Consultant on Early Essential Newborn Care and Primary Health Care
BACKGROUND
A newborn infant (an infant between birth and one month of age) dies every two minutes in the Western Pacific Region. Some 230 000 newborns die each year, representing more than half of all deaths in children under five. Newborn deaths are concentrated in the first three days of life and are often preventable. Simple low-cost practices are available to save at least 50 000 newborn lives each year, but are not reaching the babies that need them. In response to the challenge of continued high rates of newborn mortality, the WHO Western Pacific Regional Office (WPRO) has developed an Action Plan Towards Healthy Newborns in the Western Pacific Region (2014–2020). The Regional Action Plan outlines an approach for implementing and scaling up an Early Essential Newborn Care (EENC) package of interventions by improving the quality and reach of key newborn services and demand for these services. EENC is a package of interventions delivered to the mother and newborn between delivery and the first three days after birth. EENC interventions are simple and low cost and have been demonstrated to be effective in preventing newborn deaths from the most common causes. EENC interventions are delivered during delivery and the period immediately after delivery. In addition, EENC promotes the cessation of outdated, harmful or ineffective practices that are still widespread. Implementation of EENC has focused in eight countries with the highest rates of newborn mortality (Cambodia, Lao PDR, Mongolia, Papua New Guinea, Philippines, Solomon Islands, Viet Nam) and the highest number of newborn deaths (China). A ninth country (Vanuatu) was added in 2019. These countries are all signatories to the WHO Regional Action Plan for Healthy Newborn Infants and committed to taking action. The WHO Regional Office for the Western Pacific (WPRO) is supporting improved quality and reach of EENC by improving routine health systems. Implementation and systems improvements for EENC (using EENC coaching and health the facility strengthening approach) are underway in all nine priority countries – in these countries emphasis on beginning EENC with Caesarean section and introduction of Kangaroo Mother Care (KMC) is needed. The next phase of implementation will include work to institutionalize hospital-based HMIS tracking of EENC indicators and tablet-based methods for collecting and aggregating EENC Annual Implementation Reviews (AIR) data to improve accuracy and ease of data management; and to improve pre-service training and allocation of midwives to ensure that skills match job requirements.
At the same time, countries have requested support in use of practical programme approaches to assess and strengthen Primary Health Care (PHC) services for women and children, linked and integrated with EENC. These include approaches to strengthen the quality of family planning, antenatal care (ANC) and child care. Ten-year strategic plans in most countries are currently being developed, with technical support needed at regional and country levels. At the regional level a number of activities are now required to support EENC and PHC programming in the Region, including finalization of regional tools and methods; mentoring of staff in the use of new methods; and documentation of progress through data analysis and development of papers for publication in peer reviewed journals. Safe and Affordable Surgery, a new initiative, will be supported by development and testing of an adverse event tracking method in hospitals to identify practice gaps and take action to solve them; and by development and testing of sterilization assessment and planning methods.
This consultancy assignment will provide technical support and advice on policy options to senior Ministry of Health (MOH) persons and staff, development partners and WHO country representatives and staff for the development and implementation of strategies that deliver EENC and PHC services more effectively. It will focus on mechanisms to improve the quality of care provided including strengthened policies, planning and coordination, human resources, service delivery, monitoring and evaluation, better using data for decision making and tracking progress and development of community-based initiatives to improve home care and care seeking practices of women and families. It will provide technical support and facilitation for local staff in the testing and use of new methods; and develop and finalize EENC and PHC tools and methods for country use. It will emphasize documenting five-year progress of EENC implementation by conducting data analysis and writing peer review journal articles for publication as a journal series. New PHC assessment methods will be further developed, integrated into routine systems and progress documented; and integrated into patient safety approaches. In addition, support will be provided for new regional activities in the area of quality and safety for SAS, including development and testing of a hospital adverse event tracking tool and a sterilization assessment and planning approach. Finally, it will provide advice to the regional coordinator and WHO representatives on strategic steps towards improving its effectiveness towards country support. All activities will build on those already conducted in countries in 2020.
