UNICEF Zimbabwe is inviting applications for an individual consultant to conduct a National Assessment of the Health Sector Transportation Capacity for Delivery of the Immunization Programme

Consultant Medical & Health Programme & Policy

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UNICEF Zimbabwe is seeking to hire an enthusiastic and proactive individual consultant to conduct a National Assessment of the Health Sector Transportation Capacity for Delivery of the Immunization Programme

BACKGROUND:

Immunization coverage in Zimbabwe (DTP3) has been steadily declining in since 2014 from 95% in 2013 to 90% in 2019. While the decline re-dates the advent of the COVID-19 pandemic, DPT3 coverage fell further to 86% in 2020 at the start of the pandemic and remained at 86% by 2022. Consistently, the proportion of Zero-Dose and under-vaccinated children has increased over 3-fold between 2014 and 2021. The decline noticed prior to COVID-19 pandemic may be indicative of the impact of compound knock-on effects of the socio-economic context and population shifts. On the Health System supply-side, reduced institutional capacity of the health system to deliver services into the community due to increase in staff attrition and reduced operational transport capacity are some likely factors. On the demand-side, reduced financial capacity of communities to travel for routine health services is exacerbated by an increasing population of resettled and per-urban communities. However, from 2020 with the advent of the COVID-19 pandemic, the situation has been further worsened by increase in economic hardships to travel for services, and vaccine hesitancy which has been driven by widespread access to social media that can carry wrong messaging and conspiracy theories around COVID-19 vaccines and vaccinations in general.

To effectively recover the vaccination coverage and scale-up further to reach zero-dose and under-vaccinated children, the Ministry of Health and Child Care (MoHCC) is taking actions both from the supply side and the demand-side. On the supply side, the MoHCC is working on mitigating the impact of the staff attrition through more immediate steps to improve Health Care Worker (HCW) conditions of service while on the longer term developing a Human Resource for Health (HRH) Strategy. On the demand side, the MoHCC is working with partners to establish nuanced evidence to inform demand creation and community mobilization on vaccination which is culminating in a Health Sector Demand Creation Strategy that will, amongst other things leverage the community based Primary Health Care (CB-PHC) system that has been undergoing development over the past 3 years as guided by the National Community Health Strategy.

These Terms of Reference (ToR) are however confined to addressing the status of the health system transportation capacity as one of many aspects necessary for strengthening the wider health system capacity to deliver vaccines into the arm of every child in Zimbabwe. The ToR defines the scope of work to be under-taken to objectively establish the nature, scope, and required value of investments that will be necessary to sustainably revitalize and scale-up the health sector transportation operational capacity in line with the objective of catalysing vaccination coverage recovery and building resilience against future shocks.

Understanding the Problem to be addressed

Central level to provincial level

The primary purpose of transportation for this segment is to ensure vaccine stocks received into the central vaccine store at national level can efficiently be deployed to the provincial level to ensure steady availability of potent vaccine stocks at subnational level for routine activities, Periodic Intensification of Immunization (PIRI) and Supplementary Immunization Activities (SIA) without placing undue strain on the Cold Chain Equipment (CCE) capacity at sub-national level.

There is need to assess current vaccine transportation system from the perspective of the increased volume of vaccines due to addition of many new antigens over past 5 years that require more storage at national level

Provincial level to district level

The primary purpose of transportation for this segment is to ensure vaccine stocks received into the provincial vaccine store can efficiently be deployed to the district level to ensure steady availability of potent stocks at district and ultimately the facility level.

Similar to the inter-face between the national and provincial level, the assessment needs to take into account the CCE capacity versus volumes of vaccines that must be managed, but also include the consideration of a much higher number of destinations to which vaccines must be delivered, with more challenging terrains.

District level to facility level

The primary purpose of transportation for this segment is to ensure vaccine stocks received into the district vaccine store can efficiently be deployed to the facility level to ensure steady availability of potent vaccine stocks at all service delivery points.

While maintaining the same lens as under the preceding two levels, the assessment must consider the even higher number of health facility destinations to which the district must dispatch vaccine stock and vaccination commodities, with a potentially higher frequency of delivery runs to be made, especially during SIA and PIRI when re-distribution of vaccines between facilities can become necessary, taking into account the extreme terrain challenges.

Facility to community level

The primary purpose of transportation for this segment is to deliver vaccines to children without leaving anyone behind. While the assumption may be that once vaccines have reached the health facility then all children can access a vaccine, this is not the case for most of the target population. This is because Zimbabwe has a relatively large land mass with widely dispersed populations over large distances. This is compounded by the fact that population coverage of static vaccination service points remains a challenge as the health facility density for Zimbabwe is currently at 1.1 health facilities per 10,000 people below the recommended 2 health facilities per 10,000, with range between provinces being as low as 0.2/10,000 to the highest province at 1.7/10,000.

