National Consultant on Maternal Health and Establishment of High Dependency Units in UNICEF supported facilities, NOC, Kampala, Uganda, 11 Months (Ugandan Nationals 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.

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Uganda is one of the over 190 countries and territories around the world where we work to overcome the obstacles that poverty, violence, disease, and discrimination place in a child’s path. Together with the Government of Uganda and partners we work towards achieving the Millennium Development Goals, the objectives of the Uganda National Development Plan, and the planned outcomes of the United Nations Development Assistance Framework.

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Background

Ending preventable maternal and perinatal mortality is a global priority under the Sustainable Development Goals (SDG) agenda. The aim is to reduce the average global Maternal Mortality Ratio (MMR) to less than 70 maternal deaths per 100,000 live births and neonatal mortality to at least 12 deaths per 1000 live births by 2030. The current health sector development plan (2016-2020) targets are to reduce MMR from 336 to 219/100,000 live births and for institutional MMR from 92 to 60/100,000 between 2020 and 2025 has been set in the revised plan. As of 2018/2019, West Nile subregion had an institutional MMR of 99.1/100,000 live births.

Uganda achieved a remarkable progress in improving maternal new-born and child health indicators over the past decade. In 2019, the Annual Health Sector Report (2018/19) showed that 42 and 62 per cent of pregnant mothers attended 4th Antenatal care (ANC) visits and delivered in Health Facilities compared to 38 and 60 percent in 2017/2018 respectively. These improvements in coverage indicators have translated into some reductions in maternal mortality. The number of maternal deaths among 100,000 health facility deliveries reduced by 12% to 92 per 100,000 facility deliveries in 2018/19 from 104 per 100,000 in 2017/18. This achievement is beyond the target of 102 per 100,000 facility deliveries for FY 2018/19 however the main causes of mortality remain the same. Obstetric hemorrhage is the leading cause of maternal deaths accounting for 46% of all the maternal deaths reported, followed by hypertensive disorders (11%) and puerperal sepsis (6%). Abortion related complications accounted for 5% of maternal deaths.

Specifically, post-partum hemorrhage (PPH) accounted for 39% of all deaths and 84% of all cases (206) of obstetric hemorrhage with ruptured uterus due to obstructed labor estimated at (34%), uterine atony (19%), and rupture of previous scar (16%). Hemorrhage after Caesarean section accounted for 4% of maternal deaths. PPH has therefore been a key area of focus of the Safe motherhood technical working group and specific guidelines are under development and there is interest in addressing the other major causes; pregnancy induced hypertension, sepsis and complications of abortion.

While there is paucity of data on near-misses in developing countries, a BMJ study estimates that “for every maternal death, there are nine women who develop severe maternal ‘near-miss’ morbidity: Many of these women will need critical and the WHO near miss approach recognizes that women who survive life-threatening conditions arising from complications related to pregnancy and childbirth have many common aspects with those who die of such complications.

UNICEF in partnership with the MOH, district local governments and implementing partners such as Baylor, Intra-health and AVSI, are working to strengthen the capacity of the districts to deliver an integrated package of Reproductive, Maternal, New-born, Child and Adolescent Health and Nutrition (RMNCAHN) services inclusive of HIV, and Nutrition using a Health System Strengthening approach and Quality Improvement (QI) approaches. Additional efforts are geared towards supporting facilities to implement the WHO QOC standards for mothers, newborns and children, and support the application of learning from MPDSR.

The UNICEF-supported activities aim to strengthen the continuum of care for maternal, new-born and child health with emphasis on three result areas including;

1. Increasing availability and service readiness of Essential Maternal New-born Child Health services (Emergency Obstetric and New-born Care, Ante Natal Care, Deliveries, Post Natal Care, Integrated Community Case Management) at the facility and community levels in priority districts
2. Increasing utilization of quality maternal, new-born child health services, including emergency obstetric and new-born care at the community and referral facility levels
3. Increasing community awareness, demand and acceptance of lifesaving MNH interventions through innovative approaches for MNCH services.

To strengthen the availability and quality of services for critical care for mothers, UNICEF will recruit an obstetrician on consultancy terms to support Ministry of Health, targeted hospitals and districts to support functionalisation of High Dependency Units (HDUs), provide technical oversight and strengthen systems for the implementation of MNCH quality improvement guidelines and standards as described below in the tasks/deliverables.

