Technical Officer (Review National Inpatient Guidelines and Training Package in South Sudan) - Grade: NOC
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Background
Malnutrition continues to be a key contributor to the poor health status of children under five years. The Country continues to face overlapping crises including floods, conflict, and food insecurity – all contributing to the persisting high level of acute malnutrition that has remained at 16.0% which is above the WHO emergency threshold of 15% since 2019 (FSNMS Rond 26). High food insecurity, elevated prevalence of diseases, and poor hygiene, health, and environmental sanitation services, along with inadequate maternal and childcare are the main drivers of acute malnutrition in South Sudan. The ongoing conflicts and political crisis in the country are worsening an already fragile situation. In 2023 an estimated total of 2,175,546 children and women (1,469,919 in the host community, 315,503 returnees, and 390,125 internally displaced people -IDPs) will require lifesaving nutrition care and treatment. These include 480,000 children for severe acute malnutrition (SAM), 1, 170,000 moderate acute malnutrition (MAM), and 870,000 pregnant and breastfeeding women (PBW). (IPC report Nov 2023).
Children with severe acute wasting are nine time more likely to die as compared to healthy children Nearly 10-20% of children with severe acute wasting are also expected to develop medical complications associated with wasting representing a life-threatening condition for children under five years of age. However, it is possible to substantially reduce the mortality rates by modifying treatment to consider the physiological and metabolic changes that occur in cases of severe acute malnutrition.
Justification
In March 2022, WHO updated the training course on hospital-based management of children with severe acute malnutrition, it provides guidance on the current evidence and best practices in the inpatient management of wasting for 0-59 months admitted in stabilization centers as well the updated guideline/recommendations on prevention and management of wasting and nutritional edema in children 6-59 months in July 2023. The new training package includes some updates, ranging from admission criteria for inpatient care; to criteria for transfer to outpatient care and criteria for discharge from all care for children aged six months and above; doses for routine antibiotics; vitamin A and atropine, transition to RUTF, transition for children with edema, rehabilitation phase for children on F-100, admission criteria for infants aged 0-6 months, feeding for infants aged 0-6 months, criteria for transfer to outpatient care and criteria for discharge from all care for infants aged 0-6 months.
Therefore, one of the critical strategies to reduce the mortality rate attributed to wasting is to review the protocol and develop the health workforce's capacity to manage severe acute malnutrition based on the latest updated WHO guidance and ensure quality of care. Case fatality rates have decreased to below 5% in treatment centers applying appropriate management schemes recommended by WHO guidelines.
Overall goal
To review and update the national guideline for inpatient management of severe acute malnutrition and tools (Job aids, training package).
Specific objectives
1. Revise and consolidate the current guidelines for severe acute malnutrition based on updated global evidence recommendations and field experiences in the context of South Sudan.
2. Update the training package and job aids based on the finalized guideline for inpatient management of severe acute malnutrition
Main Assignment
The Consultant will work closely with the Technical Working Group including technical experts from the Ministry of Health, UNICEF, WHO, and UN agencies to support the finalization of the guideline review process by reviewing and updating the component of the inpatient care for the management of SAM with medical complications (Inpatient Therapeutic Programme) and to produced related documents.
Deliverables
- An inception report on the consultancy with an accompanying 4 months' work plan
- Consultative workshop conducted.
- Report on the contextual analysis and findings of the current SC guidelines in South Sudan
- Final edited copy of the revised updated guideline (including Infants less than six months with SAM) and related training materials shared.
- Validation workshop conducted.
- Final report documenting all the entire event.
- ToT on the revised guidelines conducted.
- Final report of the consultancy
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TASKS
1. Preparatory tasks:
The consultant has to collect and gather the necessary information to be considered for the reviewing end updating of the Stabihtatian Centre {SC) guideline and the training package/job aids. These may include but are not limited to;
· Desk review of the existing national, regional, and global CLIAM guidelines and training materials for SC.
· Gather information from the users to beef up the review process,
· Deveiap inception on the consultancy and a 4 months' work plan for the development of the Stabilization center guidelines and related materials such as annexes.
