Senior consultant to develop and support implementation of Transition Strategy from MCH week campaign to routine, Kigali Rwanda, 6 months, work in different districts – For Rwandan Nationals ONLY at United Nations Children’s Fund: (Deadline 28 June 2024)

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Background:

Integrated Maternal and Child Health (MCCH) Week is being implemented in all 30 districts of Rwanda twice a year, with deworming planned to take 3 times a year in high endemic districts. The key interventions during the campaign were Vitamin-A supplementation among children aged 6-59 months, de-worming for children aged 12 – 59 months and children between 5-15 years, and adults 16 years and above in districts with high prevalence of intestinal worms, malnutrition status screening for children aged 6 – 59 months, provision of micronutrient powder/ONGERA for children aged 6-23 months, vaccination of defaulters who missed vaccination appointments, and provision of family planning methods. Besides those interventions, some other opportunities were also taken such as health education for community engagement in behavior change, sensitization on malaria prevention, family planning, and hygiene and sanitation promotion.

Rwanda has made tremendous efforts to improve maternal and child health in the country. The United Nations General Assembly adopted universal health coverage (UHC) as one of the sustainable development goals. Universal health coverage aims to ensure that every person and community, irrespective of their circumstances, has access to the health services they need, at the time and place they need it, without the risk of financial devastation. In the last couple of decades, Rwanda has improved the health and well-being of all its people. The country also made significant extensions of Community-Based Health Insurance schemes which cover of the population. Moreover, the government spending on health (15.6% as of the 2019/2020 fiscal year required under the 2001 Abuja Declaration.

It is against this backdrop and in line with UHC principles, that Rwanda is pursuing the transition from vertical campaign-based service delivery into integrated & decentralized routine mass and individual health services delivery through strengthening primary and community health care. Given the strong community health program and health posts service level and the effectiveness of existing frontline health workers in delivering a range of preventive, promotive, and curative health services related to health and nutrition, it is high time for Rwanda to transit from vertical campaign to routinely decentralized mass and individual service delivery at community and health facility levels. This transition will improve cost efficiency and sustainability besides strengthening the health system. This ToR outlines the scope, objectives, and activities for a consultant supporting the development and piloting of the strategy from vertical MCH week campaign into a routine decentralized mass and individual health service delivery in community and health facilities in selected districts, as well as revision of the health post service package to better address the needs of women, children, adolescents, and mothers in primary health care and link to community health service delivery.

Purpose of Activity/Assignment:

Objectives

The primary objective of this project is to formulate a comprehensive transition strategy, including cost analysis and timeline, to seamlessly integrate all MCH week campaign activities into routine decentralized mass and individual health service delivery in community and health facilities.

Specific objectives include:

1. Development and piloting of transition strategy for decentralized routine mass and individual health interventions delivered in community and health facilities.
2. Revise the Health Post service package to include activities transitioning into routine services

1. Key Tasks:

The project will encompass the following activities:

1.     Conduct a thorough review of current MCH week campaign activities in the community and primary health care facilities as well as community non-health platforms such as community gatherings (inteko z’abaturage), family evening gathering (umugoroba w’imiryango), Early childhood Centres (ECD), religious gatherings, school platforms, and identify suitable platforms/channels for integration of MCH week campaign services within routine service delivery. The review will include thorough document review and discussion with relevant stakeholders at national, district, sector and village level.

2.     Analyze the costs associated with transitioning MCH campaign services into routine health and non-health system delivery platforms.

3.     Develop a costed transition plan, including a detailed timeline, transition strategy, geographic locations, and planned support and monitoring of implementation. This should outline key milestones and steps required for the seamless integration process.

4.     Develop an auto and independent monitoring and evaluation framework for the effectiveness of the routine decentralized mass and individual health interventions at all levels (national, district, sector and village).

5.     Identify potential facilitators, challenges and barriers to the integration and devise strategies to overcome them at all levels (national, district, sector and village). Conduct the cost-benefits analysis and show the health and economic benefits of the routine decentralized mass and individual health interventions

6.     Collaborate with RBC, MOH, NCDA, MINALOC, MINEDUC, UNICEF, and all relevant stakeholders to ensure buy-in and support for the transition strategy. This requires national stakeholder consultations, review and feedback, addressing of feedback, and consensus.

