Agreement for Performance of Work- Developing a Policy Brief for Addressing the Shortage of Nurses in Fiji

BACKGROUND

The COVID-19 pandemic unmasked the fragility of health systems and existing inequities, revealing critical areas that require significant improvement, including the health workforce in Fiji. The Government of Fiji faces sustained challenges in assuring the production, deployment and retention of sufficient human resources for health, including nurses. The shortage of skilled nurses, who make up 74% of the primary health care services, is unprecedented and poses a threat to both the stability, accessibility and quality of essential care delivered at primary, secondary and tertiary levels.

The recent nursing outmigration has evolved into a health system crisis for Fiji due to the global shortage of health workers and aggressive international recruitment. Recent reports indicate that more than one-third of nurses at the national referral hospital have resigned, with similar concerns echoed across health facilities in the country. The nurses’ outmigration causes a loss of investments made in the education and training of nurses and exacerbates the brain drain of highly skilled professionals. Further, the migration of nurses from rural to urban health facilities has been increasing due to vacant positions created by the outmigration.

Recognizing the challenges posed by the recent increasing exodus of nurses, Fijian government led by the Ministry of Health and Medical Services (MoHMS) developed and implemented several strategies to attract and retain nursing workforce in the public sector. Despite all the ongoing efforts, the skilled and competent nurses continue to leave the public health facilities to either abroad or private hospitals in the country.

Therefore, the MoHMS identified the urgent need to analyze the current challenging situation in the context of increasing exodus of Fijian nurses vis-à-vis strategies developed and implemented by the government. Subsequently, develop a Policy Brief, identifying the potential ‘push and pull’ factors, corresponding feasible measures and policy options for the Fijian government and relevant stakeholders to overcome the persistent challenges, attract and improve retention of nurses at the health facilities, where their services are required the most, with an aim to address the shortage of nursing workforce in the longer term.

PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY

The APW partner will work closely with the Chief Nurse & Midwifery Officer (CNMO) and the Human Resources Manager (HRM), MoHMS, Fiji and WHO Division of Pacific Technical Support (DPS) in developing a Policy Brief for addressing the shortage of nurses in Fiji. The Policy Brief shall identify the potential ‘push and pull’ factors, corresponding feasible measures and policy options for the Fijian government and relevant stakeholders to overcome the persistent challenges, attract and improve retention of nurses at the health facilities, where their services are required the most, with an aim to address the shortage of nursing workforce in the longer term.

DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT

The APW partner will work closely with the CNMO and HRM, MoHMS, Fiji and WHO DPS to deliver the following deliverables:

• Situational analysis of nursing workforce and current persistent challenges in the context of increasing exodus of Fijian nurses vis-à-vis strategies developed and implemented by the government.
• Explore and document all the potential ‘push and pull’ factors and corresponding feasible measures to address the ongoing challenges contributing to the shortage of nursing workforce in Fiji for now and in the future.
• Draft the Policy Brief, that can be used by the MoHMS for convening policy dialogue(s) with relevant stakeholders, including nurses, government agencies, partners and private hospitals.

METHODS TO CARRY OUT THE ACTIVITY

Working closely with the CNMO and HRM, MoHMS, Fiji and WHO DPS, the APW partner will:

• Review all the relevant data (including available data and information from recruiting countries) and documents including exit interview responses collated by MoHMS, global, regional and national policies and guidelines (including grey literature) such as WHO Global Code of Practice on the International Recruitment of Health Personnel and it’s subsequent implementation reports, studies conducted by other UN agencies and partners, Fiji Public Service Rules and Regulations etc.
• Convene interviews and consultative meetings and discussions with the relevant nurses, policy makers and stakeholders, including but not limited to: MoHMS, Fiji Nursing Council, Fiji Nursing Association, selected public and private health facilities and selected nurses.
• Present the final draft Policy Brief to the senior management, MoHMS, Fiji.

QUALIFICATIONS & EXPERIENCE

EDUCATION

Essential: Master’s level university degree in health policy, health workforce management, health research or other public health-related sciences.

Desirable: Postgraduate qualification in health policy, health workforce management, health research or other public health-related sciences.

EXPERIENCE

Essential:  An institution/company/firm with a minimum of 10 years of experience in public health policy analysis, health labour market analysis, health workforce management, health system analysis, health services management.

Desirable: Experience in research methods including systematic reviews and qualitative research and working in developing countries preferably in the Pacific.

TECHNICAL SKILLS & KNOWLEDGE

• Expert knowledge on health policy analysis and planning, health labour market analysis, health workforce management, health services organization, health systems strengthening.
• Demonstrated experience and ability to provide coherent and advocate policy options based on evidence.
• Demonstrated working experience with academics, research centres and national technical institutions.
• Excellent communication skills with the ability to work well with, and positively relate to, people at all levels and from all backgrounds and orientations.

LANGUAGES

• Essential: Expert knowledge in English (reading, writing, and speaking).

COMPETENCIES

• Producing results
• Respecting and promoting individual and cultural differences
• Communicating in a credible and effective way
• Moving forward in a changing environment

DUTY STATION:  FIJI

ADDITIONAL INFORMATION:

The Expression of Interest should include the budget details based on the above listed deliverables.

Submitting a reply to a call for expression of interest for pre-qualification does not automatically guarantee receipt of the solicitation documents when issued. Invitations to Bid or Requests for Proposals and any subsequent purchase order or contract will be issued in accordance with the rules and procedures of WHO.

APPLICATIONS

Qualified and interested experts should submit their CV {for individual contractors} or Company Profile {for institutional applications} and Expression of Interest {cover letter} to the Supply Officer through WP RO UNGM at wproungm@who.int by 30 September 2023 17:00 Philippines time. 

The cover letter should outline how their experience and qualifications make them a suitable candidate for this position and should include their proposed daily consultancy fee and availability.

Please use Tender Notice No.  WPRO_2023_PHS_DPS as subject to all submission. Only successful candidates will be contacted.