South Sudan (Republic of): IMCI Consultant

Summary
Purpose Review and harmonize the current South Sudan IMCI Guidelines and Protocols for adaptation as a National IMNCI Guidelines and Protocols in line with the current WHO/UNICEF standards.
Expected fee Mid-level professional expert, "Please indicate your expected monthly fee for providing the services of the above assignment, providing justification where possible."
Location UNICEF Country Office, Juba
Duration 6 months
Start Date 1 June – 30 November 2013
Grant # GS1200048
Project & Activity Codes 4040/AO/01/001/002
Reporting to Health Specialist (PHC) under overall guidance of Chief H&N

Background:

South Sudan, the newest nation in the world, has an estimated population of 9,297,254 which includes 1,952,423 children under the age of five years and 2,324,314 women of child bearing age. The newly independent country suffers from one of worst burden of the high rates of mortality, fertility and under-nutrition. The Infant Mortality Rate (IMR) and under-five mortality rates (U5MR) stand at 75 and 105 per 1000 live births respectively.

The main causes of morbidity and mortality among children under-five in South Sudan are malaria, diarrhea, pneumonia and malnutrition. According to the 2010 Sudan Household Health Survey (SHHS), only 24% percent of children with suspected malaria received anti-malarial drugs within 24 hours of onset of symptoms and only 9% of children received ACT. Access to the treatment of malaria is largely inequitable. The children of richest quintile received the anti-malarial treatment four times higher than the children of poorest quintile. Urban children were twice as likely to be tested for malaria as compared to rural children (57.7% versus 23%). Malaria morbidity and mortality remains high due to low coverage of LLITNs (Long-lasting Insecticide Treated Nets) with only 34.2% households owning a long lasting insecticide treated net. There are also still challenges in the management of diarrhea. With regards to its home management, one in ten mothers gave nothing to drink and stopped giving food while one in three reduced both drinks and food. More educated mothers were more likely to give increased drinks. Pneumonia remains one of the main killer diseases for children and according to the 2010 SHHS, 47.2% of caregivers with children with pneumonia saw an appropriate provider, with a remarkable urban rural difference (63.8% versus 44.2%). Urban children were almost twice as likely as rural children to receive antibiotics for suspected pneumonia (52.4% versus 27.8%).

In responding to this high mortality and morbidity rates in the country, the government and its implementing partners introduced the integrated management of childhood Illness (IMCI) in 2007 in an attempt to reduce the childhood mortality. The IMCI strategy, developed by WHO and UNICEF, aims to improve the management of childhood illness at the primary health care level. In South Sudan, only a few counties are implementing IMCI strategy to some degree, mainly focusing on improving case management skills and health care delivery systems. With support from WHO, UNICEF and other partners, training has been provided for health workers, reaching some counties partially. However, implementation of IMCI strategy remains highly inadequate. The main challenges include lack of an updated and harmonized guidelines, low training coverage and barriers to access for community. A recently conducted County Health System assessment supported by UNICEF in five counties showed that almost none of the health facilities visited provided under-five consultation in line with the IMCI protocol. Factors contributing to this situation are: lack of appropriate training and mentoring services on IMCI; absence of essential job-aids like IMCI chart booklet, and registration books.

The current edition of IMCI guidelines was developed in 2006 and the guidelines needs to be updated to incorporate the latest global development as well as the harmonization and adaption of the guidelines as a national IMNCI guidelines for the country with inclusion of neonatal IMCI to combat the high rates of neonatal mortality.

Justification:

At the primary care level, it is important to strengthen the case management of common childhood illness applying the IMCI standards in order to fast track progress towards the reduction of child mortality in South Sudan. The Government felt that there is a need to review and update the existing IMCI guidelines to align with the latest development of IMCI including neonatal IMCI component. Moreover, it is an opportunity to make changes while the new nation is having strong momentum of commitment and promises to nation building after the self –determination of South Sudan in July 2011.

The Ministry of Health has requested technical support from UNICEF through outsourcing an international expert with strong background and work experience in IMNCI specifically programme management, planning, guidelines development, training and mentoring skills. Hence the main aims of this consultancy is to review and update the existing IMCI guidelines, protocol, training materials and job aids and thereafter to design and conduct a TOT to develop a core team of IMNCI trainers and mentorship using follow-up after training tools.

Purpose of the Assignment:
Under the overall guidance of Chief Health and Nutrition and with direct supervision of the Health Specialist (PHC) in UNICEF, the consultant will work closely with the Child Health Focal point in the Ministry of Health, Directorate of Community and Public Health to,

1. Develop the draft inception note with detailed plan of action and time frame guided by this TOR and provide copies to Directorate of Community and Public Health, MoH and UNICEF. .

