Consultant - Maternal and Neonatal Child Health - for Somalia (UNICEF)

[Admin]

Background:
UNICEF as part of its overall mandate to promote child survival, advocates, mobilizes resources and builds capacity in government systems and communities to improve the health and nutrition of mothers-to-be and provide quality reproductive health services which are pivotal to addressing many underlying causes of child and neonatal mortality. It is assumed that high cost neonatal care hospital units is the only way to treat sick newborns.
There is now evidence proving that a large proportion of newborn death and disease can be reduced by implementing simple, low-cost interventions during delivery and in the vulnerable days and week post-partum, both in the facility and at home.
These essential interventions include drying the newborn and keeping the baby warm; initiating breastfeeding as soon as possible after delivery and supporting the mother to breastfeed exclusively; giving special care to low-birth weight infants; and diagnosing and treating newborn problems like asphyxia and sepsis.
UNICEF Somalia is working with zonal Health Ministries, UNFPA, WHO and partners, in developing home-based maternal and newborn care program based on successful models of Community Health Workers, and/or community women’s groups, while strengthening health facilities and the referral linkages between communities and health facilities providing emergency obstetric care. Justification: Somalia has one of the highest maternal mortality rates in the world, a ratio of 1,044-1,400/100,000 live births, coupled with a high total fertility rate of 6.2-6.7 translate to a life-time risk of dying of one in 10 women.
The perinatal mortality rate is estimated to be 81/1,000 live births. The situation of women and young people is especially precarious. Many Somali women who die or are disabled during childbirth would have preferred to postpone pregnancy but lacked access to family planning services. There are considerable unmet needs in all major fields of reproductive health in Somalia. Only one out of four pregnant women attends antenatal care. For those that do, services are of poor quality and women hardly receive any useful interventions (constituting a major missed opportunity).
Newborn care is neglected, with major missed opportunities to secure immediate improvements in mortality reduction. More than 90% of women deliver at home and more than half are assisted by a traditional birth attendant.
The 15% of pregnant women who experience miscarriage have little access to care. There is poor access to skilled delivery care and emergency obstetric care at almost all locations but rural and nomadic populations particularly, are virtually without access to timely obstetric interventions when needs arise.
There is a major lack of facilities able to offer basic emergency obstetric care (BEmOC) and a grave shortage of qualified professional health workers for Sexual and Reproductive Health (SRH), especially qualified community midwives. For birth care, auxiliary staff do not qualify as skilled attendants, and many of those providing essential services are traditional birth attendants (TBAs). UNICEF has planned to improve access to effective SRH - services in Somalia.
This will be achieved through transforming existing service providers at community level, health centre and referral hospital level to be able to produce high-volume high-quality comprehensive SRH services. Plans also include increasing demand and assuring linkages between the community and higher level clinical intervention. A special focus will be given on improving access to Basic Emergency Obstetric Neonatal Care (BEmONC).
Voucher scheme is an approach which has been tested in various countries, including Bangladesh, Uganda and Kenya, to finance greater uptake of MNCH services with largely successful results. The scheme could provide a form of subsidy where the consumer of the service is directly subsidised rather than the service provider. Women who qualify as eligible for the scheme will be identified and vouchers provided for a package of services that will be offered to them. The service provider will subsequently be reimbursed for the agreed value of the package of services. Vouchers are useful for the provision of health care to vulnerable and/or underserved populations. Purpose: The overall objective of the consultancy is to design MNCH voucher management system to strengthen UNICEF / European Commission (EC) SRH project.

Main Duties / Responsibilities: Under the overall guidance of the Chief of Health and daily supervision of the Maternal and Child Health (MCH) Specialist, the consultant will work in close collaboration with relevant Ministries, partners, cash transfer working group livelihood cluster in Nairobi and UNICEF zonal Accelerated Child Survival & Development (ACSD) managers. The consultant will undertake the following key tasks as part of the overall assignment.