· Present the inception report and work plan to CMAM TWG for input,
· Olganiza and prepare the workshops for the review and validation of the documents in collaboration with the TWG
ü Guide identaücation of the participants,
ü Deveicp the agenda
ü Prepare handouts and supporting documents,
ü prepare the presentations.
ü Facilitate the workshops.
3. Reporting
The consultant has to make sure that the final report has all the necessary information and is of good quality. This may include but not limited to;
· Record all the meetings
· Edit the final approved documents
· Submit the final report alongside the final products
Specific Tasks
Under the overarching guidance of the MoH Department of Nutrition and in close consultation
With the CMAM-TWG the consultant shall undertake the following responsibility:
- Create an inventory of useful resources that will inform the development of the guidelines. This includes identification, review, and documentation of existing national relevant policies, strategies, programs, and guidelines, as well as global and regional evidence-based guidelines, recommendations, and principles, on the management of acute malnutrition.
- Undertake a technical review of current guidelines while adhering to current international evidence base and best practices.
- Work closely with the Ministry of Health Department of Nutrition and engage with key Stakeholders at both national and state levels to ensure the guideline is aligned with existing national policies and protocols relating to health and nutrition and draw on synergies with other relevant sector policies.
- Undertake consultative field visits (including travels) to conduct contextual analysis in collaboration with current partners implementing nutrition programs, to identify coverage gaps, operational challenges/constraints, and best practices that will inform the review process.
- Participate in the relevant nutrition cluster meetings, health cluster meetings, Strategic Advisory Group (SAG), and joint programming meetings, to enrich the background for the formulation of the guidelines and share updates on the achievements relating to the formulation of the guidelines.
- In collaboration with the CMAM technical working group build consensus on all the proposed changes and develop the draft guideline for inpatient management of severe acute malnutrition.
- Draft and present an initial report of key findings of the current guidelines' gaps and the proposed amendments to the key stakeholders.
- Undertake consultations with the CMAM forum, Emergency Nutrition Network, South Sudan MoH, and UN Agencies to support the process of validation of the Guidelines.
- In collaboration with the Ministry of Health and nutrition partners facilitate the development and roll out strategy for guidelines.
- Play a lead role in facilitating the national validation of the final guidelines and implementation strategy with key stakeholders before submission of the final guidelines to the Ministry of Health for approval and endorsement.
- Participate in the organization of a national-level workshop to launch and disseminate IMAM guidelines.
Expected Deliverables
Expected Outputs
· An inception report on the consultancy with an accompanying four-month work plan to be developed and submitted in the 1st month.
· Summary report on contextual analysis or findings of the current guidelines in Southern Sudan by 1st Month.
· Reports on national and state-level engagement events/meetings shared by 2rd month.
· First draft report on guidelines updated framework by 3rd month.
· National guidelines for the management of IMAM in Southern Sudan including implementation tools (job aids, training manuals, and training package) at the end of the contract.
· National Rollout strategy for the guidelines.
Expected background (Qualifications & Experience)
Required Qualifications
Education
Essential: University Degree in one of the disciplines relevant to the following areas: Bachalor Degree in Medicine and Surgery, Public Health & Nutrition, Health Sciences, International Health & Nutrition, Family Health & Nutrition, Health & Nutrition Education or other relevant discipline.
Desirable: Post graduate degree in Paediatrics or Specialization in Nutrition.
Work Experience
Essential: At least five years' experience in planning and management of inpatient therapeutic program (ITP) in South Sudan, knowledge on inpatient management of severe acute malnutrition with medical complications based on National Guidelines 2018, development of IM-SAM guidelines and proven experience in training and facilitation skills.
Desirable: Experience in working with UN Agencies, INGOs or Nutrition Program in South Sudan.
Critical Skills
· Good analytical skills: resourcefulness, initiative, maturity of judgments, tact. negotiating skills.
· Ability to communicate clearly both oral and in writing:
· Ability to work in a team and establish effective working relations with persons or different nationalities and cultural backgrounds.
· Ability to deal patiently and tactfully with people of different nationalities and backgrounds:
· Willingness to work extra hours and to travel extensively:
· Demonstrate evidence to work under complex crises and challenging situations
Language
· Fluency in both oral and written English is required, Arabic will be an added advantage
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