International Consultant: Immunization Equity Assessment (Non-Gambian only)

Contract

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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, hope

For over 40 years, UNICEF and partners have supported countries in the global drive to bring vaccines to the world’s most vulnerable children, defending their rights to survive and to be healthy. Immunization is one of the most powerful tools to end preventable child deaths, saving up to 3 million children a year. In the last 5 years, global immunization coverage has stagnated around 84%, leaving 19 million children unprotected every year. These children belong most likely to the poorest families, have the least access to health care and bear the largest burden of preventable diseases and deaths. An estimated 1.5 million unvaccinated children die each year from vaccine preventable diseases.

The Global Vaccine Action Plan aims at 90% coverage nationally and 80% in every district and calls for recasting or Reaching Every District Approach to Reaching Every Community, with an emphasis of reaching marginalized communities with lifesaving vaccines. UNICEF along with its partners are fully engaged and support the goals outlined in the Global Vaccine Action Plan (GVAP).

While the Gambia has recorded impressive gains in EPI coverage over the years, there is increasing evidence of slippage in coverage of individual antigens and overall full immunization coverage remains elusive. Administrative coverage data from the EPI/MOH indicates BCG coverage dropped from 94% in 2018 to 81% in 2021. This signifies a drop in first contact of newly born babies with the health system. Coverage for Measles vaccine second dose also dropped from 71% in 2018 to 62% in 20220. This signals a drop in consistence of attendance of EPI clinics. The country has started recording outbreaks of measles and data from Medical Research Council (MRC) studies indicates risk of Rubella as well.

Furthermore, over the same period, there have been delays in the implementing the MR campaigns and the introduction of HPV also encountered challenges. The outbreak of COVID-19 and the subsequent disruption of health services also negatively impacted on routine immunization uptake.

It is against this backdrop of lowering coverage and inequities in immunization that UNICEF assists the governments to plan and implement equity assessment which will help refine strategies to address inequities, low coverage and ensure that all target populations, wherever they live and whatever their status, can access and choose to access Immunisation services with ease and without hinderances.

How can you make a difference?

The consultant would develop a work plan to cover the following activities:

• Design and conduct a rapid community-based equity assessment with focus on immunization services. The assessment will focus on: Attendance and regularity of immunization clinics; assess reasons women and children are not regularly attending EPI Clinics. (Refusal/hesitancy; missed opportunities, cancelation of clinics).
• S/he will also review the existing immunization data to identify pockets of communities with low coverage and tease out reasons for such low coverage.
• Generally, review the national EPI operation to identify reasons for faltering EPI services

Under the direct supervision of the Health Specialist, the consultant will work in close collaboration with the Immunization Officer, EPI/MOH and other stakeholders in the country. S/he will provide technical guidance and assist EPI, ineffective planning, design, implementation of Equity Assesment and timely reporting .

Activities, Tasks, Outputs and Deliverables

In order to achieve the above, the Consultant will work in close collaboration with the national EPI manager, and the WHO/UNICEF Country Offices. The consultant will provide technical support to ensure that all activities are conducted in timely manner and ensure incorporation of all inputs by the country technical team for the final deliverables. The consultant will be responsible for the following tasks/activities listed below:

1. Develop and administer survey tool to be used at selected health facilities. This is focus on understanding the impact of program issues of access and utilization of vaccination services.

2. Develop and administer survey tool to be used at selected communities (rural and urban). This is focus on understanding the impact of issues of access and utilization of vaccination services within the community. (5 days).

3. Facilitate a 1-day national orientation / planning workshop together with other UNICEF and Ministry of resource persons. (3 days)

4. Supervise field data collection using the tools developed at facility and community level.

5. To provide recommendation for community approaches and communication for immunization strategies in the Reach Every Child (REC) approach, as appropriate. This will be incorporated in national plans and Country Multi Year Plan (cMYP).
6. To review supportive supervision guideline, monitoring and evaluation tools (which will also include monitoring of community engagement) and mechanisms to use them.
7. To review periodic EPI meeting guideline to analyze data on causes of bottlenecks, solutions and use of data for action (monitoring for action, 5 whys, feasible solutions)
8. Facilitate coaching and mentorship of National EPI staff using the developed tools.
9. Review evidence in immunization equity and document lessons for Reaching Every Community (report and peer reviewed article)
10. Organize a workshop for dissemination of key findings of equity assessment report.
11. Provide final report on the equity assessment to MOH/UNICEF.

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

• Background in social science with experience in public health.
• Previous work on immunization services would be an advantage
• A University Degree in Social Science/Public Health preferably master’s level from a recognized university.
• Minimum of five years of professional experience in the management of public health programs.
• Knowledge of national immunization programs and health systems
• Familiarity with the determinants-based approach to bottleneck analysis is an asset
• Previous experience with UNICEF programs 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 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.