QoC assessments consultancy

1. Area of expertise:

QoC assessments consultancy: Quality of sexual, reproductive, maternal, newborn, child and adolescent health Care Assessment & BeMONC TOT training in Somalia

2. Purpose of consultancy

The purpose of this consultancy is to provide technical support in conducting a comprehensive baseline assessment of the quality of the Sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) services in three main geographical zones of Somalia (Mogadishu, Puntland, and Somaliland) and deliver a technical report with recommendations and next steps for quality improvement

3. Background

According to the Somali Health and Demographic Survey 2020, the population of Somalia is 12.3 million 51 per cent dwelling in Urban areas, 23 per cent in rural areas, and 26 per cent are nomads. Estimates suggest that Somalia has one of the highest fertility levels in the world the total fertility rate for Somalia stands at 6.9 children per woman. 37 per cent of currently married women have an unmet need for birth spacing services (29 per cent for spacing births and 8 per cent for stopping childbearing). The Maternal Mortality Ratio is estimated at maternal deaths per 692 live births 100,000. 1 in 1000 women aged 15-49 die due to pregnancy- or birth-related complications and 1 in 20 women would be expected to die from pregnancy-related causes during their reproductive lifetime (SHDS, 2020). The leading causes of maternal mortality are postpartum haemorrhage, pre-eclampsia/ eclampsia, obstructed labour, and sepsis. 32 per cent of births were delivered with the assistance of a skilled health care provider. 21% of births were delivered at a health facility (SHDS, 2020). According to the estimates generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEE) 2018, newborns mortality is 38/1000 births and stillbirths are 36/1000 births the major causes of newborns mortality are 23% preterm complications, 37% intrapartum related events, 16% sepsis and tetanus which can be prevented by providing quality care to during pregnancy, childbirth, and the postnatal period (MCEE, 2018).

The RMNCAH services provided at the facilities are of compromised quality as the Somali Service Availability and Readiness Assessment (SARA, 2016) data showed that there are poor availability of health service amenities and responsiveness, challenges in maintaining the quality of services such as infection prevention and control standards, access of diagnoses and care, readiness to provide RMNCAH services in the health facilities. Close to one-third of the functional facilities were able to offer birth-spacing services, although these facilities fell short of enabling the visiting clients to make informed choices due to periodic stockouts of Family planning commodities, various other reasons, and unavailability of quality improvement standards. The SARA 2016, survey illustrates that 66% of facilities provided antenatal care (ANC) services, although not very comprehensively, with 43% of the facilities having on average fewer than 5 of the 11 service components included in the ANC service package. SHDS, 2020 has similar results as antenatal care courage is only 31%, out of which only 24%of women had at least four ANC visits during their pregnancy. At a closer look at antenatal care components, 89 per cent of women who received antenatal care had their blood pressure measured, 64 per cent had a urine sample taken, and 68 per cent had a blood sample taken. Twenty-seven per cent of births were protected against neonatal tetanus. Which makes the quality of the services provided by the skilled birth attendant a question mark.

To contribute to SRMNCAH quality assessment and improvement in Somalia, WHO Somalia Country Office collaborates with the Government of Somalia Ministry of Health (MOH) and relevant stakeholders to support the strengthening, of sexual and reproductive health including maternal, neonatal, and Child health (SRMNCAH) services. WHO has been supporting Somalian MOH to develop SRMNCAH services in the country and moving towards the implementation of SRMNCH evidence-based interventions in relevant areas,

WHO Somalia Office will take a systematic approach to design the intervention/ improvement requirement in the SRMNCAH starting with the Quality of Care (QOC) assessment in three main geographical zones of Somalia (Mogadishu, Puntland, and Somaliland). The finding will be shared with the ministry of health in Somalia and based on the findings; collectively WHO with the Somalia MOH will design and ensure the SRMNCH quality improvement response plan.

