International consultancy on healthcare waste management (HCWM) with UNICEF in Uzbekistan

Contract

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Background

According to data from January 2021, the Republic of Uzbekistan is estimated to produce over 173 tons of hazardous medical waste per day. This situation is expected to have increased significantly due to the COVID pandemic, mainly due to vaccination campaign wastes and increased use of PPE (facemasks, gloves, gowns). The two COVID hospitals in Tashkent alone, when operating at capacity, are estimated to generate 2.4 tons of medical waste per day.

Wastes generated directly from healthcare activities are considered worldwide to be a major indirect and direct risk factor to human health and the environment. WHO has published global guidance on the practical steps that need to be taken to reduce the public health and environmental risks, including undertaking a baseline assessment to inform national roadmaps and set national healthcare waste improvement targets.

During March 2022, a representative baseline survey was undertaken of healthcare waste management practices in Tashkent City and the Regional areas. Syrdarya Region was chosen for convenience however, the results are likely to be indicative of the problems faced in the other 12 Regions of Uzbekistan outside Tashkent. The rapid healthcare waste baseline assessment in Tashkent City and Syrdarya Region has shown that a large investment be required across Uzbekistan to revitalize the healthcare waste sector. It is recommended that investments are structured around hardware, software and enabling environment interventions under six pillars as follows.

UNICEF, jointly with national partners modelling new waste management systems in rural and urban settings. In addition, the revision and development of health care waste management normative-legislative base are in progress. The healthcare waste management concept and costed national waste management roadmap were developed and submitted for Government approval. National partners requested to build capacities of the key decision makers, managers, and health workforce to sustain waste management services. Responding to the necessity to integrate waste management indicators in health systems monitoring, quality improvement efforts, documentation of lessons learned from modelling, and capacity building requires support from international experts to national partners. In order to provide the technical support mentioned above, an international expert in the field of waste management systems will be recruited.

Objectives

The objective of the assignment is to provide technical assistance to the Ministry of Health of the Republic of Uzbekistan in the capacity building of the healthcare waste-management (HCWM) system and in the implementation and documentation of six HCWM models results for future national scale-up.

Timeline & Deliverables

Start day of the assignment: November 1, 2022

End day of the assignment: September 30, 2023

The selected consultant will be hired for 131 working days.

Methodology/Activities

The expert will work under the supervision of the Chief of Health and Wellbeing in collaboration with the Health and Nutrition Specialist, Program officer (procurement), Immunization officer, the Ministry of Health, SES, national partners, and experts.

1. Training for healthcare managers and workers on waste management (waste minimization, recycling, segregation, storage, transportation, treatment, and disposal methods) based on developed SOPs and SanPIN in the Republic of Karakalpakstan (RoK). One in-country visit - 6 days. This task includes the following actions:

• Use the developed training package for training of health care workers and managers on waste management (waste minimization, recycling, segregation, storage, transportation, treatment, and disposal methods)
• Facilitate training for healthcare workers from modelling districts (Kungrad, Muynak and Bozatau) on waste-management
• Build the capacity of the national team on waste management to ensure future sustainability
• Prepare training report.

2. Assessment of new facilities proposed by the MoH for installation of waste management equipment. Visit Uzbekistan (Namangan, Andijan, Syrdarya and Djizzah regions). This task includes the following actions:

• Learn the rapid assessment results from Namangan and Andijan regions (1 day remotely)
• Learn the list of facilities provided by the MoH where HCWM equipment may be installed (1 day remotely)
• Visit facilities with the national engineer to conduct a rapid assessment and evaluate possibilities to instal equipment (13 days in country visit)
• Preparation of the report with the list of facilities where equipment can be installed (4 days remotely)
• Finalize the report based on CO and national partners' feedback (1 day remotely).

