International Consultant for Feasibility Assessment to integrate a Model for Early identification and Early Intervention services within existing programmes of the Ministry of Health of Uzbe

Consultant Medical & Health Programme & Policy

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Background:

The first five years are fundamental building blocks in the life of every child when she acquires behavioral competencies and learns social skills necessary for development and inclusion in the society. Early identification and intervention (EIEI) for children with disabilities is a multi-disciplinary mechanism, triggered at birth or the earliest possible after that, aiming to support the child in achieving her maximum potential, remedy impairments and create a positive experience for the whole family.

In Uzbekistan, the national definition is somewhat unbalanced disproportionately emphasizing “correction” and “delays” and underplaying the importance of social support and quality of life. However, it is a workable definition that should now be developed into practical measures to ensure the availability of EIEI services for children from birth on.

In 2022 the Government of Uzbekistan adopted several legislative acts aimed at simplifying access to disability determination procedures, improving the quality of medical and social services provided to persons with disabilities, developing Uzbek sign language and Braille alphabet, improving the procedure for the appointment of pensions6, adapting jobs and professions for persons with disabilities.

However, the legislative or conceptual framework for early intervention services, multidisciplinary and holistic approaches for assessment or evidence-based educational and social interventions or family information and support systems is absent.

Availability of community-based social support services is the main prerequisite for realisation of the child’s right to grow up in a family environment. Due to societal prejudice and lack of EIEI services, children with disabilities are placed in segregationist settings and deprived of access to essential services necessary for their development. This includes placement in residential institutions and boarding schools, subpar health and rehabilitation services, and lack of inclusive education at all levels. These shortcomings prevent children with disabilities from having a fair start in life and putting them at a lifelong disadvantage.

Conversely, absence of age-appropriate affordable and non-discriminatory support services is often the reason behind placement of children into state care. However, availability of public services in the community is largely limited to the Republican Centre of Social Adaptation of Children (RCSAC). While the Tashkent Centre and its three regional branches in Ferghana, Samarkand and Karshi provide useful and necessary services to children and young people with disabilities, they are hardly able to respond to the ever-increasing demand for rehabilitation services in the community: according to the RCSAC website, each branch services up to 1500 children with disabilities a year.

In Uzbekistan, the Ministry of Health (MOH) is responsible for early identification and intervention. The current system is fragmented, and health care providers don’t have appropriate knowledge and skills. The referral system and multisectoral collaboration is lacking due to the absence of standards and protocols and limited staff capacity, particularly in rural and remote areas. Families’ only local contact in healthcare are general practitioners at outpatient Primary Health Care (PHC). They are often not equipped with knowledge on early diagnosis and as result, children do not get timely referral to receive qualified interventions and services. Through Universal Home Visiting Program, the MOH with UNICEF’s support can provide families not only with early identification of developmental delays and health issues, but also increase parent knowledge of child development, improve parent practices, prevent child abuse and neglect, and increase children’s school readiness.

Due to novelty of a concept of early childhood intervention for the country and lack of local capacity, an international expertise is required to support the Ministry of Health in conducting Feasibility Assessment to integrate a Model for Early identification and Early Intervention services within existing programmes of the Ministry of Health of Uzbekistan.

Purpose of the study:

The purpose of this consultancy is to generate evidence on existing EIEI approaches and services as well as recommendations for integrating a Model for Early identification and Early Intervention services within existing programmes of the Ministry of Health of Uzbekistan.

Objectives of study/research:

1. Understand the current situation of EIEI within the MOH in Uzbekistan:

• analyse provision of family-centered, multi-sectoral EIEI services in terms of types of programs, availability, access, utilization, financing etc;

• analyse the capacities of existing support services of all types as well as service arrangements for delivering integrated, multi-sectoral and interdisciplinary family-centered EIEI systems;

• analyse case management and effective referrals to other complementary services;

• identify potentially promising programs and practices for scale up, scope of services within those EIEI programs, their coverage in terms of child and family characteristics, human resource capacities, needs for training and support, and gaps in current services.

2. Review the current targeting and screening assessment tools and understand their use.

3. Provide evidence-based recommendations on how to improve the tools to ensure children with developmental delays and disabilities are identified and linked to the appropriate services and update tools accordingly.

4. Test the updated tools and adapt for implementation.

Methodology:

The methodology features a “mixed methods approach” to data collection. Both primary and secondary data sourced will be used. A desk review will be conducted first, followed by qualitative data collection (high-level interviews and focus group discussions).

