Organization: UN Children's Fund
Country: Papua New Guinea
Closing date:
19 Feb 20161.Nature of Consultancy:
All forms of malnutrition persist in Papua New Guinea (PNG); for instance, more than four in ten children present with stunting (short for age). Wasting, in the same population, is determined at more than 10% (HIES 2009/10). Malnutrition has persisted for decades. Unfortunately, malnourished children have a high risk of contracting infections, thus, increases the incidence, severity, and duration of common childhood diseases, such as diarrhea, acute respiratory infections, and measles; diseases that start from communities. Worst, the malnourished risk death. Cumulatively, Pediatric reports show that more than 2,000 malnourished children have died in less than half a decade, regrettably, challenging efforts for improved child survival. Many would have already died in communities, due to ignorance about the problem or even lacking access to necessary specialized care. Any survivors live with permanent damages, which follow through generations. Yet, at community level, malnutrition is largely preventable. Moreover, children with wasting form of malnutrition can easily endure if they receive timely treatment and rehabilitation. The community has a major role in both preventing the problem occurring, or even timely identification and referral for appropriate treatment and care.
PNG’s SAM management protocol for use by health workers was updated to be aligned with 2013 WHO standards. Training in management of SAM has been done for nearly 100 health workers in 15 provincial hospitals in the past one year. A cascade approach has started at provincial level, in Madang and Simbu, with plans to roll out to lower health facilities at district level. Collectively, the trained health workers are currently implementing SAM management in their respective provinces, and in two of them, up to district level. The services benefit both hospitalized cases as well as outpatients. Doing so brings the identification and treatment of SAM as close to the community as possible, reducing hospital treatment costs; facilitating early identification before reaching the worst stages, and increasing treatment adherence due to addressing transport, geographical and financial and security barriers to utilization of the services. We are yet to gain pace, with SAM management service demand, but importantly, reaching the most unreachable communities. To do so, there is need to strengthen and scale up IMAM services while involving I/NGOs and VHVs/CBDs/CBOs. There is no doubt that PNG’s recurrent shocks, not limited to ongoing severe drought calls for acceleration of the integrated management of acute malnutrition (IMAM) scale up plans. Thus, the consultancy seeks to;
· Reinforce and scale up IMAM services with Health System Strengthening (HSS). This requires means that Provincial Health Authority must be engaged / actively involved in the process,
· Conduct ToTs, face to face trainings, on-the-job mentorships, supportive supervision and mentorship, hence, technical capacities to be strengthened at all levels of the health system, and at community level,
· Link IMAM and infant and young child feeding (IYCF). Lessons learned from the ongoing experience in the two provinces where IMAM services are starting/ already available /decentralized to be used to inform scale up plan in other districts/provinces.
2.Purpose of Consultancy/Institutional Agreement:
To support Papua New Guinea’s Provincial Health Authority to ensure that district health centers and communities have the capacity to detect and treat acute malnutrition among children under-five. The consultant, while working with Family Health coordinator and or Nutrition focal persons, where they exist, shall ensure that staff are trained and supervised, commodities and supplies for therapeutic feeding are available, data capture and record keeping is clear, and that VHVs/CBDs/CBOs are equally trained and supervised*.* Further, that there is well coordinated strengthened and linked services.
- Programme Area and Specific Project Involved: Young Child Survival and Development
4.Work Assignments:
The consultant will perform the below tasks under the supervision of the UNICEF’s Nutrition Specialist and overall guidance of the Chief of Young Child Survival and Development.
I. In six provinces, conduct assessments of the SAM management activities within the district health system, involving both public and Church or I/NGO led facilities and other relevant community structures. The assessments shall be two-fold; bottleneck analysis (with all the stakeholders involved in IMAM services. Secondly, conduct assessments in provinces where the scale up will take place to identify additional health facilities where to establish the services and foresee gaps.
i. Expand the existing hospital SAM protocol, to detail a community approach of managing the problem, and build capacity for a strong National pool of trainers.
ii. In the six provinces, lead the National ToTs, to conduct face-to-face trainings of IMAM and perform mentorships to kick-start the integration of community management of acute malnutrition (CMAM). After the face-to-face trainings are carried out, closely support establishment of IMAM services, then conduct on-the-job coaching, and provide ongoing joint supportive supervisions.
iii. In the six provinces, in all implementing institutions, collate monthly data, to inform service uptake and intervention outcomes. An integrated supervision, performance and information management system needs to be designed and put in place so it is sustained beyond the consultancy period.
iv. Ensure that functional equipment and therapeutic foods are available, and supplies flow is integrated into the existing health system. Support district and PHA level planning and budgeting for targeted nutrition activities specific to the treatment of acute malnutrition.
v. Support NDoH to review IMAM indicators in the NHIS to match with SAM management strategy.
vi. Perform other tasks that may arise during the implementation of the above tasks that are within the SAM management strategy, and contribute to reducing malnutrition related deaths in the country.