3. Provide support to UNICEF CO in technical evaluation of bids within bidding processes for procurement of healthcare waste supplies – 3 days. This task includes the following actions:

• Develop the ranking criteria for the HCWM supply
• Review all documents submitted by suppliers, and ensure that all supply is in line with developed specifications
• Request additional information on supply quality if needed
• Prepare evaluation report (comparative matrix).

4. Training for healthcare managers and healthcare workers on waste management (waste minimization, recycling, segregation, storage, transportation, treatment, and disposal methods) based on developed SOPs and SanPIN in Termez district of Surkhandarya region One in-country visit – 7 days. This task includes the following actions:

• Use the developed training package for training of health care workers and managers on waste management (waste minimization, recycling, segregation, storage, transportation, treatment, and disposal methods)
• Facilitate training for healthcare workers from modelling districts (hospital and all selected PHC facilities) on waste-management
• Build the capacity of the national team on waste management to ensure future sustainability
• Prepare training report.

5. Facilitate/supervise training for healthcare managers and healthcare workers, and 14 national level trainers on waste management based on developed SOPs and SanPIN in Boyavut district of the Syrdarya region. One country visit (Boyavut district). This task includes the following actions:

• Use the developed training package for training of health care workers and managers on waste management (waste minimization, recycling, segregation, storage, transportation, treatment, and disposal methods)
• Co-facilitate training for health care workers from modelling districts (hospital and all PHC facilities) on waste management with the national team of trainers
• Build the capacity of the national team on waste management to ensure future sustainability
• Prepare training report.

6. Facilitate/supervise training for healthcare managers and workers on waste management based on developed SOPs and SanPIN in Republican Emergency hospital. One in-country visit. This task includes the following actions:

• Use the developed training package for the training of healthcare workers and managers on waste management (waste minimization, recycling, segregation, storage, transportation, treatment, and disposal methods)
• Co-facilitate training for health care workers from a modelling facility (urban model) on waste management with the national team of trainers
• Build the capacity of the national team on waste management to ensure future sustainability
• Prepare training report.

7. Develop the HCWM consumables supply plan for new HCWM facilities and support evaluation of healthcare waste supply tender. This task includes the following actions:

• Based on the list of facilities selected for HCWM equipment installation and information on the number of hospital beds and number of visits to polyclinics (will be provided by UNICEF and national partners) develop HCWM consumables supply plan (3 days remotely)
• Present to partners, discuss and finalize, based on provided feedback, the supply plan for 20 healthcare facilities (1 day remotely)
• Review all documents submitted by suppliers, and ensure that all supply is in line with developed specifications (1 day remotely)
• Request additional information on supply quality if needed (1 day remotely)
• Prepare evaluation report (table) (1 day remotely).

8. Supervision of the quality of trainings conducted by national partners. One in-country visit (Namangan region). This task includes the following actions:

• Visit the training facilitated by national trainers, supervise quality, and provide daily feedback to the team of trainers to improve the quality of trainings (4 days)
• Prepare supervision report with recommendations on quality improvement and to present the national team of trainers (1 day).

9. Conduct one supportive supervision visit to HCWM modeling facilities to support the implementation of new SOPs and collect information to update costing tool. Visit to Uzbekistan (four regions). Online and offline. This task includes the following actions:

• Online meetings with 6 health care modelling districts/facilities to discuss challenges in implementations and provide technical guidance and remote support (4 days remotely)
• Develop a short supervision tool, consult with the national team of trainers and finalize based on feedback (3 days remotely)
• Train national trainers on supportive supervision visits methodology (1 day in the country)
• Conduct one supportive supervision visit (jointly with national trainers) to HCWM modelling districts/facilities, collect information to update costing tool and SOPs (12 days in-country)
• Prepare a supportive supervision report with recommendations for HCWM improvement. Discuss the report and finding with the national team of trainers and finalize it (3 days remotely)
• Present report to the management of modelling districts/facilities (1 day remotely).

10. Update draft costing tool developed in the beginning of 2022 for healthcare waste-management system (HCWM) model for urban and rural districts (remotely). This task includes the following actions:

• Update costing tool, present updated toll to national partners, discuss and finalize.

