National consultancy to provide technical assistance to the MoHSPP RT in strengthening the quality of care for small and sick newborns, 256 w/ds (for Tajik nationals only) (deadline extended

Consultant Medical & Health Programme & Policy

Contract

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For every child, Health

The fundamental mission of UNICEF is to promote the rights of every child, everywhere, in everything the organization does — in programs, in advocacy and in operations. The equity strategy, emphasizing the most disadvantaged and excluded children and families, translates this commitment to children’s rights into action. For UNICEF, equity means that all children have an opportunity to survive, develop and reach their full potential, without discrimination, bias or favoritism. To the degree that any child has an unequal chance in life — in its social, political, economic, civic and cultural dimensions — her or his rights are violated. There is growing evidence that investing in the health, education and protection of a society’s most disadvantaged citizens — addressing inequity — not only will give all children the opportunity to fulfill their potential but also will lead to sustained growth and stability of countries. This is why the focus on equity is so vital. It accelerates progress towards realizing the human rights of all children, which is the universal mandate of UNICEF, as outlined by the Convention on the Rights of the Child, while also supporting the equitable development of nations.

According to Demographic and Health Survey 2017, in Tajikistan infant mortality rate was 27 per 1,000 live births; under-five mortality - 33 per 1,000 live births; child mortality – 17. 95 % of births was attended by the skilled providers and 64% of women received the recommended four (or more) antenatal care in 2017 (compared to 53 % in 2012) (DHS, 2017). Despite the substantial reduction in the under-five mortality rate (U5MR), from 102 per 1,000 live births in 1990 to 34 per 1,000 in 2019, and the infant mortality rate (IMR) from 81 per 1,000 live births in 1990 to 30 per 1,000 in 2019, the neonatal mortality rate decreased from 30,9 per 1,000 live births in 1990 to 14,5 per 1,00 live births in 2019 (UN IGME 2020).

According to MoHSP’s data, in 2022, the total number of deliveries was 239,233. The number of cesarean sections was 24,150 (10%). The number of preterm newborns was 12,392. The number of newborn deaths was 2,240, and 79,6% occurred in the early neonatal period. The number of stillbirths was 2,500. 1,5% of deliveries happened at home. In some mountain districts, home delivery is relatively high.

The MCH system is primarily geared up for providing strong maternal health services with midwives and obstetricians at the core of service delivery. This is also reflected in a very low MMR of 16.63 per 100,000 live births in 2020 (WHO, 2023). The system works on the concept of risk segregation where high-risk women deliver at tertiary care facilities while the ones who are perceived as low-risk deliver at lower-level health facilities.

In February 2023, an international UNICEF field mission was conducted on the quality of maternal and newborn healthcare. Findings of the experts’ visit confirmed a high mortality of newborns with birth weights over 2,500 grams in tertiary facilities demonstrating the need to improve quality of care and case management practices. The referral system for newborns to a higher center for appropriate management should also be strengthened, and stabilization of newborns before transportation is crucial to benefit from these referrals. Advanced newborn care (clinical records for NICU, infection control and treatment, appropriate use of medicines, neonatal developmental care, communication with parents, and transport of critical infants) has room for improvement.

In order to provide technical support to the MoHSP in strengthening the quality of care for newborns, a national expert in the field of neonatal care will be recruited.

How can you make a difference?

Under the overall oversight of the Chief of Section and direct supervision of Health Specialist, the consultant will work closely with MoHSPP’s Maternal and Child Health department on the planning, implementation and monitoring of the portfolio related to strengthening the quality of care for small and sick newborns. The consultant will be the main technical liaison between UNICEF, MoHSPP and other development and local partners for MNH related area of work.

