PHC Consultant

Purpose of the Consultancy

To provide technical support to the MoH in oPt to introduce primary health care (PHC) quality improvement approach in PHC facilities in Gaza.

Background

Over the past decades Gaza Strip has been witnessing occupation, war, conflict, and economic closure which draws attention to the particular vulnerability of children in such situations. Statistics shows that the number of children in the age group 0-14 years in Palestine is accounting for about 37% of the population[1]. Moreover, the under-five Child mortality rate per 1000 live birth is 14.2 deaths per 1000 live births, infant deaths account for 85% of deaths in children under the age of five (12.1/1000)[2] In Gaza, Infant mortality rate accounted for 10% of all mortalities in 2020. The most common causes of death were, congenital anomalies (26.9%), prematurity and low birth weight (15.3%), respiratory diseases (22.2%), heart problems (10%) and sudden death and communicable diseases (10%), malnutrition (2.3%)[3] , other causes including cerebral palsy, accidents and cancer (3.6%). The Sustainable Development Goals (SDGs) adopted by the United Nations in 2015 were developed to promote healthy lives and well-being for all children. WHO calls to innovative, multiple, and tailored approaches to increase access, coverage, and quality of child health services.

Nurturing care for early childhood development developed a framework for helping children survive and thrive to transform health and human potential. Improving the services for young children and their families is among the five components of NC. Health and nutrition services are prioritized through provision of care before, during, and after birth, promote breastfeeding and good nutrition, monitor growth, and prevent and treat common childhood illnesses. Although, this is already in place continuous, there will always be a need to strengthen services wherever there are gaps – when services have poor coverage or quality.

In Gaza, Child health services are provided at primary health care level through 27 clinics run by Ministry of health and 22 Primary Health Care clinics run by UNRWA in addition to 19 clinics run by NGO and 5 clinics run by medical military services. MoH and UNRWA are considered the key health providers for child health services. As per MoH reports, child health programs provided at MoH is linked to immunization visits and screening of phenylketonuria and congenital hypothyroidism and nutritional services. However, there is no unified protocol or guidelines for child health services. MoH follows Integrated Management of Childhood Illness (IMCI) and infant and young child nutrition which was lastly updated in 2014. While UNRWA has its own internal technical instruction for provision of child health services which was lastly updated in 2010. In general, there is a little evidence about the quality child health services provided to children.

Primary health care Quality Improvement approach identifies strengths and gaps in the quality and availability of core survive and thrive interventions for infants and young children at primary care facilities. The focus is on all children between birth and five years of age who are at highest risk of morbidity and mortality. Survive interventions address illnesses accounting for most deaths of children including vaccination. Thrive interventions ensure early childhood development and prevention of disabilities, injuries, violence, abuse, and neglect. All programmes must ensure survive and thrive interventions are delivered effectively. As coverage of survive interventions increases and child mortality declines, thrive interventions are usually added.

The Ministry of health is currently in the process of updating its child health guidelines for well and ill child. Within it, an assessment on quality of PHC care for infant and child will be necessary to indicate the gaps and priorities to subsequently address.

Work to be performed

In Gaza

Output 1: Technical support to the MoH and UNRWA to introduce PHC assessment, planning and quality improvement approach for infant and child health care in PHC facilities

Deliverable 1.1: Child health - Review of local guidlines for well and sick child with local review team.

Deliverable 1.2 : work with the national team on adaptation of the tool for Primary Health Care

Quality Improvement of Care for infants and young children

Deliverable 1.3: Assist in coaching PHC teams/facilitators; follow up assessment and planning implementation

Deliverable 1.4: work with national team to use data to determine priority actions, recommendations for quality improvement and annual action plan for improving child health at outpatient facilities

Specific requirements

- Qualifications required:

1. Medical degree
2. Public health or paediatric or family medicine or other relevant master or doctorate level degree

• Experience required:

1. At least 5 years of experience in developing country settings

2. At least 10 years of practical experience supporting country and health facility level planning, implementation, scale up, monitoring and evaluation of child health programmes

   Desirable: Working experience in West Bank and Gaza or middle-eastern countries.

• Skills / Technical skills and knowledge:

1. Expertise in the gathering, analysis and use of epidemiological data – particularly in the area of child health
2. High level technical skill in core areas such as programme planning, management, monitoring and evaluation
3. Experience in planning and facilitation of meetings and workshops; writing and development of tools, methods and guidelines; publications in RMNCH topic areas; and advocacy and discussions with senior country staff about programme financing, policy and advocacy.

• Language requirements:

1. English language; expert level required for reading – writing – speaking

Place of assignment

a. Remote support: review and development of reports, policies, guidelines; data analysis and reporting; technical backup and follow up on technical issues.

b. Field work in Gaza: visits to NoH and PHCs; observations and interviews with mothers and staff; observations of clinical practice and of facility systems; facilitation of review meetings and planning; clinical coaching on job training in PHCs.

In case travel will not be possible, remote support will replace field visits. In this case, methods and tools will be developed accordingly, to allow replacing remote activities to be effective.

Medical clearance

The selected Consultant will be expected to provide a medical certificate of fitness for work.

Additional Information section

- This vacancy notice may be used to identify candidates for other similar consultancies at the same level.

- Only candidates under serious consideration will be contacted.

- Renumeration is in line with WHO applicable consultant payment rates.

- Successful candidates will be included in the roster for consideration for future contractual engagement via a consultancy, as they become available. Inclusion in the roster does not guarantee any future contractual relationship with WHO

- A written test may be used as a form of screening.

- If your candidature is retained for interview, you will be required to provide, in advance, a scanned copy of the degree(s)/ diploma(s)/certificate(s) required for this position. WHO only considers higher educational qualifications obtained from an institution accredited/recognized in the World Higher Education Database (WHED), a list updated by the International Association of Universities (IAU)/United Nations Educational, Scientific and Cultural Organization (UNESCO). The list can be accessed through the link: http://www.whed.net/. Some professional certificates may not appear in the WHED and will require individual review.

- For information on WHO's operations please visit: http://www.who.int. - WHO is committed to workforce diversity. - WHO has a smoke-free environment and does not recruit smokers or users of any form of tobacco.

- Applications from women and from nationals of non and underrepresented Member States are particularly encouraged.

- WHO's workforce adheres to the WHO Values Charter and is committed to put the WHO Values into practice. - Consultants shall perform the work as independent contractors in a personal capacity, and not as a representative of any entity or authority. The execution of the work under a consultant contract does not create an employer/employee relationship between WHO and the Consultant.

- WHO shall have no responsibility whatsoever for any taxes, duties, social security contributions or other contributions payable by the Consultant. The Consultant shall be solely responsible for withholding and paying any taxes, duties, social security contributions and any other contributions which are applicable to the Consultant in in each location/jurisdiction in which the work hereunder is performed, and the Consultant shall not be entitled to any reimbursement thereof by WHO.