2. Carry out the implementation of the inception note/plan of activity to deliver expected consultancy outputs. Conduct desk review of current IMCI guidelines, protocols and WHO/UNICEF standards/recommendations and other relevant documents as deemed necessary, in close coordination with the implementing partners.

3. Develop a draft updated guidelines, protocol and job aids on IMNCI based on most recent WHO Publication on IMNCI Guidelines adapted to South Sudan context, in close consultations with the IMNCI implementing partners and the Malaria TWG members.

4. Share/Present the first draft of documents (guidelines, protocols, training modules, mentoring/supportive supervision tools, job aid, sick neonate / child forms, and sick child registration books) with UNICEF, MoH and other implementing partners through a multi-sectoral consultation meeting for discussion and comments to further improve the guideline, protocols and training modules.

5. Update the first draft and make necessary revision to incorporate appropriate inputs during the multi-sectoral consultation meeting and present the revised version to UNICEF and MoH Directorate of Community and Public Health, WHO, and other child health partners and Malaria TWG.

6. Design and develop IMNCI supervision checklists and tools

7. Facilitate a consultative workshop to validate the guidelines, training protocols and supervision tools

8. Facilitate and coordinate national level master training of trainers on IMNCI

Education and work experience:

• University degree in Medicine with specialty in Pediatrics or MPH is an advantage
• Work experience in child health training program, especially in development of IMCI guidelines and protocols and facilitating child health/IMCI training.
• Five to eight years of work experience in National Child Health program and monitoring and evaluation of IMCI programs is an asset.
• Excellent communication skills
• Good team player with ability to work independently and under considerably tight deadlines; Creative thinking, drive for results and strong commitments.
• Good inter-personal relationship even in diverse work environment.
• Work experience in South Sudan is an added advantage

Language: Fluent spoken and written English

Payment schedule and Reporting

It is anticipated that the payment schedule will be on a monthly basis based on agreed deliverables. The last payment will be upon submission of the final draft documents with satisfactory evaluation.

Reporting:

Monthly progress report; first draft updated IMNCI Guidelines, Protocols and implementation plan and the final draft National IMCI Guidelines and Protocols and implementation plan

Expected Deliverables: (Hard and e-copy)
1. Inception note with detailed plan of action and time frame.
2. Monthly progress report 3. First draft updated IMNCI guidelines and protocols (IMNCI facilitator’s guide, IMNCI modules, IMNCI chart booklet, 0-2 months sick young infant registration book, 2-59 months sick child registration book, mentoring/follow-up after training tools and agreed national and implementation plan/strategy)
4. Training completion report of one batch IMNCI ToT
5. Final draft of the updated IMNCI supervision and monitoring checklists
6. Final draft of IMNCI implementation plan/strategy
7. Final consultancy technical report.

Duration of Assignment:
It is expected that the work will last about six months.

General Conditions: Procedures and Logistics
The organization will assume responsibility for the following:

 The consultant will work from UNICEF office and/or the MOH in Juba. Depending on the availability of office space in both offices.
 The consultant will be required to come with his/her laptop/ other service tools needed but UNICEF will provide other supplies related directly to the task for duration of the consultancy.
 Final payment to the consultant will be dependent on the completion of deliverables as well as hand over notes and submission of the completion of consultancy evaluation.
 UNICEF will only cover the costs of economy class airfare from place of residence to Juba and back to residence. All work related transport (land/plane) costs within South Sudan will also be covered by UNICEF.
 Unless authorized, UNICEF will buy the tickets for the consultant. In exceptional cases, the consultant may be authorized to buy his/her travel tickets and shall be agreed to beforehand.

Policy both parties should be aware of:
 The consultant is not entitled to payment of overtime. All remuneration must be within the contract agreement.
 No contract may commence unless the contract is signed by both UNICEF and the consultant.
 Consultant will have to complete the online basic and advance security training prior to travel to Juba, South Sudan.
 Signed contract copy or written agreement must be received by the office before the consultancy can be undertaken by the consultant.
 UNICEF is not responsible for insurance cover for the consultant and waiver in the event of injury while executing the duty is required from the consultant.
 The consultant will not have supervisory responsibilities or authority on UNICEF budget.
 The Consultant will be required to sign the Health Statement for consultants/individual contractor prior to taking up the assignment, and to document that they have appropriate health insurance, including Medical Evacuation.
 The Form Designation, change or revocation of beneficiary must be completed by the consultant at the HR Section.

Human Resources Officer
UNICEF South Sudan Country Office, Juba
OR PREFERABLY: Email: jubavacancies@unicef.org