5.Work Schedule:
The contract shall commence as soon as possible but not later than 15 March 2016 and shall be for a period of 9 months.
The consultant will submit reports according to the end products and work schedule described in paragraph 6 below.
- End Product:
Not all key tasks carry specific dates or timelines, therefore the tasks/end-products provided below are based on a broad schedule.
Task
Deliverables
Work Assignments #1: Assessments and National ToTs
a. Conduct baseline assessments of the SAM management activities within the district health system, involving both public and Church or I/NGO led facilities and other relevant community structures.
b. Build capacity for a strong National pool of trainers for IMAM.
· Joint assessment and bottle neck analysis report for work done in all facilities in at least six provinces
· At least 2 ToTs conducted
Estimated Date of delivery
–Mar-April ( 2 mo)
Work Assignments # 2:Expand protocol, decentralize trainings, mentorships and IMAM piloting
a. Expand existing SAM management protocol to detail community management approach
b. Conduct face-to-face trainings and identify areas to start IMAM implementation. Perform on-job mentorships to kick-start the integration of community management of acute malnutrition (CMAM). While doing so, scale up IMAM in two provinces (Madang and Simbu), and in all others, identify scale up plan. Support supervision*. Link IMAM Implementation and IYCF strategy.
c. Collate monthly data*, to inform service uptake and intervention outcomes.
· Training and mentorship report for work performed in 6 provinces, with clear success stories and lessons for the two IMAM provinces (Madang and Simbu) and a scale up plan for all the others.
· Data base informing service uptake and intervention outcomes for all implementing institutions
Estimated Date of delivery
–May-Aug ( 4 mo)
*ongoing
Work Assignments #3:Central and PHA level support and coordination
a. Ensure that functional equipment and therapeutic foods are available, and supplies flow is integrated into the existing health system. Support district and PHA level planning and budgeting.
b. Review IMAM Indicators in the NHIS to match with SAM management strategy.
c. Other tasks that may arise during the implementation of the above tasks that are within the SAM management strategy*
· Deliver trainings, tailored to the various audience (e.g. information personnel, supplies managers, pharmacists, health standards, etc.), might need to be planned and delivered by the consultant
· Data base informing stock of supplies and integration status.
· A supervision, performance and information management system that can be sustained beyond the consultancy period is designed and put in place.
· Record of coordination meetings to review IMAM and indicators in the NHIS
Estimated Date of delivery
Sept – Oct ( 2 mo)
· Final report with clear successes and lessons, and should inform PNG’s concrete IMAM guidelines
November ( 1 mo)
- Estimated Duration of Contract: Period of contract is 9 months.
8.Supervisor of the contract
The consultant will work under the direct supervision of the Nutrition Specialist, guided by EAPRO’s Adviser Nutrition, and the Chief of Young Child survival and Development Section at UNICEF. The consultant will work in collaboration with NDoH, Pediatric Society, selected provinces and Church or I/NGO led facilities for skills transfer and capacity building.
9.Qualifications or Specialized Knowledge/Experience Required:
· First degree in Nutrition. Advanced university degree in the fields of Nutrition, nutritional epidemiology, global/international health and nutrition, health/nutrition research, or other health related science field
· At least three years of relevant work experience in the area of community management of acute malnutrition (CMAM) or the integrated management of acute malnutrition (IMAM).
· Knowledge of infant and young child feeding strategy
· Ability to work independently and to meet deadlines.
· Ability to write clear and concise reports in English
· Demonstrated ability to effectively work and communicate in a multicultural environment
· Computer literacy
· Excellent knowledge of WHO SAM protocol.
10.Consultants work Place
The consultancy will sit at UNICEF 10% of the time and for the remaining 90% of the time s/he will be in the selected provinces.
11.Nature of Penalty Clause to be Stipulated in the contract If any deliverable/output is not satisfactory in technical quality, UNICEF reserves the right to delay the consultant’s fee until s/he submits satisfactory deliverable /output and/or UNICEF reserves the right to reduce the fee prorated according to the deliverables that are not satisfactory.
How to apply:Candidates are requested to submit CV and P-11 (http://www.unicef.org/about/employ/files/P11.doc), full contact information of minimum 2 references, availability and proposed all-inclusive fee by **19th of February 2016* to Rhonda Glaimai at the email address rglaimi@unicef.org with cc to Thomas Mabaso at* *tmabaso@unicef.org**. Please note the air tickets under UNICEF contract shall be re-routable, refundable type (economy class and most direct route). The consultant will be responsible for own travel insurance, visa fee and terminal expenses. If there are any queries with regard to the TOR kindly contact Hanifa Namusoke (hnamusoke@unicef.org).
*All-inclusive fee/ rate to include professional fee, travel costs from home base to and from Port Moresby and living expenses in Port Moresby. Please note that UNICEF will not pay living expenses exceeding the UN DSA rate in Port Moresby.
Important note: Incomplete applications will not be taken into consideration.