PURPOSE OF THE CONSULTANCY
The consultant works with the Maternal Child Health and Quality Safety Unit of the WHO Regional Office for the Western Pacific (WPRO) and WHO Country Office focal staff, team leaders and WHO Representatives in priority countries (Cambodia, China, Lao PDR, Mongolia, Papua New Guinea, Philippines, Vanuatu and Viet Nam) on Early Essential Newborn Care (EENC) and development of approaches to improve the quality of primary health care (PHC) services for women and children linking and integrating with EENC; and of safe and affordable surgery services (SAS).Reproductive, maternal, newborn and child health (RMNCH) activities will focus on: developing and updating 10-year country and regional strategic plans – and continuing strategic support to scale-up and institutionalize EENC and other RMNCH programmes; supporting the collection, analysis and use of EENC, Family Planning (FP), antenatal care (ANC) and child health data for national and sub-national programme planning; development of virtual approaches for EENC/Kangaroo Mother Care (KMC) coaching and quality assessment training; developing and testing a rapid coaching-based approach for improving Integrated Management of Childhood Illness (IMCI) practices; and conducting reviews of midwifery policies and practices. Additional activities will focus on development of the safe and affordable surgery programme across the Western Pacific Region, using principles and methods developed for EENC and PHC, including: 1) Testing, development and scale-up of an adverse event monitoring approach and use of data for planning; and 2) Testing, development and scale-up of a sterilization assessment and planning approach and use of data for planning.
Primary areas of work:
a) To provide policy and technical advice towards developing overall programme tactics and help establish guidelines that ensure country level efficient implementation. Working closely with National Governments, advise on strategically improving the implementation and evaluation of projects and initiatives across the various WHO programmes that are related to EENC, primary health care for women and children and SAS. Advise on integrating these efforts to ensure maximize efficiency and address cross-cutting issues.
b) To provide technical advice to build country capacity for the next phase of EENC (Caesarean section deliveries, KMC for preterm and low birth weight babies, integration of EENC into pre-service curricula, integration of EENC into quality and safety mechanisms including regulation and accreditation mechanisms, development of EENC centres of excellence) and PHC scale-up through reviews, assessments, coaching, policy development and strategic planning at national, subnational and facility levels. Assist with development and finalization of country 10-year strategic plans. Further develop approaches to institutionalize hospital-based monitoring for EENC through Health Management Information System (HMIS) data reviews and strategic recommendations to hospital and ministries of health leaders in target countries; conduct midwifery policy and practice assessments and use data to improve pre-service training and staff allocation and deployment; and support development of tablet-based data collection and cloud-based data aggregation for EENC Annual Implementation Review (AIR) assessments.
c) To support development and finalization of regional tools in collaboration with country policy-makers, programme managers and facility staff including: Caesarean section guidance; Primary Health Care Quality Improvement Guide (PHCQIG): Module 2: Antenatal care (ANC); IMCI clinical coaching guidelines; quality and safety adverse events and sterilization assessment and planning guidelines. Integrate EENC and PHC quality measures into patient safety and accreditation approaches in collaboration with regional and country WHO staff and country counterparts.
d) To support and facilitate testing and adoption of Primary Health Care Quality Improvement Guides (PHCQIGs); IMCI clinical coaching approach; quality and safety adverse event monitoring; and sterilization assessment and planning approaches in Cambodia, China, Lao PDR, Mongolia, Philippines, Vietnam, Vanuatu; mentor local staff in the approach. An emphasis will be placed on the development and application of tablet-based e-data collection methods, beginning with EENC AIR and PHCQIG Child Health assessments.
e) To develop, write and finalize papers for peer reviewed journals on EENC and PHC implementation (regional summary of progress in 8 countries; management of preterm babies in eight countries); facility-based child health, family planning and ANC quality of care; early experience with testing adverse events and sterilization tools and links with SAS.
f) To provide technical advice on compliance to related international treaties and legislation; back stop the coordinator in strategic initiation of cross-sectoral work with health officials.
g) To liaise with senior ministries of health staff, WHO-representatives and development partners to review assessment and mission findings, to institutionalize the EENC, revise primary care plans and SAS including incorporation of the tools noted above, to secure funding and provide technical assistance to these groups as needed.
h) To provide technical support to meeting planning, implementation and reporting. This will include planning, organization and facilitation of regional meetings and workshops and all documentation and reporting from these reviews.
METHODS TO CARRY OUT THE ACTIVITIES
Work to be performed:
The consultant will provide remote or in-person support to coach and mentor local staff in: EENC, KMC for preterm and low birthweight infants, introduction of EENC with Caesarean section; use of new Primary Health Care Quality Improvement guidelines for care of infants and young children, preventing unplanned pregnancies, assessing the quality of antenatal care and assessment and strengthening management of complications of pregnancy; and testing and introduction of adverse event tracking and sterilization assessments.
