeted workshop and ensure the sustainability of quality breastfeeding counseling and promotion services in the country.

Iran currently has active breastfeeding counseling units in almost every medical university, and the equipping and commissioning process is in progress accordingly. In this regard, an educational curriculum was developed for training breastfeeding counselors in a short-term course. This curriculum was designed for 167 hours of training and it was conducted in 3 phases as follows:

• Theoretical session (52 hours);
• Practical session (Clinical skills 23 hours);
• Work placement/internship (Observation and perform 92 hours).

All medical universities were requested to nominate people that met the below selection criteria.

Medical doctors and those with a Bachelor of Midwifery and Nursery, who have obtained at least 80% of the entrance examination score (source: a guideline for breastfeeding support a promotion in baby-friendly hospital.). Except for pediatricians, neonatologists, obstetricians, and midwives, the rest should have had at least two years of related work experience in maternal and childcare, in addition to having a history of participating in breastfeeding training courses.

The selected participants that received the above training were: Neonatologists, Pediatricians, Gynecologists, General Practitioners, Bachelor and Master of Midwifery, Nursing, and Public Health, that are currently working at the hospitals, lactation counseling centers, and Primary Healthcare Centers (PHCs).

The participants then took the OSCE examination, verbal and written tests, and English language tests, through which 90 participants were admitted. The 90 admitted participants from the ASCI test results then underwent 4 workshops:

• The first workshop (two-day theoretical sessions) - 7 and 8 June 2015
• The second workshop (two-day theoretical sessions)- 20 and 21 December 2015
• The third workshop (3x five-day theoretical and practical courses)- 13to 31 August 2016
• Fourth workshop (3x three-day theoretical and practical courses) April 29 to May 15, 2017

The total 167 hours of the educational curriculum were performed as follows:

• Theoretical session (52 hours including group discussion, guided self-study, and role play)
• Practical sessions (23 hours of clinical skills practical workshop)
• Practical sessions (92 hours in hospital, the maternal ward, Postpartum, NICU, PICU, and the Operating room)

The workshop participant’s knowledge was evaluated through an examination in July 2018 consisting of written, verbal, and practical assessments. The source of the examination is the main reference that was introduced and utilized during the workshops;

“Core curriculum for lactation consultant practice, third edition, international lactation consultant association, 2013”.

The 77 participants that regularly attended the workshops took the exam, and 50 that successfully passed the test were selected to attend the international supplementary course organized by UNICEF to become Master Breastfeeding Counselors. 25 of these selected health professionals attended the first round of the UNICEF supplementary course in 2018. As a result of this supplementary course:

• 1032 BF expert counselors (168 hours of training) were trained by the Master trainers;
• 688 BF counselors (48 hours of training) were trained by Master trainers;
• 140,000 BF counseling sessions were conducted nationally promoting breastfeeding among pregnant and lactating women; and

• 10,000 BF counseling centers were activated PHCs and hospitals.

  This consultancy aims to technically support the facilitation of the second round of these training and the development of an integration roadmap.

Objective

General Objective: To enhance the capacity of the Ministry of Health and Medical Education (MoHME) in order to train and educate pool of trainers on Breast-Feeding Consultation as Master breastfeeding counselors.

Specific Objectives

1. To establish a process of consultation with key players in the area of BF among MoHME experts and academics in order to develop a tailor-made course for the context of Iran;
2. To design and develop a specific course of BF consultation based on IBCLC expectations and the context of Iran;
3. To implement ToT workshops targeting consultants nominated as the BF consultation master trainers.

Activities, Methodology, and Technical Approach

Initially, the consultant must study the existing desk reviews and materials relevant to the current BF practices, services, related documents, available policies, and factors preventing mothers from breastfeeding. During the mission in Iran, the consultant will have a technical meeting with MOHME in order to get familiarized with the level and quality of BF-related services provided. The training sessions will combine classroom and hands-on clinical sessions supplemented with technical seminars that provide the participants with the theoretical foundations of the intervention. Additionally, practical sessions will be provided giving the participants the chance to practice the training skills that are introduced during the classroom sessions. At the end of this workshop, the counselors will know how to conduct a brief needs assessment of their target audience and contextualize their training sessions based on the needs of their province and the targeted PHC.

