Early Infant Diagnosis and Care of Exposed and Infected Children


Consultancy Information
Consultancy Title: Consultant to Conduct Early Infant Diagnosis and Care of Exposed and Infected Children.
Name of the Project: Global Fund to Fight AIDS, Tuberculosis and Malaria.
Supervisor: Project Manager, Global Fund Programme (The consultant will be seconded to the MOH, WHO and UNICEF).
Contract Type: Individual Contractor (IC).
Duration: 3 months.
Duty station: Juba, South Sudan with travel to the field.
Deadline of application: Friday 25th January, 2013.
No of Post: 1.
Possible Starting Date: early February 2013
Background
The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) was set up as an international financing institution to increase resources to fight the three diseases namely HIV/AIDS, Tuberculosis and Malaria. The Global Fund has supported large scale prevention, treatment and care program against the three diseases. The purpose of GFATM is to attract, manage and disburse resources in public-private partnership that will make sustainable and significant contribution to the reduction of mortality and morbidity caused by the three major diseases and contributing for achievement of millennium development goal Fund.
UNDP is a key partner to the GFATM and is the UN Agency assuming the role of Principal recipient of GFTAM grants in South Sudan. As Principal Recipient for GFATM, assisting the country to meet its main goals in reducing mortality and morbidity from HIV, TB and Malaria, UNDP South Sudan Country Office is responsible for the financial and programmatic management of the GFTAM grants as well as for the procurement of health and non health products. In all areas of implementation, it provides capacity development services to relevant national institutions, Sub-Recipients and implementing partners. Currently, UNDP as Principal Recipient bears full responsibility for the operational and financial management of four grants: Round 4 HIV/AIDS, Round 5 TB/HIV, Round 7 Tuberculosis and Round 9 HSS.
Background to early infant diagnosis, treatment and care:
In South Sudan, by end of 2011, over 40 health facilities were providing ANC services that also provide HIV T&C for pregnant women. The service ensured a total coverage of only 8% of pregnant women who were tested for HIV and received results. Also in the same year, only about 5% of HIV infected pregnant mothers and 1% of infants born to HIV infected mothers received ARVs to reduce the risk of MTCT. By end of 2011, 22 health facilities were providing HIV care and treatment services with a total of 3,976 receiving treatment of which 106 were children. The numbers of children prevented from acquiring HIV and those infected that access care and treatment services are extremely low (Universal Access report, South Sudan, 201). While globally the number of newly infected children is declining as a result of successful PMTCT programmes, the coverage is quite low in South Sudan.
Low coverage and therefore uptake of services among children can be a result of (but not exclusively) absence of appropriate, updated, effective, locally applicable and efficient knowledge and skills among the health providers.
Innovations and scaling up the utilization of updated and simplified low-cost interventions at both facility and community level provides an opportunity to accelerate actions to prevent and initiate HIV/AIDS care and treatment among children and also to strengthen prevention of maternal transmission of HIV health services. With support of development partners (WHO, UNICEF, UNDP etc), the RSS-MoH/ NAP have a strategy to build capacity of health providers. The strategy aims to prevent deaths in infants and children by promoting early diagnosis of HIV, early initiation of Antiretroviral Therapy (ART) and initiation of other prophylaxis and treatments. A number of challenges however, undermine the planned strategy. These include:
• Lack of an efficient surveillance system in communities and facilities to identify exposed and infected children
• Predominantly, relying on symptomatic presentation among infant and children to make a provisional diagnosis of HIV/AIDS among infants and children. This approach in the changing world is considered inefficient for early diagnosis and often considerably delayed (falling short on positively impacting on improving quality and quantity of lives of HIV infected children). This is a result of lack of knowledge and skills to carry out EID by use of DNA/PCR method (in terms of EID sample collection, efficient and effective transportation)
• High loss to follow up among those infant and children identified by the health system, suggesting a lack of efficient tracking system to ensure appointment adherence.
In February – March 2013, WHO consultant was hired for “Guideline development & material adaptation, training and follow up of health professional Providers on Paediatric HIV diagnosis, Care and treatment in South Sudan”.
