Re-advertisement: International consultant to conduct a root cause analysis of the measles outbreak in Kazakhstan and develop an improvement plan

Consultant

Overview

Conduct root cause analysis of measles outbreak and develop improvement plan

You have:

• University degree in Public Health, Immunization, Biostatistics or other health relevant field. Advanced degree will be an advantage.
• Minimum 8 years of experience in the area of public health;
• Experience in measles outbreak investigation;
• Proven experience in development of action/operational plans, preferably in the area of immunization;
• Good knowledge of health systems/ immunization programs;
• Fluency in English and Russian (both written & oral) is required. Knowledge of Kazakh language will be an asset.
• Experience in designing and facilitating workshops;
• Previous work experience with UNICEF or another international organization will be an advantage;
• Experience in working with government and/or nongovernmental organization;

Contract

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International consultant to conduct a root cause analysis of the measles outbreak in Kazakhstan and develop an improvement plan

Type of contract: Consultant contract Hiring unit: Kazakhstan Country Office Workplace: remote-based Timeframe: 26 working days, Aug 2020 – October 2020

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. Across 190 countries and territories, we work for every child, everywhere, every day, to build a better world for everyone. And we never give up. For every child, a fair chance

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Background

Despite the achievements of immunization programmes nationally in recent decades, immunization rates are decreasing and uneven across oblasts — from as high as 99 per cent in South Kazakhstan to as low as 70 per cent in Mangistau. Although the immunization coverage remains relatively high overall in Kazakhstan, at 95 per cent in 2018, with most districts having maintained coverage above the World Health Organization target of 95 per cent for basic antigens, there have been major declines in immunization rates in many districts in the recent years. At the same time, national averages also mask disparities. A third of the oblasts in Kazakhstan have districts with DTP3 coverage below 80 per cent, and half of the oblasts have districts with MMR (measles, mumps, rubella) vaccine coverage below 80 per cent. There are significant equity gaps by geographical area, income, urban/rural location. National-level coverage can mask pockets of low coverage at the local level, resulting in an accumulation of susceptible individuals that often goes unrecognized until outbreaks occur. In the past five years, Kazakhstan has faced measles outbreaks. Over 15,000 cases of measles have been registered in this region during 2018-2019 with 19 children and young adults dying from measles’ complications. The decrease in immunization rates is influenced by a combination of factors that influence vaccine availability, access to services and their quality and demand for immunization. Many oblasts in the country failed to establish good governance for providing effective and quality immunization services for all. Poor planning and forecasting mechanisms for vaccine procurement and weak vaccine management systems affect the continuity and success of national immunization programmes. The weak data management and the top-down, punitive approach still present in the country put pressure on health professionals at local and district levels to report high coverage, leading to unreliable data, which also affect the quality of decision making and programming. Besides supply chain challenges, which may affect immunization coverage, there is a growing vaccine hesitancy across the country, the false perception that influenced by people’s concerns related to the vaccines safety, myths and misconceptions, often disseminated through traditional and social media, anti-vaccination (or so called ‘pro-choice’) movements, but also by a decreasing trust in the health system, health professionals and quality of services, influenced by negative past experiences and negative stories that are distributed through social media. Evidence also suggests that although health professionals are the most trusted source of information for caregivers, they rarely engage in meaningful communication to provide the necessary information, and to address their fears, false beliefs and concerns, due to poor interpersonal communication skills and limited time for interaction. Moreover, there are pieces of evidence that some health professionals, especially specialists (surgeons, neurologists etc) discourage parents to vaccinate their child and contribute to increasing of false contraindication numbers. This is complemented with poor in-country capacity to prepare for and respond in immunization-related crisis situations, which diminishes public trust in the health system.

How can you make a difference?

The consultancy requires specialized expertise in the area of immunization/measles outbreak investigation to assist UNICEF and Ministry of Health in supporting routine immunization system strengthening towards a comprehensive assessment of measles outbreak response.

Purpose of the Assignment

Purpose This consultancy will help to identify critical bottlenecks and root causes of low routine immunization coverage at national and subnational level.

Methodology The assignment will include a combination of desk review, on-line interviews and focus group discussions, as well as workshops at the national and sub-national level to identify and discuss main bottlenecks and complete the root cause analysis of low immunization coverage at a sub-national level from both supply and demand in priority oblasts: Turkestan, Karaganda, Almaty, Zhambyl, Mangistau, East-Kazakhstan and three biggest cities Almaty, Shymkent and Nur-Sultan. More priority oblasts can be included nationally if required per agreement with the technical working group. Based on available information and characteristic of measles outbreak, root cause analysis will dig deeper to determine why persons were not vaccinated and/or why the vaccine failed to protect them. Some causes of vaccine failure among specific individuals may not be immediately preventable (e.g., primary and secondary vaccine failure), and some policies may create permissive environments for failure to vaccinate (e.g., not allowing vaccination after a certain age). Ultimately, the root causes of the outbreak may be determined through a series of "why" questions, where the answer to each "why" question leads to another "why" question that reveals the chain of causality down to the most fundamental causes.

Expected outcomes: 1. Root cause analysis of measles outbreak (to be decided per each oblast context and needs). The analysis should include: • A descriptive analysis of the outbreak: history of the disease immunization programme, policies and past performance in the area • Characterization of the most affected groups and subgroups • Contributing factors to the outbreak (vaccine failure, gaps in immunization, failure to vaccinate, nosocomial transmission, etc.) • Origin of the outbreak and specific strain/genotype involved • Description of the response measures implemented • Description of the surveillance system performance (timeliness, completeness, etc.) • Strengths and weaknesses of the immunization system • Strengths and weaknesses of the previous response

2. Recommendations for the national and sub-national level to improve routine immunization coverage

Performance indicators for evaluation of results: The evaluation of the results will be based on • Quality of work (i.e. work is acceptable by UNICEF); • Timeliness of work (delivered according to schedule below); • Responsibility. • Communication.

