MR/TCV Immunization Coverage and Assessment Consultant
Background
In March 2018, WHO recommended introducing typhoid conjugate vaccine (TCV) for infants and children over six months of age in typhoid-endemic countries. This new policy expanded access to typhoid vaccination in communities most impacted by the disease. Typhoid is responsible for nearly 12 million infections and between 128,000 and 161,000 deaths yearly.
The TCV recommendations were issued following a review of evidence on TCVs by WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization in October 2017. The group considered data on vaccine safety, efficacy, feasibility, and affordability, as well as growing rates of drug-resistant typhoid. Based on these discussions, SAGE recommended TCVs for children over the age of six months.
The WHO guidelines emphasized the use of typhoid vaccines to control endemic and epidemic typhoid. Where feasible, vaccine introduction was recommended to be accompanied by catch-up vaccination campaigns for children up to 15 years of age in endemic countries. Furthermore, the position paper recommended prioritizing TCV introduction in countries with the highest disease burden or a growing burden of drug-resistant typhoid.
Given the high burden of typhoid disease in Malawi, the Ministry of Health (MOH) and its partners commenced processes to introduce the TCV vaccine into the country to control the burden of the disease.
Since the onset of COVID-19 pandemic, most countries, including Malawi have experienced declining coverage in routine immunization. The country’s Measles-Rubella coverage has been significantly affected, and the occurrence of measles outbreaks in neighbouring countries further heightens the risk of measles- rubella outbreaks in the country.
Achieving optimal immunization coverage (≥ 95%) with 2 measles- and rubella-containing vaccine doses at all subnational levels while bridging immunity gaps in all age groups is crucial for the elimination of measles and rubella.
To reduce the burden of Measles–Rubella and Typhoid whilst addressing the immunization coverage gaps, the MoH and its partners have initiated processes to introduce TCV into Malawi and conduct Supplementary Immunisation Activities (SIAs) for Measles-Rubella to reach all zero- dosed under-immunized and unreached communities with these life-saving vaccines.
It is against this background that WHO would like to hire a consultant to provide technical expertise to support a Post MR/TCV SIA vaccine coverage survey.
Task/Assignment
Purpose of the activity
The purpose of the consultancy is to conduct a Post MR/ TCV SIA Coverage Survey following the planned integrated TCV/MR SIA.
Description of activities to be carried out
Under direct supervision of the WHO Country Representative and in close collaboration with the WHO EPI manager and Ministry of Health and key immunization stakeholders in the country, the consultant will provide technical guidance and ensure that the following activities are conducted with high technical quality:
- Lead the preparatory processes for the conduct of a Post MR/TCV SIA Vaccine Coverage Survey using the WHO Stratified Cluster Survey approach.
- Support the MOH/EPI, the NPO and survey steering committee to develop survey protocols highlighting key components such as the design the survey, sample size, target groups, sampling methods, data management systems etc.
- Develop training guidelines and protocols for training of data collectors, supervisors, data management team members and coordinate the implementation of the trainings.
- Develop a comprehensive logistics plan for the survey
- Develop comprehensive costed budgets for the conduct of the survey and dissemination of the findings of the survey.
- Lead the conduct of a Post MR/TCV SIA Coverage Survey using the WHO Stratified Cluster Survey approach.
- Coordinate data collection processes for Post MR/TCV SIA Vaccine Coverage Survey in the various clusters.
- Support field supervisors to conduct field supervision of filed activities in the various clusters
- Coordinate daily review meetings from field supervisors to review processes, identify gaps and develop interventions to address or mitigate effects of gaps.
- Coordinate the data collation and analysis process for all data reported from the various clusters and consolidate to have a comprehensive database of entire exercise.
- Coordinate the data analysis process
3. Support Stakeholder consultation to gather data and contribute to interpretation of data
3.1 Conduct focused group discussions and Key Informant Interviews using structured
questionnaires to collect qualitative data to aid interpretation of findings and enrich
survey findings
4. Develop comprehensive report of the Post MR/TCV SIA Coverage Survey
4.1. Develop a comprehensive report on the findings from the coverage survey highlighting
the methods, findings, challenges, best practices, and recommendations. Report should
highlight data including trends, geographic disparities in coverage, important determinants
of under-vaccination ‘including but not limited to gender, socio-economic status,
education, religion, disability, geographical location and effective social change,
communication and interpersonal approaches aimed at addressing identified vaccination
challenges.
5.0 Facilitate national consultative workshop with national participation of MoH, WHO, and other
partners
5.1 With support from the MOH/EPI and NPO, conduct a validation meeting with
stakeholders to review and validate key findings form the survey ahead of finalisation of
report.
5.2 Finalise Report and coordinate the dissemination of findings to all relevant stakeholders.
Output and Deliverable
Output 1: Pre- Survey Preparations
- Post TCV/ MR Survey Protocol/ Guideline for Implementation
- Post TCV/ MR Survey Training Manual for Field Officers and Supervisors
- Post TCV/ MR Survey Data Management Guideline
- Post TCV/ MR Survey Budget
Output 2: Implementation of Post TCV/ MR Coverage Survey
- Report on a repository of all identified data sources
- Summary Field activity Report
- Database on all collated data from all clusters across the country
Output 3: Stakeholder consultation to gather data and contribute to interpretation of data
- Report on findings from bilateral consultation and validation meetings with key stakeholders and donors
- Report on findings from field visits to regions in low performing districts and high performing districts, to be considered in the methods based on the survey tools
Output 4: Report on data, findings, and recommendations
- Comprehensive report on major findings, challenges, and recommendation’s
Output 5: Facilitate national consultative workshop with national participation of MoH, WHO, and other partners
- Incorporate feedback from consultative members in Final survey report
- Develop final report with an executive summary of the key findings and recommendations, improvement plan, and the dataset
Qualifications, experience, skills, and languages
Education Qualifications
Essential: Postgraduate degree in a public health or related field
Desirable: At least a master’s degree in Medicine, Public Health or other related field of Social Sciences
Work Experience
Essential: Minimum of eight years of professional experience in the management of public health programs
Desirable: Research experience in both quantitative and qualitative methods
Knowledge of national immunization programs and health systems
In-depth knowledge and experience with Reaching Every Community (REC) approach
and Immunization coverage Assessment
Previous experience in the countries or regions with similar context to Malawi is an
Asset
Skills/Knowledge
- High capacity for data analysis meta-analysis and data triangulation and produce data repository
- Excellent communication skills
Languages and level required
Proficiency in English language is required (Read - Write - Speak)
Competencies
- Teamwork
- Effective communication
- Producing results
- Knowing and managing yourself