The Key deliverables in this mission included:
1. Updated IMAI training package to include special consideration for children
2. Care and tracking of ANC/PNC mothers, PMTCT Logistics – as a continuum of care for exposed and or infected infants
3. Clinical care for HIV EXPOSED infants including PIHTC – Key counselling messages, tracking exposed infants, follow-up and case conferences
4. Adapting of tracking tools for:
a. Patient appointment tools for longitudinal follow-up
b. Exposed infant and ART clinical referral form
c. Exposed infant clinical care card (longitudinal)
d. Exposed infant summary form
5. Provided sample indicators covering PMTCT/EID, to be adapted/adopted into the monitoring system
Overall Purpose of the assignment:
Purpose of the consultancy:
The overall purpose of the consultancy is to lead the collaboration in the process of improving EID systems in South Sudan, that will include;
1. Establish and rollout EID Strategy for South Sudan
2. Guide the process of capacity development among health providers for EID and conduct EID training for health workers
3. Optimizing identification of HIV/AIDS exposed and infected infants
4. Introduction of clinical care complement to on-going Laboratory EID sample handling (that will include sample collection, storage)
5. Introduce mechanisms (in collaboration with the National reference laboratory) that will complement sample transportation in an efficient and cost-effective manner (decrease return time and return ratio for caregivers)
6. Strengthen the care of exposed infant with the aim of reducing further HIV infection and overall care of child health within the context of HIV
7. Strengthening linkages to care and treatment for HIV infected infants
8. Strengthening knowledge and skills among health providers to efficiently and effectively implement Early Infant Diagnosis (EID) in health facilities in South Sudan
9. Identification and development of strategies that will strengthen the program management for EID.
Objectives of the consultancy:
The objectives of the consultancy are to establish and rollout EID strategy that is relevant, effective, efficient, and sustainable. Specific objectives include the following:
• Establish and rollout EID Strategy for South Sudan
• To conduct a desk review of all existing documents related to current implementation of HIV AIDS , that will include but not limited to current implementation and training documents for HIV/AIDS, PMTCT, IMCI complementary, current SOPS for care of infants
• Adapt/adopt an EID facility based training package for health workers to enable EID implementation at facilities and train health workers on EID
• Identify an optimal sample handling system complementing the laboratory processing of DNA samples
• Develop a training package to provide knowledge and skills that will enhance and significantly reduce possible HIV infection among those exposed and enrolment of those infected – that will predominantly address current challenges like; tracking exposed infants, early enrolment, and linkage to other related programs.
• Guide the process of capacity development among health providers for EID
• Provide the MoH with strategies to adapt/adopt to strengthen programming for EID
Scope of the consultancy:
The consultancy will analyse the current EID environment in South Sudan and develop appropriate strategy to address the existing needs. It will refer to the UNDP activities under the PR and others to design an effective and sustainable EID strategy. The consultant will be seconded to the MOH, WHO and UNICEF to work on this assignment.
Methodology:
The consultancy will utilize both qualitative and quantitative methodology. Thus both primary and secondary data will be utilized. Data collection including desk evaluation of important documents (support document, policies and guidelines, reports) with PR,CCM and SRs, in-depth interviews with PR, CCM members, SRs and field visits to selected health facilities and implementing agencies.
Key deliverables:
The consultant will produce a comprehensive structured standard report.
1. A report containing (a hard copy, a soft copy in MS Word and Acrobat Reader, Times New Roman, Size 12, Single Spacing):
a) Executive summary of conclusions and recommendations
b) Introduction, rational, objectives and methodologies,
c) Strategies (this need to include key tools, guidelines and materials developed)
d) An optimal sample handling system complementing the laboratory processing of DNA samples
e) Sustainability plan for the EID strategy
f) Conclusions and recommendations
g) Annexes: ToRs, field visits, people interviewed, documents reviewed questionnaires, etc.
2. Provide a draft report on the last date of the assignment and submit a final report within two weeks
3. Debrief UNDP, CCM members, SRs and health facilities.
UNDP’s obligations:
UNDP will:
1. Provide the consultant with all the necessary support (not under the consultant’s control) to ensure that the consultant undertake the study with reasonable efficiency.
2. Appoint a focal point in the programme section to support the consultant during the evaluation process.
3. Collect background documentation and inform partners and selected project counterparts.
4. Meet all travel related costs to project sites as part of the project evaluation cost.
5. Support to identify key stakeholders to be interviewed as part of the evaluation.
6. The programme staff members will be responsible for liaising with partners, logistical backstopping and providing relevant documentation and feedback to the evaluation team.
7. Cover any costs related to stakeholder workshops during dissemination of results.
8. Organize inception meeting between the consultants, partners and stakeholders, including Government prior to the scheduled start of the evaluation assignment.