The consultant is expected to perform tasks and provide deliverables as shown below.

1. Tasks/Milestone: 1) Develop list of related documents 2) Coordinate desk review with involved national experts of the technical group including meeting with partners 3) Conduct review of national decrees, standards, reports etc. Deliverables/Outputs: Desk review of relevant immunization related documents Date: 6 working days (out of country)

2. Tasks/Milestone: 1) Conduct online meeting with service providers 2) Conduct online meeting with FG 3) Develop practical recommendation on the finding of the root cause analysis 4) Developing report "Root cause analysis" with practice recommendation 5) Conduct online meeting with national experts of the technical group for the analysis discussion Deliverables/Outputs: Root cause analysis in 2-4 low-performing oblasts. This will include interviews with relevant stakeholders, workshops and focus group (FG) with beneficiaries). Date: 12 days (in country). Nr. of days in country can vary, depending on oblast context (to be discussed with UNICEF Health and Nutrition officer and MoH). Can include weekends/holidays, but only with supervisor’s written approval. If the epidemiological situation does not allow traveling, then conducting through online Approaches, e.g. Zoom, Skype etc.)

3. Tasks/Milestone: 1) Develop draft country report 2) Conduct online discussion with national experts of the technical group for the action plan discussion 3) Develop final country report 4) Conduct online discussion with national stakeholders for the final action plan discussion 5) Finalize final country report Deliverables/Outputs: Final country report which include: root cause analysis at national and sub-national level in 2-4 selected oblast/ districts; and recommendations for improvement of measles routine immunization at both national and subnational levels Date: 8 working days (out of country)

To qualify as an advocate for every child you will have… • University degree in Public Health, Immunization, Biostatistics or other health relevant field. Advanced degree will be an advantage. • Minimum 8 years of experience in the area of public health; • Experience in measles outbreak investigation; • Proven experience in development of action/operational plans, preferably in the area of immunization; • Good knowledge of health systems/ immunization programs; • Working experience in the Europe & Central Asia region will be an advantage; • Familiarity with the health systems/ immunization programs; • Working experience in the Europe & Central Asia region will be an advantage; • Experience in designing and facilitating workshops; • Experience in working with government and/or nongovernmental organization; • Previous work experience with UNICEF or another international organization will be an advantage; • Fluency in English and Russian (both written & oral) is required. Knowledge of Kazakh language will be an asset. • Competencies: - Communication; - Working with people; - Drive for results; - Technical competencies: 1) Undertaking of root cause/bottleneck analysis in the area of immunization 2) Development of action/operational plans, preferably in the area of immunization 3) Health systems/ immunization programs 4) Designing and facilitating workshops 5) Working with government and/or non-governmental organization

For every Child, you demonstrate… UNICEF’s core values of Care, Respect, Integrity, Trust and Accountability (https://www.unicef.org/about/unicef-culture) View our competency framework at http://www.unicef.org/about/employ/files/UNICEF_Competencies.pdf

Remarks: • The consultant will work under the direct supervision of UNICEF Kazakhstan Country Office Health & Nutrition officer and in close collaboration with health specialists from Kazakhstan. • In case trip to country will be possible, it will be covered by UNICEF Kazakhstan Country Office as per the regulations. • Country office jointly with National technical working group will be responsible to organize interviews, subnational workshops and provide relevant documents/information. • Completion of the UN/UNICEF mandatory trainings is obligatory upon commencement of the consultancy. • Only shortlisted candidates will be contacted and advance to the next stage of the selection process. • The candidate will be selected based on "best value of money" and will be governed by and subject to UNICEF’s "General Terms and Conditions for individual contracts.” • 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. • 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. • All deliverables will be reviewed by UNICEF and relevant partners. • All materials developed will remain the copyright of UNICEF and UNICEF will be free to adapt and modify them in the future. • UNICEF reserves the right to use interim project products (all type ones) in other project sites. • The Consultant will perform his/her duties in line with UNICEF standards and procedures. • The successful candidate will be required to have medical insurance (at his/her own cost), covering the whole period of contract, including travel. • Deadlines may shift and the exact schedule of activities, being agreed with the consultant. • 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. • UNICEF reserves the right to terminate the contract without a prior notice and/or withhold all or a portion of payment if performance is unsatisfactory, if the rules and the regulations regarding confidentiality, ethics and procedures of UNICEF and the project partners are not followed, if work/outputs are incomplete, not delivered or for failure to meet deadlines. • The consultant will be paid based on deliverables: 50 per cent of the total amount will be paid upon submission of the first 2 deliverables and the final payment (50%) after the final deliverables. • Payment will be based on the deliverables accomplished per country, and on the actual number of days worked. • The consultant/s shall use their own facilities to manage the work, but, where circumstances demand otherwise, shall be allowed to make use of available UNICEF office space, computer and internet facilities with prior notification and arrangement with the supervisor and UNICEF Admin/ICT. The provision of these facilities by UNICEF shall be subject to their availability. • Estimated cost of consultancy is up to 26 working days. The Consultant shall indicate daily fees in its application. The consultant will be responsible to organize its own travel and should get prior approval of the supervisor before arranging any travel. Travel will be reimbursed by UNICEF based on submission by the consultant of the air fare receipt economy class and in accordance with standard UN per diem rate for each night spent in the designated location. • UNICEF will issue a consultant contract in USD. The payment will be made in USD by bank transfer and in instalments upon deliverables as per contractual agreement.

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Potential interview questions

Added 6 years ago - Updated 1 year ago - Source: unicef.org