In-person and remote meetings, discussions and reviews will be used to continue support for monitoring and evaluation of EENC, identifying problems and addressing them; liaising with partners and ministries of health staff to fund plans; advising the regional office on effective strategies to accelerate progress on EENC and PHC for women and children; advocating for on-going support for EENC; supporting the development of updated strategic plans in countries for family planning, ANC, Emergency Obstetric Care (EmOC) and SAS; and developing and implementing midwifery policy and practice assessments.
Literature and desk reviews, data analyses and synthesis will be used to develop regional EENC and PHC supporting materials and an IMCI coaching approach; develop and support midwifery policy and practice reviews; develop and test adverse event and sterilization assessment and planning approaches; prepare papers on EENC and PNC.
Outputs:
- Output 1: Support EENC AIRs and use of data for planning (3 -5 countries)
- Output 2: Support implementation of midwifery policy and practice review (2 countries)
- Output 3: Develop IMCI clinical coaching approach and field test (2 countries)
- Output 4: Develop and field test hospital adverse event tracking tool and field test (2 countries)
- Output 5: Develop and field test sterilization assessment and planning tools and methods (2 countries)
- Output 6: Final field tests of PHCQIG modules (ANC) and completion of Regional guidelines (1 country)
- Output 7: Country support in the areas of EENC, KMC, CH, ANC, FP and SAS: policy and guideline development, clinical coaching, action planning, strategic planning, advocacy, review and strengthening of routine data systems for newborn health, development of operational research protocols and support for implementation and scale-up
- Output 8: Generate implementation research articles/technical reports on RMNCAH in the region and in selected countries
The consultant is expected to perform the work for a minimum of 15 days per month from January to December 2022.
QUALIFICATIONS & EXPERIENCE
Education
Essential: Medical (doctor, nurse, midwifery) degree
Desirable: Public health or other relevant master or doctorate level degree
Experience:
Essential: At least 15 years of experience in developing country settings; at least 10 years of practical experience supporting country and health facility level planning, implementation, scale up, monitoring and evaluation of newborn health programmes;
Desiable: Extensive working experience in the Western Pacific Region, including experience in the nine priority countries: Cambodia, China, Lao PDR, Mongolia, Papua New Guinea, Philippines, Solomon Islands, Vanuatu and Viet Nam
Skills / Technical Skills and Knowledge:
a) Expertise in the gathering, analysis and use of epidemiological data – particularly in the area of maternal, child and newborn health
b) High level technical skill in core areas such as programme planning, management, monitoring and evaluation
c) Experience in planning and facilitation of meetings and workshops; writing and development of tools, methods and guidelines; publications in RMNCH topic areas; and advocacy and discussions with senior country staff about programme financing, policy and advocacy.
Language requirements:
Essential: English language -expert level required for reading, writing, speaking
Desirable: Working knowledge of other UN languages is an advantage
Competencies
- a) Communicating in a credible and effective way
- b) Producing results
- c) Ensuring effective use of resources
- d) Building and promoting partnerships across the organization and beyond
- e) Moving forward in a changing environment
ADDITIONAL INFORMATION
Place of assignment
Off-site support will be provided. Duty travel to WHO WPRO will be scheduled as required by the MCQ Unit, and to countries when requested by WHO country offices and Ministries of Health. Due to COVID-19 travel restrictions and uncertainty around travel schedules, some activities may be provided virtually including adaptation, training and field support for testing and implementation of assessment and planning approaches, in collaboration with country counterparts.
Coordination will be carried out by email and teleconferences.
Medical clearance
The selected Consultant will be expected to provide a medical certificate of fitness for work.
Travel
The Consultant is expected to travel to WHO WPRO and WHO Country Offices if required and possible.
All travel arrangements will be made by WHO – WHO will not be responsible for tickets purchased by the Consultant without the express, prior authorization of WHO. While on mission under the terms of this consultancy, the Consultant will receive subsistence allowance.
Visas requirements: It is the consultant’s responsibility to fulfil visa requirements and ask for visa support letter(s) if needed.
APPLICATIONS
Qualified and interested specialists should submit: their CV and Expression of Interest (cover letter) to the WHO Supply Officer through WP RO UNGM at < wproungm@who.int > by 28 September 2021.
The cover letter should outline how their experience and qualifications make them a suitable candidate for this position and should include their proposed fee and availability.
For requests for additional information prior to submission of Expressions of Interest, please email the WHO Supply Officer through WP RO UNGM at < wproungm@who.int >.
Please use Tender Notice No. 144606 as subject to all submissions and enquiries. Only successful candidates will be contacted.