Understanding of Community Health Worker (CHW) roles, function and motivation in Uganda, P3-4/ NOC-D, Kampala, Uganda

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.

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

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.

Visit this link for more information on Uganda Country Office https://www.unicef.org/uganda/

How can you make a difference?

Background****:

The National Development Plan III is implemented by Government of Uganda (2021-2025) and within it integration of services is a key component. In addition, community level health promotion and prevention programs are national priorities for the health sector with the universal health coverage (UHC) goal aligned to Government of Uganda’s (GOU) Vision 2040. By 2025, the GOU and stakeholders at national and subnational level aim to achieve an increased capacity to sustainably provide an integrated package of quality services for pregnant women, including pregnant adolescents and newborns, as well as infants and young children.

A strong community health system is key in delivering high quality and equitable health services, particularly to vulnerable and rural communities. In 2001, recognizing that the majority of disease burden is preventable diseases, Uganda’s Ministry of Health (MoH) prioritized a community-based approach to primary health care through the use of Village Health Teams (VHTs) to deliver basic health services and education.

The community health system in Uganda is strongly interlinked to the overall formal health system. At the national level, formal structures are in place to govern, oversee, and supervise community health work across the country. As Uganda’s health system is decentralized, implementation and management of community health services are conducted at the district and lower (health sub-district, sub-county, parish, and village) levels. Each district has a health department, which has the mandate to plan and implement health services in their respective district. VHTs are defined as the health care system level 1 (HC1), however they are not usually recognized as part of the formal Primary Health Care (PHC) system. Other critical community resource persons also exist, including but not limited to Health Educators, Health Assistants; Community Development Officers; disease-specific community health workers (e.g., HIV linkage facilitators; case managers), private nonprofit health services; and other community groups (e.g., local council leaders, parish chiefs, religious leaders, teachers, traditional birth assistants, para-social workers, mother peer groups, girl guides, boy scouts). Political, technical, and administrative functions each play a critical role in a strong community health system.

A national community engagement strategy (CES) was launched in October 2020 as part of the Government of Uganda’s COVID-19 response. While the VHT has traditionally been a volunteer cadre, the launch of the CES announced one VHT at HC1 will be paid a monthly allowance and provided with important tools in the setting of COVID-19 that is affecting most of Uganda’s communities.

UNICEF — the United Nations Children’s Fund, is a UN agency that aims at supporting every child to realize their potential in life. UNICEF covers over 190 countries and territories across the world. UNICEF is part of Uganda’s UN Sustainable Development Cooperation Framework 2021-2025, with a strategic priority aimed at human wellbeing and resilience. UNICEF Uganda plays a key role in supporting GOU to strengthen health systems with a focus on community health systems. Community health workers are a core structure of Uganda’s health system, as defined above.

UNICEF is implementing the iCoHS initiative funded by the Rockefeller Foundation. iCoHS aims to strengthen Uganda’s community health system by supporting governance, enabling digital technology and ensuring improved community health information systems and heightened use of community level data to facilitate integrated health service delivery that will yield better maternal and child health outcomes. The iCoHS project supports Uganda’s Community Health Acceleration Roadmap which highlights six chief priorities including a need to strengthen and sustain (time and financial) investment in supervision and motivation of community health cadres to improve community health outcomes. With iCoHS support centered on strengthening community systems, a consultant will support an improved understanding of existing community health worker cadres, their role and related incentive structures.

Purpose of assignment and s****cope****:

The objective of the consultancy is to support the Government of Uganda to consolidate key findings on the roles, function and motivation of community health workers in Uganda in order to better understand, with a goal to improve, frontline of health service delivery at the community level. A recent community engagement strategy, launched during the GOU COVID-19 response was designed to strengthen village task forces to respond to the pandemic. With political will to support a monthly allowance of the VHT, it is important to recognize the influence of an incentive structure for such frontline workers.

Under the overall supervision and guidance of the Community Health Specialist, the Consultant will support the Child Survival and Development team to ensure commitment to execution of the Community Health Acceleration Roadmap priority to better understand motivation of community health cadres. In doing so, the consultant must:

1. Review literature on CHW motivation, role and function globally. Summarize the global approaches that describe or analyze motivation for CHW, and the role and function this plays in CHW service delivery.
2. Once a global framework and associated methodology is developed, and agreed to with UNICEF CSD, then establish this same approach for Uganda with a literature review for Uganda and some regional context as well. Document key findings and implications for policy and programming.
3. For gaps identified in no. 2, formulate specific questions and methodology for a qualitative study integrating key informant interviews and focus group discussions. NB: Ensure focus on pandemic limitations and restrictions for gatherings.
4. Once methodology is accepted by UNICEF, consultant must outline a plan, conduct relevant data collection, complete any required analysis and finalize a report based on all findings. A powerpoint will also be required.
5. Report must be validated, finalized and disseminated with MOH and key stakeholders from Uganda’s community health fraternity.

Tasks

1. Summarize the global approaches that describe or analyze motivation for CHW, and the role and function this plays in CHW service delivery, with an aim to create and adapt this analysis framework for Uganda.
2. With developed framework and methodology from #1, complete literature review with key findings and implications for program and policy.
3. With identified gaps from 1-2, formulate specific questions and methodology for a qualitative study integrating key informant interviews and focus group discussions.
4. Following approved methods, begin data collection, analysis and report writing. NB: During data collection, ensure focus on pandemic limitations and restrictions for gatherings given COVID-19.
5. Meeting with UNICEF to discuss findings and draft report submission
6. Integrate comments on draft report
7. Submission of final report and powerpoint presentation with findings and recommendation from each deliverable.

To qualify as an advocate for every child you will have…

The selected Consultant should have:

1. Education:

• Advanced university degree in public health, social/political sciences or other relevant field

2. Experience and skills:

• Minimum of 5 years of relevant professional work experience at national and international level in analysis and/or research and/or communication/advocacy in the area of health, primary health care, community health programming
• Extensive experience producing timely and high quality analytical research
• Knowledge of the Uganda health system or experience working in Uganda is an advantage

3. Key Competencies:

• Excellent analytical, communication, advocacy and research skills;
• Computer literacy, especially MS Office programmes, is required;
• Knowledge of the Uganda context is preferred;
• Understanding of local institutional, policy and legal frameworks is preferred.
• Ensured adherence to MOH guidelines and SOPs related to COVID-19 prevention and control

4. Language Requirements:

The language competency is English both fluent in writing and speaking and knowledge of local language will be an asset”

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.