Terms of Reference to recruit a Consultant for the preparation of contextualized ICMNCI implementation guide for DRS/Pastoralist areas in Ethiopia
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Maternal and Child Health Directorate |
Ministry of Health September 2018 |
1. Background
Ethiopia, through the progressive implementation of the Health Sector Development Programs in the last seventeen years, has made great strides to improve child survival. The under-five mortality rate (U5MR) of the country has remarkably reduced by two thirds between 1990 and 2012[1], meeting the target for MDG 4 ahead of the deadline. Currently, the U5MR, Infant Mortality Rate (IMR) and Neonatal Mortality Rate (NMR) are at 59, 41 and 29/1000 Live births respectively[2]. However, this figure is still among the highest necessitating the need for more work to do to improve child survival in Ethiopia. In addition, there are regional inequities with the U5MR being higher than the national average in the developing regions, the highest being 125/1000 live births in Afar and NMR at 41/ 1000 LB in Somali region. About 90% of mortality in under-fives is caused by pneumonia, malaria, diarrhea, measles and neonatal causes (pre-maturity, asphyxia and neonatal sepsis) with malnutrition as underlying causes for more than half of the deaths.
Effective coverage of high impact interventions should be universally accessible to reduce the current level of under-five mortality rate. Following the launching of ICCM program, the Federal Ministry of Health and its partners in 2010 developed an integrated community case management implementation plan for the reduction of under five-child mortality for the years 2010-2014. Since the development of the implementation guide other approaches, including PRCMM, demand creation for the program, program ownership and community participation have been introduced for the program effectiveness. In addition, Community based newborn care has been introduced and scaled up in Agrarian regions since 2013. The implementation of ICCM but more specifically CBNC is very limited in the developing regional states especially in the pastoralist communities. Therefore in 2017, a new guideline entitled “National Implementation Guideline For Integrated Community Case Management of Childhood Illnesses and Newborn Care” has been prepared to contribute to the reduction of U5MR, IMR and NMR to 29, 20 and 11/1000 LB by 2020 and with the objective of strengthening the delivery of quality MNCH services through implementation of integrated community based case management of newborn and childhood illnesses at PHCU levels[3].
One of the specific objectives of the above guideline is to “ensure equitable and continuous access to and availability of iCCM services to unreached communities”. In addition, the describes the huge contextual differences in Pastoralist areas with a need to have model fit for the context that would facilitate effective ICCM service provision. Though a workshop was conducted in February 2018 for initial discussion with stakeholders, the document to guide the implementation in these areas has not yet been prepared. The FMOH therefore wishes to recruit a consultant that supports the preparation of the strategic document.
2. Objective:
The objective of this TOR is to recruit a consultant who will take the responsibility of preparing a contextualized ICMNCI implementation guide for DRS/Pastoralist communities in Ethiopia.
3. Scope of work
The consultant is expected to carry out the following tasks under the guidance of the Director of MNCH and technical support of Child Survival Working Group
· Organize a brainstorming workshop for the revision of the Implementation guide based on the desk review report with Child survival TWG
· Closely work with and get support from the child survival technical working group to
o Collect relevant information from the MNCH, Health System Special Support Directorate (HSSSD) and Primary Health Care directorate as well as Regional Health Bureaus and Child survival TWG members, through interviews, group discussions, meetings and other communications to understand the context of these regions in terms of WHO building blocks as well as existing community structures, etc.
o Present draft work to the child survival TWG through meetings, and get feedback
o Organize review and validation workshop as needed
o Organize and synthesize relevant inputs from the TWG and others
· Organize a national consultative meeting including Regional Health Bureaus and Partners to jointly review the second draft implementation guide for finalization
· Organize and facilitate group meeting and consultations as appropriate at different levels
· Conduct focused group discussion or key informant interviews as needed
Some Important national documents to be referred in the process of updating the ICCM/CBNC implementation guide are:
· Newborn and Child survival strategy
· FMOH: Health Sector Transformation Plan, 2015/16 - 2019/20 (2008-2012 EFY)
· FMOH, Transforming Health Status and Health Systems in the Developing Regional States and selected Zones with Suboptimal Performance, Equitable health Services for all, Plan of Action, 2016 – 2020
· The HEP pastoralist implementation manual final draft EFY 2010
· FMOH, 2017. National Implementation Guideline for Integrated Community Case Management of Childhood Illnesses and Newborn Care
· HSTP Mid-term Review Report
· RIF related internal documentation and researches
· ICCM/CBNC implementation and other program implementation such as Nutrition, livelihood, education, etc. in pastoralist setup (IP experience)
· The Health Extension Program (including the regulation and other documents)
· FMOH Woreda planning tools
· Special survey reports on Malaria, Immunization coverage, Nutrition, IMCI service coverage, HIV etc.