PURPOSE OF ASSIGNMENT:

The consultant will work in collaboration with the MoH National Expert Group, UNICEF MNH team in Kampala and UNICEF Health Specialist in Gulu zonal office to establish and functionalize 10 High Dependency Units for care of mothers with critical care needs in selected hospitals of West Nile region and the Kawempe National Referral Hospital, in line with the national quality of care standards

To achieve this the consultant will:

• support the development of key guidelines, protocols and tools on maternal critical care;
• support set up and build capacity of clinical teams in targeted hospitals to provide critical maternal care;
• track HDU performance using agreed monitoring framework, identify bottlenecks, propose solutions and assist the hospital teams implement those;
• document the set-up/implementation process and capture evidence of improvement capacity to manage critical maternal cases, good practices and lessons learned.

Scope of Work

Overall objectives: As part of UNICEF support to strengthen the maternal and new born health with a focus on quality improvement, the consultant will closely work with MoH national expert group on safe motherhood, UNICEF MNH Specialists, UNICEF Zone office health teams and identified health facility management and clinical teams to: Develop and disseminate protocols on management of maternal complications

Development of management guidelines on major causes of maternal complications: Hemorrhage, pregnancy induced hypertension and sepsis.

• Support review /adaptation of condition specific guidelines for maternal care.
• Follow-up on identification/selection and set-up of spaces in targeted hospitals.
• Follow on distribution and installation of HDU equipment.
• Provide onsite capacity building of clinical teams on risk assessment, prevention, identification and management of obstetric complications.
• Support coordination with IPs/partners in the field.
• Monitoring and documentation of progress; sharing of learning, including linkages to Quality Improvement and Maternal and Perinatal Death Surveillance and Response (MPDSR).
• To qualify as an advocate for every child you will have…

The selected Consultant should have:

Education:

• An advanced university degree required in Obstetrics and Gynecology and other additional trainings in intensive care and quality assurance, health system strengthening and management as an added advantage.
• First university degree required in relevant areas of medicine

Work experience:

• At least 5 years of professional experience working at the frontline in a secondary or tertiary health facility managing obstetric conditions.
• Experience in public health and or related field, including the development of strategies, program management and QI approaches in clinical setting is highly desirable.
• Experience in data collection, analysis, and monitoring of maternal health programmes.
• Experience working with the national and district local governments in Uganda, and a solid understanding of the health system.
• Proven ability to conceptualize, plan and execute ideas as well as to transfer knowledge and skills.
• Strong writing and communication skills and the aptitude to handle competing messages and priorities with multiple audiences.
• Proven ability to manage relationships with UNICEF partners, including UN organizations, NGOs and the private sector.
• Willingness and ability to travel often and to work in remote and sometimes insecure locations.
• Fluency in written and verbal English.

Competencies:

Core Values

• Commitment
• Diversity and inclusion
• Integrity

Core competencies

• Communication
• Working with people
• Drive for results

Functional Competencies:

• Planning and organizing
• Formulating Strategies and Concepts
• Analysing
• Relating and networking
• Deciding and Initiating action
• Applying technical expertise

Application Procedure/Call for Proposals

Interested candidates are required to submit a technical proposal on how they intend to approach the work. The proposal should include a timeline, and methodology, based on the Terms of Reference. The proposal must also include detailed CV of the consultant, as well as a financial proposal, clearly indicating daily rate for professional fees. The financial proposal must be all-inclusive of all costs (consultancy fees and where applicable air fares, airport transfers, daily living expenses). This is an international level consultancy and competitive market rates should apply.

Evaluation of Candidate:

The consultant will be competitively selected from a list of applicants based on their past experience of doing similar work (extensive experience in writing donor reports, in compiling and editing annual reports for various UNICEF offices).

For every Child, you demonstrate…

UNICEF’s core values of Commitment, Diversity and Integrity and core competencies in Communication, Working with People and Drive for Results.

The competencies required for this post are….

View our competency framework at

http://www.unicef.org/about/employ/files/UNICEF_Competencies.pdf

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 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, therefore, undergo rigorous reference and background checks, and will be expected to adhere to these standards and principles.

Remarks:

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.