After the training, the consultant will also facilitate a half-a-day consultative session to discuss and provide recommendations on the possible next steps for further adaptation, incorporation, and scale-up of the BFHI and IBCLC standards in the current PHC settings and home follow-up. The session will also cover the discussion on methods of monitoring and evaluation of the intervention effectiveness in different settings. Finally, the consultant must provide all of the abovementioned recommendations and roadmaps for the adaptation, incorporation, and scale-up of this program in detail in the final report.

Deliverables, Indicators, Timeframe, and Schedule of Payment

Act 1: Preparation of the educational materials, guidelines, handouts, and agenda for the workshop at least two weeks before the workshop

Corresponding Deliverable: Educational Materials

Indicator: The approved materials are submitted

timeframe: 15 days

Payment %: 20

Act 2:

1. Technical meeting with MoHME: half a day
2. Conducting the training workshop according to BFHI/IBCLC standards: 6 days
3. Conduct half-a-day consultative meeting on monitoring and evaluation of the program: half a day

Corresponding Deliverable: Training Workshop

Indicator: The training Workshop including the consultative session is conducted

timeframe: 7 days

Payment %: 50

Act 3: Submit the final report including the applicable recommendations and roadmap

Corresponding Deliverable: Final Report

Indicator: The report is submitted

timeframe: 10 days

Payment %: 30

Total number of required working days: 32

N.B. All reports and presentations should be submitted in English

Management and Organization

Management:

UNICEF is the contractor of the consultant who will work under the supervision of UNICEF and in close collaboration with the MoHME Child Health office;

The focal responsible department in MHME is Population, Family, and School Health Dept.;

UNICEF will supervise the consultant however any payment will not be released to the consultant before reception of official satisfaction of UNICEF and MoHME;

The consultant is responsible for delivering all tasks as agreed in the table under section 5 of this document.

Organization:

• After submission of the consultative process report and the proposed agenda of the ToT workshop and subsequent approval of the contractor, the consultancy is to develop the workshop and all needed materials as per details under section 5 of this TOR;
• Upon finalization of this stage, the consultant must visit the selected location of the country to conduct the course;
• The deliverables will be reviewed by both MoHME and UNICEF and the feedback will be provided to the consultant;
• The consultant is responsible to arrange his/her trip. The cost should be included in his/her financial proposal

Conditions of Work

• The consultant/s will work under the direct supervision of the Health and Nutrition Officer from UNICEF and MoHME;
• The trips and mission to the field will be organized and supported by UNICEF.
• The consultant shall use his/her own facilities to manage the work, but, where circumstances demand otherwise, shall be allowed to make use of available UNICEF office space, computer and internet facilities with prior notification and arrangement with the supervisor and UNICEF Admin/ICT. The provision of these facilities by UNICEF shall be subject to their availability.

NOTE FOR CONSULTANTS AND INDIVIDUAL CONTRACTORS:

The Consultant should submit a technical proposal including a plan and a timeline for conducting the consultancy and an overview of the subject to demonstrate his/her knowledge.

Please submit a financial offer along with your proposal, which contains the following information:

• Fee for services to be provided – based on the deliverables in the Terms of Reference
• Wherever possible, indicate the itemized cost of the travel (air tickets etc.) if an international consultation, and daily living costs for your stay in the country.

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

• Holding the relevant degrees: Medicine (preferably pediatrics), Public Health, Nutrition/Dietetics and other related fields
• Trainer/s to be IBCLC certified;
• Experience in holding International TOT workshop on BF consultation
• Experience in the area of Baby-Friendly Hospital Initiative;
• Experience and sufficient knowledge of the International Code of Marketing of Breast- Milk Substitutes;
• Experience in working with UN agencies is an asset.

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:

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. The candidate may also be subject to inoculation (vaccination) requirements, including against SARS-CoV-2 (Covid).

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