Across all segments of the vaccine delivery chain, there is need to objectively assess the status of the current transportation capacity and to generate recommendations on how each segment could be optimized in terms of equipment types and quantity based on an agreed operational framework within which the equipment must be deployed to render the respective segment more resilient and efficient, taking into account terrain challenges and resource limitations for inputs such as fuel especially at the lowest Primary Health Care Level.

Purpose of the assignment: Provide evidence to justify and guide utilization of Gavi HSS-2 funding for closing transportation capacity gaps for the immunization programme

Major tasks and deliverables:

Tasks/Milestone:****Deliverables/Outputs:****TimelinePreparatory phase

Initial desk review

Preliminary stakeholder analysis

Preparation for the inception phaseConsultations with the MoHCC UNICEF and WHO for constitution of assessment field teams at national and subnational level

Scheduling of stakeholder appointments.Week 1Inception phase

Preparation of draft inception report and data collection tools

Engagement with stakeholders on inception report

Finalization of inception report1. Presentation of the draft inception report and instruments

Recipients: MoHCC, Gavi Secretariat, UNICEF, WHO

2. Final inception report

After feedback from MoHCC, Gavi Secretariat, UNICEF, WHOWeek 2

35% upon completion of deliverables 1 and 2Data collection & drafting phase

• Preparation for data collection, including piloting of instruments
• Data collection
• Data analysis and drafting
• Preparation of a PowerPoint presentation on emerging findings, conclusions, and recommendations

Engagement with stakeholders on draft report3. Presentation of Preliminary Findings – on emerging findings, lessons, and recommendations Recipients: MoHCC, Gavi Secretariat, UNICEF, WHO, extended EPI partners group, community members, Ministry of Transport and Infrastructure Development, Health Development Partners Group.

4. A complete first draft report

Recipients: MoHCC, Gavi Secretariat, UNICEF, WHO

Presentations of key findings and recommendations will be reviewed by MoHCC, Gavi Secretariat, UNICEF and WHO prior to the presentation.Week 3- 7

30% upon completion of deliverables 3 and 4Validation and completion phase

Incorporation of final inputs and finalization of report and final deliverables5. A final report Detailed recommendations on each theme should be presented in a separate concluding chapter

Recipients: MoHCC, Gavi Secretariat, UNICEF, WHO

6. Package of final deliverables

• PowerPoint presentation slide deck summarizing the findings
• Final Assessment Report not more than 50 pages with an executive summary of maximum two pages,
• 2 pager summary info graph,
• Electronic vehicular equipment geo-referenced inventory with guidance for maintaining it by the MoHCC,
• Costed procurement plan detailing equipment type and specifications, quantities, estimated cost, and proposed distribution plan.
• Estimates for operational and maintenance costs per vehicular type.

Dissemination and strategy as deliverables are received.Week 8-12

35% upon completion of deliverable 5 and 6To qualify as an advocate for every child you will have…

Education: Advanced university degree from a recognized academic institution in one or more of the following areas is preferred: Public Health, Business Administration, Project Management.

Experience:

Five (5) years relevant work experience in managing large-scale projects involving fleet management for supplies and logistics management in resource-limited settings. Experience in monitoring and evaluating operations, and risk management, mitigation will be an asset.

First university degree in public health, project management, business administration combined with relevant professional work experience and understanding of relevant functions may be considered in lieu of advanced university degree combined with at least 7 years of experience health services management.

Languages:

Written and spoken fluency in English required and knowledge of main local languages (Shona and Ndebele) is an added advantage.

The detailed consultancy terms of reference is downloadable via this link Terms of Reference.pdf

If interested and available to undertake the individual consultancy, please submit your application online and attach the required documents including the technical proposal and an all-inclusive financial proposal incorporating an approximate number of travel days for field (local) travel.

Technical proposal: The Technical Proposal should articulate an understanding of the TOR and include the proposed Tasks/Milestones, Deliverables/Outputs, Timeline and level of effort by deliverable. The similar table provided in the TOR is indicative. Applicants may use the indicative table as a guide or deviate as per the proposed approach. The proposal should also cost-effectively propose the local travel proposed by the applicant to undertake the assignment.

Financial proposal: The Financial Proposal should include the costs (providing a daily rate as justification) for each task, including consultant fee, proposed travel costs and perdiem, communications costs and any other proposed cost.

For every Child, you demonstrate…

UNICEF's values of Care, Respect, Integrity, Trust, Accountability, and Sustainability (CRITAS).

To view our competency framework, please visit here.

UNICEF is here to serve the world’s most disadvantaged children and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, age, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, or any other personal characteristic.

UNICEF offers reasonable accommodation for consultants/individual contractors with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment.

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 be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.

Remarks:

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.

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.

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts.

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Added 10 months ago - Updated 10 months ago - Source: unicef.org