· Newborn corner and neonatal intensive care unit (NICU) training materials and guides
· All relevant WHO and UNICEF Publications on child and maternal survival in pastoralist areas in Ethiopia and beyond
· Any other documents that will be identified in consultation with the child survival TWG
4. Qualification of the technical assistant
The technical assistant should have:
· A minimum of master degree on public health or paediatrics and a degree in medical sciences
· More than 10 years direct related consultancy experience in one or more professional disciplines with a Master’s degree, or equivalent combination of relevant education and experience
· experience in planning and implementation of child health or related programmes
· extensive knowledge of child health issues and actors specifically at community level
· knowledge and experience of the Ethiopian health system
· good understanding of the decentralized health system, the HSDP and related policies and strategies
· research experience, good analytical and English writing skills,
· good skill in communicating, organizing group discussion, and presentation
· prior experience as a consultant in development of similar documents
· flexible, capable of working under pressure and in tight timelines
5. Duration & Time frame of the technical assistant:
The full period for technical assistance will be 2 ½ months and the consultant is expected to start assignment as of October 15, 2018 and through December 31, 2018.
6. Responsibility of Save the children
Save the children is responsible to:
· Ensure the process and output is in agreement with the child save guard policy
· Arrange and provide necessary logistic and transport for accomplishment of the activities
· Provide the winner all information related to the documentation
· Supervise Quality of Work and ensure comments for improvement by CSTWG was addressed.
· Cover consultation and per-diem fee based on agreed work plan
· Arrange and cover refreshment and hall fee during 1st , and 2nd draft review by CSTWG under guidance of MOH
· Organize a national consultative meeting including Regional Health Bureaus and Partners to jointly review the second draft implementation guide for finalization and expected to cover all related costs
· Ensure submission of electronic and hard copy to FMOH
7. Management and supervision
The technical assistant will work with the Directorate of Maternal and Child Health in FMOH and report to the Director of Maternal and Child Health.
The expert is expected to submit his/her work plan within a week after arrival and should obtain the go ahead from the director of MNCH. The expert should try to ensure that in the process of supporting the Ministry with this task there is a proper skill transfer to staffs within FMOH, Officers within Child Survival Case Team in particular.
8. Deliverable
1. Draft work plan outlining detail activity with corresponding timeline for within one week of signing the contract
2. The final product of this assignment – a contextualized ICMNCI implementation guide for DRS/pastoralist areas - final document in Microsoft word electronic copy and hard copy by the end of the contract period (three months from start of contract)
3. Summary Power Point Presentation of the implementation guide same time as the final document submission.
[1] 2013 report from the UN Interagency Group for Child Mortality Estimates (IGME)
[2] UNICEF, 2018. Levels and Trends in Child mortality
[3] FMOH, 2017. National Implementation Guideline for Integrated Community Case Management of Childhood Illnesses and Newborn Care
The technical assistant should have:
· A minimum of master degree on public health or paediatrics and a degree in medical sciences
· More than 10 years direct related consultancy experience in one or more professional disciplines with a Master’s degree, or equivalent combination of relevant education and experience
· experience in planning and implementation of child health or related programmes
· extensive knowledge of child health issues and actors specifically at community level
· knowledge and experience of the Ethiopian health system
· good understanding of the decentralized health system, the HSDP and related policies and strategies
· research experience, good analytical and English writing skills,
· good skill in communicating, organizing group discussion, and presentation
· prior experience as a consultant in development of similar documents
· flexible, capable of working under pressure and in tight timelines
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