Further to ensure SRMNCAH quality of care assessment and improvement, MOH Somalia has requested WHO to support the capacity building of their health workers to be equipped with a comprehensive set of evidence-based skills and prepare them for delivering basic emergency obstetric and newborn care (BEMONC), particularly in rural areas.

Most of the skilled health workforce in Somalia does not have the requisite knowledge and skills to identify, prevent and manage most of the causes of maternal newborn morbidity such as haemorrhage, infection, pre-eclampsia/eclampsia, obstructed labour and newborn asphyxia, hence the need for such training is crucial to prevent avoidable maternal, deaths in Somalia

BEmONC is a strategy aimed at reducing maternal and newborn mortality adopted to achieve globally set targets for sustainable development goals by 2030It involves a certain set of technical skills that if applied by the health worker can prevent, identify complications in good time, manage conditions appropriately and promote the health of both mother and baby.

4. Deliverables

Output 1****: Review and adapt SRMNCAH quality-of-care assessment tools for Somalia MOH in line with WHO recommendations for Somalia

Deliverable 1.1: To assist in conducting desk review for the existing tools

Deliverable 1.2: To discuss and agree with the national and sub-national counterparts for the tools.

Deliverable 1.4 To conduct training of assessor

Deliverable 1.5 To complete pre-testing of tools

Output 2****: To provide technical assistance in conducting the assessment in three geographical Zones (Banadir, Hargeisa, Garowe (regions names may change after discussion with MOH after election) (pilot region one in each Somaliland, Puntland, and Mogadishu

Deliverable 2.1: To complete assessment of the selected facilities in the three regions

Deliverable 2.2: To complete analysis and interpretation of the assessment

Deliverable 2.3. To draft report and share with Stakeholders.

Deliverable 2.4: To submit final report

Deliverable 2.5: To conduct meeting at the national level to disseminate the results of the report and recommendation

Output 3: To participate in conducting 12 days of standardized BEmONC TOT training for master trainers

Deliverable 3.2: To conduct BEmONC TOT to the identified master trainers at national level.

Deliverable 3.3: To submit training report.

Output 4: In collaboration with EMRO Mission, provide technical input for capacity building SRMNCAH programme and services of Somalia team and MOH.

Deliverable 4.1: In coordination with EMRO team prepare the agenda and training support materials.

Deliverable 4.2: Training Report.

5. Qualifications, experience, skills and languages

(Identify the educational qualifications and expertise needed for the terms of reference outlined above.)

Educational Qualifications:

· A medical doctor, Nurse/Midwife with University Degree

· Master’s degree in public health is desirable

Experience:

· Previous experience in assessment of the SRMNCH Services

· Previous experience working with UN agencies in LMICs.

· 5 to 6 years of experience in areas related to effective programme management.

· Previous experience in conducting consultative meetings.

Skills / Technical skills and knowledge:

· Report-writing skills (in English).

· Strong analytic skills.

· Excellent communication and time-management capacity.

Languages and level required (Basic/Intermediate/Expert):

· Excellent knowledge in English (Written and Spoken)

6. Location

· The consultant will be working in-country in Somalia and remotely, however it is preferable to be based in Somalia.

7. Travel

Travel dates will be agreed upon by the consultant and the responsible officer.

All travel arrangements will be made by WHO – WHO will not be responsible for tickets purchased by the Consultant without the express, prior authorization of WHO. While on mission under the terms of this consultancy, the Consultant will receive subsistence allowance.

Visas requirements: it is the consultant’s responsibility to fulfil visa requirements and ask for visa support letter(s) if needed.

8. Remuneration and budget (travel costs are excluded):

Remuneration: Level B (Low end of range) – USD $7,000 (Monthly)

a. Expected duration of contract (Maximum contract duration is 11 months per calendar year): 4 months.

Additional Information:

• 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.

· Interested candidates are strongly encouraged to apply on-line. For assessment of your application, please ensure that your profile on Stellis is updated; all experience records are entered with elaboration on tasks performed at the time. Kindly note that CV/PHFs inserted via LinkedIn are not accessible.

• 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.
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• 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.
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