11. Technical support to Service of Sanitary and Epidemiological Welfare and Public Health of the Republic of Uzbekistan to update HCWM legislation and SOPs based on modelling experience (remotely). This task includes the following actions:

• Based on information collected during the supportive supervision visit review SOPs were bottlenecks, or other problems were identified (9 days)
• Present updated SOPs to national partners and finalize based on provided feedback (1 day)
• Based on information collected during supportive supervision, provide recommendations on a review of the current SanPIN (3 days)
• Discuss recommendations with partners from SES (1 day).

12. Conduct a technical assessment of HCWM models and develop recommendations on national scale-up. Visit Uzbekistan (Karakalpakstan, Syrdarya, Surkhandarya and Tashkent city) and work remotely. This task includes the following actions:

• Develop technical assessment tool, discuss with the national team of trainers, and finalize based on feedback (3 days remotely)
• Train national trainers on assessment methodology (1 day in the country)
• Conduct technical assessment visits (jointly with national trainers) to HCWM modelling districts/facilities (10 days in the country)
• Prepare assessment report with lessons learned and recommendations on HCWM scale-up. Discuss reports and recommendations with national partners (8 days remotely).

13. Facilitate the national meeting to present HCWM modelling results, lessons learned and recommendations for national scale-up with an approximate cost. Visit Uzbekistan (Tashkent city) and work remotely. This task includes the following actions:

• Develop the national meeting agenda, presentations, and handouts and discuss them with CO and national partners (5 days remotely)
• Co-facilitate the meeting (1 day in the country)
• Prepare the meeting report (1 day remotely)

Resource requirements and payments

The basis for the calculation of consultancy fees is based on the complexity of work and level of expertise. The final costs will be set based on the “best value for money” principle. Payments will be made on a delivery basis. Payments might be partially or fully withheld in case of unsatisfactory performance of duties or failure to provide quality deliverables.

Note. The fees will be paid via bank transfer upon acceptance of deliverables.

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

• Postgraduate degree in engineering, chemistry, environmental science and management, Public Health, or other relevant fields
• At least 10 years of progressive professional experience in the field of WASH/healthcare waste management
• At least 5 years of proven experience preparing national reports and assessments on waste management.
• At least 5 years of proven experience in Policy/Regulatory and Institutional assessments on WASH and waste management
• At least 5 years of proven experience in capacity building on WASH/waste management
• At least 5 years of proven experience in costing of WASH/waste management system
• At least experience in evaluation/assessments of WASH/waste management projects
• At least one year of work experience in CIS countries and knowledge of the Soviet health care system. Working experience in Uzbekistan will be an asset
• At least 1 year of working experience with UNICEF
• Good command of written English
• Good command of Russian will be an asset

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.

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.

Procedures and Working Conditions

The assignment will be performed home-based partly and partly in Uzbekistan. At least five in-country visits are expected. Travel expenses should be included in the financial offer of the candidate. The consultancy is responsible for obtaining an entry visa to Uzbekistan. However, UNICEF, within its means, shall facilitate the process. UNICEF will extend administrative/logistical support to facilitate meetings with national partners. The applicants shall be required to submit a statement of good health prior to commencement of work and take full responsibility for the accuracy of that statement. Consultants are not eligible to participate in the life or health insurance available to UN staff members.

Reservations

UNICEF reserves the right to withhold all or a portion of payment if performance is unsatisfactory, if deliverable(s) incomplete, not finalized, or fails to meet deadlines. UNICEF will reserve the copyright of all developed materials and own primary data collected through this assignment. The materials cannot be published or disseminated without the prior written permission of UNICEF. UNICEF will be free to adapt and modify them in the future. The contractor must respect the confidentiality of the information handled during the assignment. Documents and information provided must be used only for the tasks related to these terms of reference.

UNICEF undertakes no liability for taxes, duty or other contributions payable by the consultant on payments made under this contract.

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.