DUTY STATION/DURATION:

Duration: 256 w/ds (August, 2023 - December 31, 2024)

Duty station: Dushanbe, Tajikistan

Supervisor: Health Specialist, UNICEF Tajikistan

Objectives

The objective of the assignment is to support the MoHSPP in strengthening the quality of newborn care by building national, regional and district level capacity to plan and to provide evidence- based care by:

• Assessing the quality of care in selected maternities and mapping perinatal service with geospatial links at all levels of care
• Developing five-year operational plan with interventions to improve the quality of care for mothers and newborns.
• Developing “task shifting” recommendations for maternities with no or a limited number of neonatologists and a sufficient quantity of midwives or nurses.
• Developing/updating policies and guidelines for referral and transportation of small and sick newborns from first to second and tertiary levels; an essential list of indicators on the quality of MNH care to be integrated into dashboards.
• Providing support in the implementation of interventions to improve the quality of care for mothers and newborns.
• Building national, regional and district hospitals' capacity to use all types of medical equipment related to maternal and newborn care; to develop facilities' quality improvement plans based on the guidelines/ tools piloted in the country within projects supported by UNICEF and WHO.
• Conducting regular visits to selected health facilities to ensure strengthened quality of newborn care.

Description of the assignment.

The consultant will provide ongoing technical support to government MNCH entities/ units to improve the quality of newborn care especially for small and sick newborns. The consultant will support the capacity building of MNH personnel on the use of MNH medical equipment and in provision of quality health care to newborns. The consultant will support relevant facilities to develop facilities’ quality improvement plans and to follow national protocols and standards. The consultant should consider lessons learned from other countries in the region or from other projects implemented in the country that focused on improving the quality of care for small and sick newborns.

Required tasks are focused on improving the quality of care for small and sick newborns in relevant health facilities throughout the country (68 maternities that provide service as secondary level facilities (level 2A and 2B), 12 tertiary level facilities).

Work Assignment

Tasks/Milestone:

Deliverables/Outputs:

Timeline

Payment schedule

1. Jointly with MoHSP staff, assess the quality of care in selected maternities and map perinatal service with geospatial links at all levels of care.

Del.1. Assessment and mapping report with findings and recommendations to improve service provision planning and close gaps in critical aspects of quality of care, including space, processes, staff, and supplies.

The report should classify facilities into three groups (A, B and C). The A group is facilities with adequate equipment, infrastructure, services, and staff for providing care based on national standards. The B group is facilities with partial equipment, infrastructure, services, and staff availability. The C group is institutions with insufficient equipment, infrastructure, services, and staff for providing care

40 working days. At least first three months.

August- November, 2023

Payment 1:

16 % of the total cost.

2. Jointly with MoHSP and international partners, develop five years operational plan with interventions to improve the quality of care for mothers and newborns. Use prioritisation criteria for maternities to arrange immediate support.

Del.2. The five years operational plan to improve the quality of care for mothers and newborns is approved by MoHSP.

30 working days.

By the end or the 4th or 5th month.

November 2023 or December 2023

Payment 2:

16 % of the total cost.

3. Jointly with MoHSP, develop “task shifting” recommendations for maternities with no or a limited number of neonatologists and a sufficient quantity of midwives or nurses

Del. 3. The “task shifting” recommendations for maternities agreed upon and approved by MoHSP.

10 working days. By the end of 6th month.

January 2024

4. Jointly with the national biomedical engineering consultant and partners, develop a training programme and materials, training plan for health for health personnel of selected PHC, secondary and tertiary level facilities (doctors and nurses) on the use of MNH medical equipment, including the provision of oxygen therapy to women, newborns and children.

Del.4.Training programme and training materials, training plan approved by MoHSP

20 working days. By the end of the 7th month.

February 2024

Payment 3:

19 % of the total cost.

5. Capacity building of health personnel in selected tertiary, secondary and PHC facilities on the use of medical equipment (based on the training plan).

Del.5. At least 80% of health personnel in selected health facilities are trained in the use of medical equipment. Training reports.

6 working days (at least 3 trainings two days each for 80 participants). By the end of the 8th month.

