Djibouti Health Sector Specialist

TERMS OF REFERENCE – HEALTH SECTOR SPECIALIST
PLEASE NOTE: the recruitment campaign for this position is anticipatory and is subject to donor funding approval Contract length: 1 year

CARE DJIBOUTI

Background The Republic of Djibouti is a primarily Muslim country bordering Eritrea, Ethiopia and Somalia. The total population is estimated at 818,600, of which, more than 70% live in urban centers. In rural areas, an estimated two-thirds of the population is pastoralists. Djibouti has a hot and dry climate, which is mostly made up of volcanic desert. Agriculture is therefore extremely limited and meets only 3% of the country’s food requirements.

Two consecutive failed rains combined with soaring food and fuel prices have dramatically increased food insecurity in Djibouti. Although rainfall fluctuations and drought are normal in Djibouti's semi-arid climate, the current drought far exceeds the normal variation and is severely affecting the most vulnerable people. The crisis has resulted in substantial loss of livestock, destruction of livelihoods, and degradation of fields and pastures. The UN now estimates that 146,000 people are experiencing a food security crisis in Djibouti. According to WFP, some 42% of rural households are food insecure. Of the five rural districts in Djibouti, Ali Sabieh and Dikhil Districts have the highest food insecurity rate, with 54% of the population understood as food insecure and an additional 24 - 25% of the population understood as moderately food insecure.

Djibouti also hosts over 17,000 refugees, mainly from Somalia (70% of which are women and children) in Ali Addeh camp located in Ali Sabieh District in Djibouti. Ali Addeh camp was established in 1991 for a population of 7,000 refugees and is now severely overcrowded. Somali refugees continue to arrive on a daily basis, many having walked hundreds of kilometers to get to Djibouti. According to the Camp Administrator, between 120 and 130 refugees are arriving on a weekly basis. Based on the current rate of arrivals, UNHCR expects the total refugee population to reach 20,800 by the end of 2011. Due to the scale of new arrivals and the limited capacity of UNHCR and its partners, the camp does not meet minimum standards.

Given that Ali Sabieh District is already amongst the most food insecure districts in Djibouti, new arrivals are putting substantial pressure on the host community, which has been severely affected by the current drought. Malnutrition, as well as lack of water (less than 10 liters of water per day) and limited livelihood opportunities mean that the host community finds itself in a particularly precarious situation.

Due to the increasing number of refugees living in Ali Addeh camp and the poor living conditions in the host community, UNHCR and the Government of Djibouti have decided to re-open the Hol-Hol refugee camp, which was closed in 2006 following the large-scale voluntary repatriation of Somali refugees. Hol-Hol camp has a capacity to host up to 15,000 people and will enable UNHCR and its partners to decongest the existing camp and secure additional space for new arrivals. This should help to improve the overall conditions in the camp, while also lessening the burden on the refugee host community.

Djibouti is also faced with unique migration challenges owing to its location. Every year, thousands of irregular migrants travel from Eritrea, Ethiopia and Somalia and pass through Djibouti as they flee conflict, famine and poverty in their countries of origin. Those with additional financial means are more likely to transit on to third countries, meaning that those that remain in the refugee camp are among the most vulnerable.

CARE Canada is proposing that a temporary operation be launched in Djibouti in support of refugees focused on Health, WASH, and Nutrition/Food Security (for a total of 15 months ending in December 2012).

Due to the complexity and cost of operating in Djibouti, it is recommended that this intervention focus on working through partners and in supporting and building the capacity of existing government structures rather than the full set up of a CARE Country Office. This approach will build on recommendations set out in the recently published “Partnership in Emergencies” paper and will seek to limit CARE’s physical footprint with a focus on a presence in the field.

In support of the refugee population, CARE Canada is proposing to take over the key sectors currently managed by AMDA, including health and food security/nutrition, and in both Ali Addeh camp and in the newly established Hol-Hol camp. UNHCR has confirmed its desire to engage CARE as an implementing partner both in the final quarter of 2011 and throughout 2012.

Responsibilities and Tasks 1. Program development –Identify Key priorities and prepare work plan Conduct Health Assessments (RHAs), in order to identify groups most 'at risk', determine risk factors, ascertain essential health information, determine nutritional status, calculate morbidity and mortality base-lines, assess environmental conditions, and identify resources available (including laboratory) Monitoring and evaluation of activities utilizing the UNHCR HIS system and appropriate qualitative tools to address quality 2. Conduct capacity assessment of existing staff and create capacity development plan Plan and design emergency health interventions at Primary, Secondary or Tertiary level as required, with the emphasis on Primary and Community Health, Reproductive Health, Mother & Child Health (MCH) Establish priority health needs with MOH in order to reduce mortality and morbidity among vulnerable groups. Define the required activities, especially in infectious diseases (e.g Measles), communicable diseases (e.g Malaria, Tuberculosis, HIV-AIDS), water-borne diseases (e.g Cholera, Polio), acute respiratory infections (e.g Pneumonia), and Malnutrition Mainstream gender and GBV prevention into health programming Operations 3. Develop health sector proposals for HCR and additional funding 4. Ensure compliance with WHO protocols and principles of medical ethics, and SPHERE technical standards Key Internal Contacts Team Leader and/ or CO Emergency Manager where appropriate Team members in health-related sectors Security adviser Key External Contacts UNHCR UNFPA Other UN agencies (Unicef, WFP, UNDP) Ministries of Health Reporting Lines Reports to the Team Leader and CO manager

Selection Criteria Required qualification and experience • MD or Nurse • Post-graduate public health qualification • 3-5 years experience in health sector management and coordination in emergency settings • 3-5 years humanitarian aid experience working overseas with international NGOs or agencies • Proven experience in managing multiple sectors such as food, water, and community education • Capacity to develop work plans, budgets and funding proposals • Proven knowledge of CARE policies and procedures, Sphere and the Red Cross/ NGO Code of Conduct. Requires general finance, administration, information management and telecommunication skills and proficiency in information technology/ computer skills. • French fluency required ; Arabic desirable

Core Competencies • People Skills: Ability to work independently and as a team player who demonstrates leadership and is able to support and train local and international staff and also able to work with disaster affected communities in a sensitive and participatory manner. • Communication Skills: Well developed written and oral communication skills. Able to communicate clearly and sensitively with internal and external stakeholders as a representative of CARE. This includes effective negotiation and representation skills. • Integrity: Works with trustworthiness and integrity and has a clear commitment to CARE's core values and humanitarian principles. • Resilience/Adaptability and flexibility: Ability to operate effectively under extreme circumstances including stress, high security risks and harsh living conditions. Works and lives with a flexible, adaptable and resilient manner. • Awareness and sensitivity of self and others: Demonstrates awareness and sensitivity to gender and diversity. Have experience and the ability to live and work in diverse cultural contexts in a culturally appropriate manner. Has a capacity to make accurate self-assessment particularly in high stress and high security contexts. • Work style: Is well planned and organized even within a fluid working environment and has a capacity for initiative and decision making with competent analytical and problem solving skills.

How to apply:

Contact Information: Please apply online at www.care.ca or www.careersunited.org .You will need to register before submitting your resume.

Notes: We thank all candidates for the responses to this advertisement. However, we regret that we will be able to contact only short listed candidates.

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