Tentative timetable (South Sudan)
The consultant:
Orientation with PR, finalize and agree on ToR, revision of the plan of action, avail documents, evaluation of methodologies, desk evaluation of relevant documents, interview with CCM members and PR on 18 February 2013
Desk evaluation from 19 February to 22 February 2013
Discussion with SRs and PR from 25 February to 1 March 2013
Field visits to selected SRs implementation sites and health facilities to see project implementation result from 4 March to 15 March 2013
Preparing draft strategy for first presentation to stakeholders from 18 March to 22 March 2013
Presentation of draft strategy to stakeholders on March 25 2013
Finalizing strategy and preparing training plan from March 26 to 29 March 2013
Preparing and organizing training of implementers from 1 April to 5 April 2013
Conduct the first training from 8 April to 12 April 2013
Conduct the second training from 22 April to 26 April 2013
Follow up mentoring and finalizing strategy and training guide/manuals/tools from 29 April to 24 May 2013
Presentation of final strategy and training tools to stake holders on May 27
Incorporation of comments and submission of final report with clear set of recommendation from 28 May to 31 May 2013
Total days for consultancy will be 90 working days. The schedule can be rearranged as needed.
Note: The schedule is subjected to revision if there is a need from the organization.
Key recommendations expected from the consultant includes:
The recommendations will be based on the current situation and need to include
• Project frame work: possible strategies, output and indicators
• Project areas: the recommendation need to include the strategy, sustainability plan, training manuals, anticipated challenges.
• The capacity gaps of SRs in managing the strategy with regards to human resources.
Reporting:
The consultant will be reporting directly to Project Specialist HIV/AIDS GF-UNDP.
Competencies:
• Builds strong relationship with SRs, focuses on impact and result for the PR and responds positively to feedback
• Consistently approaches work with energy and a positive, constructive attitude
• Demonstrates strong oral and written communication skills
• Ability to work independently with minimal supervision and to maintain flexibility in working hours
• Good interpersonal skills; ability to work in a multi-cultural, multi-ethnic environment with sensitivity and respect for diversity.
• Demonstrated ability to develop and maintain effective work relationships with counterparts
Experience:
The consultant will have the responsibility for the overall co-ordination and for the overall quality and timely submission of the consultancy report UNDP South Sudan Country Office.
The consultant needs to have experiences and skills in the following fields
• Primary health care system, functionality of health system
• Knowledge on paediatric HIV/AIDS management
• Program designing and strategic planning
• Procurement and Supply Chain Management System at international level,
• Monitoring and evaluation of the implementations system, designing of work flow
• Experience in GFATM process and programmes will be an asset
Educational Background:
Education back ground of Consultant
Master in Public Health or Advance paediatric Degree from a recognized University. Or Masters in Social Sciences or any other related field. PhD in public health will be an added advantage.
• Specific experience: proven experience of a minimum of 5 years preferably with UN experience. Knowledge and familiarity of the United Nations system, its reform process and UNDP programme policies, procedures.
• Relevant experience in HIV/AIDS care;
• Familiarity and practical experience in the implementation of HIV/AIDS service including having experience in WHO recommended strategies “Integrated Management of Childhood Illnesses”, IMAI, PMTCT, development of HIV/AIDS training packages, especially in low resource countries
• Proven track record of similar type of expertise
• At least 5 years of professional experience in maternal and child health related program implementation, especially in a clinical setting
• Good analytical, communication, networking and facilitation skills;
• Ability to prepare analytical reports independently, prioritize and organize work assignments;
• Previous experience in curriculum/training plans and conducting trainings.
• Knowledge of the political, cultural and economic situation in south Sudan or ability to quickly acquire such knowledge is desirable
• Excellent writing and analytical skills
• Ability to meet tight deadlines
Language proficiency
Fluency in written and spoken English.
Application Documents to be Submitted
The consultant shall submit an updated CV, a cover letter stating candidate’s suitability for the assignment and a financial proposal covering consultancy fees (fee, living allowance in Juba and other incidentals) plus a round ticket cost.
Conditions of Work
Consultant will be expected to use their own laptop computers. UNDP will support and facilitate the consultants travel, provide administrative, logistics and facilitate security related issues of the consultancy. Consultant will be expected to arrange their accommodation during consultancy period.
Reference materials
The consultants should study the following documents among others:
a) PMTCT guidelines b) IMCI guidelines
c) SOPS for care of infants
d) IMAI training packages
e) WHO guideline for EID
f) Draft EID for South Sudan
g) Ethical Code of Conduct for UNDP consultancies;
h) UNDP Results-Based Management: Technical Project Documents and relevant reports
i) Documents and materials related to the GFATM (proposal, agreement, etc.)
Notice: UNDP, as a matter of practice, does not charge any application, processing or training
How to apply:
Interested candidates can send a cover letter and updated CV to bids.juba@undp.org
Early Infant Diagnosis and Care of Exposed and Infected Children Early Infant Diagnosis and Care of Exposed and Infected Children Reviewed by Unknown on 12:09:00 PM Rating: 5

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