7.     Outline revisions needed for key service packages and protocols that will be affected, including conducting direct revision of the Health Post Service package, to include services from MCH week as well as other missing MNCAH services, determined in consultation with MOH, RBC, NCDA, UNICEF, WHO and key partners in primary health care.

8.     Pilot-test the transition strategy in seven selected districts to assess its feasibility and effectiveness.

9.  Refine the transition strategy Including budget based on feedback and lessons learned from pilot testing.

10.  Develop necessary guidelines and protocols for monitoring and evaluating the integration and decentralization of MCH campaign services into routine health and non-health system delivery platforms, including any proposed revisions of routine data systems (e.g., HMIS or CHIS indicators)

11.  Develop training package and train healthcare providers and staff on the new protocols and procedures associated with the integrated delivery model.

12.  Service packages must be revised, and frontline workers should be equipped with the necessary tools and training to accurately record, and report data related to the provision of Vitamin A, deworming, and other basic services at high quality. Sourcing reporting and recording materials, such as data collection forms and registers, should be prioritized to facilitate this process.

13. Establish mechanisms including SBC for ongoing support and sustainability of the integrated and decentralized routine delivery model beyond the project’s scope.

Work Assignment Overview

Tasks/Milestone:

• Inception/Baseline report and
• Draft Transition Strategy/Transition Plan
• Endorsed Transition Plan/Strategy disseminated and/ or published.
• M&E tools and Implementation in selected districts
• Revised health post package and other service packages deemed necessary for the transition.
• Final Documentations

Deliverables/Outputs:

Payment 1: 35%

1. This must include the Inventory report detailing current MCH week campaign activities, a report on findings from research on health system delivery platforms; a Cost data collection report for the MCH week campaign transition; and a Budget analysis report for integration requirements.
2. A Transition Plan facilitating the transition of the MCH week campaign services into the routine formulated, that includes.
3. Comprehensive timeline document with key milestones and integration steps including issues tailored SBC component.
4. An implementation modality.
5. An estimated budget for implementing the plan (based on costs per activity over time with expected coverage results) and considering additional interventions.
6. A strategy for integrated short, medium, and long-term logistics and supply.
7. How to address the motivation of Health workers at all levels, and communities to ensure an effective transition from MCH week campaign into routine decentralized health service delivery.

Payment 2: 35%

8. A revised Transitional Plan including issues tailored to SBC component endorsed by the MoH for dissemination, including a selection report for pilot testing geographic locations.
9. Revised service packages including the health post service package to include transitioning as well as other key essential services.
10. Development and use of training materials/packages for training to HWs in selected districts in both English and Kinyarwanda
11. Conduct the pilot in selected districts.
12. Monitoring and support plan for implementation in selected districts.
13. Feedback analysis report from pilot sites and stakeholders.

Payment 3: 30%

14. Guidelines and protocols document for monitoring and evaluating integration progress including Training program curriculum including key soft skills on interpersonal communication for healthcare providers.

Duration and Location

The consultancy will be for 6 months from June to December 2024 and the consultant will work from different 7 districts.

Selection Criteria

Applications shall be assessed based on their technical and financial proposals. Maximum scores for technical and financial applications will be 75% and 25%, respectively.

Successful candidates in technical evaluation will be requested to send their most competitive, all-inclusive financial proposals.

To qualify as an advocate for every child you will have…

• An advanced university degree (Master’s or higher) in maternal Nutrition, public health, or early child development
• Minimum of 8 years of experience in the development and implementation of programmatic research tools and guidance for maternal health/nutrition/early child development programming/ other community health services.
• Clear understanding of maternal nutrition and health programming at the community and PHC (Primary Health Care) level.
• Highly motivated, with the ability to work independently, take initiative and finalize deliverables.
• Flexible to make frequent field trips to service delivery points – the health centers.
• Strong interpersonal, verbal, and written communication skills in both English and Kinyarwanda.

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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