The assessment will utilize to the maximum extent possible online data collection methods (high-level interviews and focus group discussions).

Timeline & Deliverables:

It is expected that selected Individual Consultant will perform the following tasks and fulfil the following deliverables in the period 1 Apr – 30 June 2023.

1. Inception phase

Tasks and Timeline:

1. A thorough desk review should (10 working days): - focus on reviewing available data sources, best practices in the region both in terms of evidence available and practical implications for change, legal frameworks that include relevant legislations, national strategies and policies and other relevant documents;

• map current targeting approaches, assessment tools, referral pathways and linkages between interventions and services;

• review the available screening/assessment tools, including associated programme outcome data (if available);

• outline the proposed methodology, workplans and tools.

2. Develop a conceptual framework, tools for the key informant interviews (KIIs) and focus group discussions (FGDs) with ethical considerations based on the stakeholders mapping (5 working days)

3. Attend an inception meeting with the MOH and key partners (1 working day)

4. Test, evaluate and adjust tools developed (4 working days)

Deliverables:

Inception report detailing the proposed methodology for meeting deliverables of this consultancy, including workplan and relevant data gathering and reporting tools e.g. interview/consultation guide and list of interview with key stakeholders

2. Data collection phase

Task and Timeline:

1. Conduct consultations/FGDs and KIIs with stakeholders to understand experiences of what is being done, what tools are used, and linkages and referrals, including bottlenecks, challenges and lessons learned with regards to use and effectiveness (5 working days).

3. Data analysis

Task and Timeline:

1. Conduct analysis of the collected data (3 working days)

Deliverables:

PPT of desk review and consultations that capture the experience and delivery of current EIEI community/HCF screening and assessment tools, including challenges, lessons learned, and recommendations to strengthen the effectiveness of the tool/programme in linkage and referral processes.

4. Finalization phase

Task and Timeline:

1. Provide evidence-based recommendations on how to improve the tools to ensure children with developmental delays and disabilities are identified and linked to the appropriate services and update tools accordingly (3 working days)

2. Develop a PPT presentation summarizing and circulating key fundings and recommendations for a validation meeting (1 working day)

3. Update the current tools in line with recommendations for improvement and strengthening of referral and linkages and develop a brief accompanying implementation guide (2 working days)

4. Develop a test phase pilot concept to determine effectiveness of updated tools for EIEI as part of existing programmes (2 working days)

5. Analyse the outcome data of the screening/assessment tool pilot (2 working days)

6. Draft a report and PPT on the test phase pilot for a validation meeting (1 working day)

7. Update the tool and implementation guide according to the outcomes of the pilot and validation meeting (1 working day)

Deliverables:

1. Final report with recommendations for improvements and comments from validation meeting incorporated and approved.

2. Updated screening /assessment tools and implementation guide based on validation meeting.

3. Concept note for the test/pilot phase including monitoring plan and outcome analysis.

4. Test phase data analysis report.
5. Updated tools and implementation guide based on outcomes of test phase pilot.

Management:

It is expected that this work will be conducted by international consultant, which will work under the direct supervision of UNICEF Health and Nutrition Specialist in close consultation with UNICEF Gender and Inclusion Specialist and identified national partners and government officials.

Resource requirements:

The timeframe is 40 working days in the period of 1 Apr – 30 June 2023, including home-based consultancy and 5-days visit to Tashkent. The estimated budget for this assignment is USD, including consultancy fee and travel expenses.

Qualifications and experience:

• Post graduate degree in early childhood education, social sciences, special needs education, early childhood intervention for children with developmental difficulties, psychology, public health or another relevant subject. Candidates with doctorate level degrees will be an asset.

• At least ten years of solid professional work experience at international level with focus on EIEI for the children with developmental difficulties, systems and evidence-based, family-centered practice.

Knowledge and skills:

• Demonstrated ability to produce high quality analytical reports. • Familiarity with the Central Asia Region’ context and previous involvement with UNICEF.

Competencies:

• Knowledge and experience of UNICEF programmes of cooperation and the human rights-based approach to programming. Prior experience working with UN/UNICEF will be an asset.

Languages

• Excellent writing skills in English language.

• Knowledge of one of the local languages (RUS, UZB) will be considered as assets.

For every Child, you demonstrate…

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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.

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