March 2024

6. In collaboration with MoHSP develop an essential list of indicators on the quality of MNH care to be integrated into dashboards in piloting digital data collection and information-sharing tools.

Provide recommendations in strengthening disaggregated data collection system, digitalisation and visualisation of MNH quality of care data.

Del.6. List of indicators.

List of recommendations agreed with MoHSP for all projects on the digitalisation of healthcare.

25 working days. By the end of the 9th month.

April 2024

7. Jointly with MoHSP and national stakeholders, develop/update policies and guidelines for referral and transportation of small and sick newborns from first to second and tertiary levels.

Del.7. The developed/updated policies and guidelines for referral and transportation of small and sick newborns approved by MoHSP.

20 working days.

By the end of the 10th month.

May 2024

Payment 4:

By the end of July: 24 % of the total cost.

8. Provide support in the implementation of interventions to improve the quality of care for mothers and newborns including 1) supporting the development of facilities' quality improvement plans and supervise implementation jointly with national partners, 2) providing support and guidance to the selected facilities in establishing best clinical practice centers to support and quide newly equipped second- level facilities and 3) ensuring proper use of MNH medical equipment selected health facilities (jointly with the national biomedical engineering consultant; 4) capacity building of health personnel in selected tertiary and secondary level facilities. Prepare quarterly reports on the implementation of the five-year operational plan.

Del.8. Relevant health facilities visited to provided technical support and guidance.

Approved facilities plan in selected medical facilities.

Selected facilities are performed as best clinical practice centres.

Supervision report with conclusions and recommendations for follow-up.

At least 3 reports on accomplished tasks are submitted to MoHSP and UNICEF (March 2024, June 2024, September 2024).

100 working days.

During the contracting period.

20 visits x 5 days each.

During the contracting period

Payment 5:

By the end of October: 23 % of the total cost.

9. Completion report with incorporation of UNICEF Technical Lead and MoHSP’s feedback and with practical recommendations and outlining recommendation for the further strengthening of service provision.

Del. 9. Final report is submitted to UNICEF and MoHSP.

5 days

December 2024

Payment 6:

2 % of the total cost.

Total:

256 days

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

• Education: Advanced university degree in health with focus in Pediatrics with specialization in Neonatal Health
• Work experience: A minimum of eight years of professional work experience in the area of MNCH and quality of health services for newborns and children; previous working experiences with Ministry of Health and Social Protection of Population of RT, or any private sector entities and familiarity with the system would be preferred; previous working experience with UNICEF, WHO, UNFPA and/or development partners (GIZ, USAID’s supported projects, AKF/ AKHS, international NGOs) working in health sphere would be an added advantage; practical experience on having undertaken similar assignments.
• Skills: Strong analytical and conceptual thinking. Excellent writing skills, including the experience in preparation of reports, analytical references. Excellent communication and presentation skills with stakeholders and the ability to work under pressure and commitment to work to a tight timeframe
• Languages: Working knowledge of English is an asset. Excellent proficiency in Tajik and Russian (written and oral) while knowledge of English is an advantage

Qualified candidates are requested to submit:

• Financial proposal specifying consultancy fee, per day of work, requested for the tasks described in the Terms of Reference in TJS, plus travel cost as per Travel Plan: Approximately 50 trips (travel cost will done as per agreed Travel Plan) and DSA 160 days.
• Short sample or links to related work previously conducted by the consultant
• Technical proposal with proposed work plan, including Travel Plan
• Other relevant documents (CV, letter of interest, training certificates)
• Contacts of three referees (recent direct supervisors)
• Applications without technical and financial proposals will not be considered.

Applications must be received in the system by 1 October 2023 on UNICEF website.

• Those who have applied already, no need to re-apply. Your qualification will be considered accordingly.

Please see the list of deliverables in Russian language at the following link below:

Vacancy National consultancy to provide technical assistance to the MoHSPP RT - deadline extended_RU_deliverables.docx - Google Docs

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.

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 10 months ago - Updated 8 months ago - Source: unicef.org