Tasks to be performed:

EC/SRH project – Make detailed design output-based aid (OBA) approach by using a demand-side subsidy delivery strategy for Sexual and Reproductive Health (SRH) and Maternal and Neonatal Health (MNH) project funded by EC:
• Review performance-based financing and demand creation activities introduced to Somalia by partners and make its detailed design for UNICEF to apply in project area.
• Conduct detailed risk analysis related to project implementation (in particular voucher management and logistics and remote control arrangements); identify potential impediments; and assess the financial feasibility of a voucher scheme by weighing the benefits of a voucher system and obstacles to implementation by answering the following questions:
Are any of the impediments great enough that they make it impossible to implement the voucher scheme?
Is the voucher scheme likely to achieve its aims?
Is there an alternative way to achieve these aims at a lower cost (or to a greater extent for the same cost)?
Will the voucher scheme introduce distortions into the health system whose effects might outweigh the benefits of achieving these aims?
• Detailed plan for voucher management in line with a binary approach which will consider the particular needs of rural/urban settings, issues of accessibility, verifiability of reported results and remote management;
• Establish criteria for Voucher Eligibility and design the voucher information system
• Design monitoring and evaluation mechanisms involving the following tasks:
Determine what aspects of the voucher scheme need to be monitored.
Determine how and when these aspects should be monitored.
Establish the necessary systems for conducting the monitoring.
Determine how, when and the basis upon which the voucher scheme should be evaluated.
• Review and if needed modify the package of demand creation measures to be fit for communities. Deliverables
Detailed risk analysis, potential impediments; and the financial feasibility of voucher scheme completed
Detailed plan for voucher management, eligibility criteria and voucher information system developed
Detailed monitoring and evaluation mechanisms developed
Final report submitted Management, Organization and Timeframe The consultant will be supervised by the MCH Specialist, in close consultation with Chief of ACSD, Chief of Health and Global Fund team. The overall time frame for the consultancy is two months.
Qualification and Experience

Education:

Master’s degree in Public Health or a post graduate qualification in a closely related field, with an advanced degree in health economics is required.

Experience:
• Essential: At least 10 years working experience either at the regional or country level managing sexual and reproductive health projects or programmes ideally in a conflict setting of which at least 5 years in designing and implementing health preferably MNCH voucher scheme.
• Knowledge and understanding of the United Nations (UN) system and capacity to promote consensus and establish positive working relationships. Integrity, tact, discretion and demonstrated sensitivity to cultural differences.
• Desirable: Experience working with bi-lateral, multi-lateral, and private sector clients.
• Familiarity with the work of UN agencies in the area of sexual and reproductive health and maternal and newborn health, and with international partnerships in the field of emergency and humanitarian action. Knowledge of issues related to the interface between sexual and reproductive health, child and adolescent health, primary health care, maternal and newborn health, and gender and women's health. Ability to develop creative approaches to addressing issues related to communication for strengthening linkages between these components.

Budget and Remuneration 1. This consultancy would require about 60 working days and fees will be negotiated on the basis of the current UNICEF P4/P5 negotiating fee range. 2. USD 3,000 per month subsistence allowance (on prorated basis) will be paid irrespective of the consultant being in Nairobi or inside Somalia. During missions in Somalia, the consultant will get DSA as per current rules and regulations.

Conditions of Work The consultant will be based in UNICEF Somalia Support Centre in Nairobi; however, planned field missions will be made into Somalia according to an agreed work plan to be developed at the beginning of the consultancy.

Interested and qualified candidates should send their applications with updated CV and copies of academic certificates to the address below. UN staff are requested to provide the last two Performance Evaluation Reports (PERs). Please quote the vacancy number in your application. Closing date for applications is 06/05/2011.

Email to: somaliahrvacancies@unicef.org

Or The Human Resources Manager UNICEF Somalia P. O. Box 44145-00100 Nairobi, Kenya

Only short-listed applicants will be contacted

QUALIFIED FEMALE CANDIDATES ARE ESPECIALLY ENCOURAGED TO APPLY

UNICEF IS A NON-SMOKING ENVIRONMENT