Epidemiologists/ Public Health physicians invited to apply- Unicef Cameroon consultancy opportunity

UNICEF CAMEROON

TERMS OF REFERENCE

Ver. March 2015

Title of Consultancy: Support 2015 Measles Rubella SIAs

(2 national Public Health/Epidemiology)

Planned Duration of Consultancy: 2 months (2 positions)

Submitted by: Young Child Survival Section

1.    Background and Justification

As 4th leading cause of child mortality in 2000, measles death is a major component to achieving MDG4. Major cause of global morbidity and mortality with more than 375,000 deaths in 2000 and despite the availability of a safe and effective vaccine for the past 45 years, measles remains a leading cause of death among young children for the WHO African Region. With a strong global support from governments, health workers and dedicated volunteers, significant progress is being made in the fight against measles, however, measles still claimed thousands lives each year in the African Region.

The current measles elimination strategy calls for increased coverage of two doses of measles vaccine (Routine, SIAs), enhanced surveillance and improved case management.

In 2011, the Sixty-first session of the African Regional Committee adopted a resolution for measles elimination by 2020. The resolution urged Member States to provide adequate resources for the implementation of national plans to sustain the gains in measles mortality reduction.

In 2012, a national plan for measles elimination in Cameroon was adopted by the Inter Agency Coordination Committee. However, several challenges are still identified, including inadequacy and sustainability of financing, weakness of the health workforce and limited access to service delivery. In addition, interventions are not implemented at full scale; procurement and supply chain systems are still weak, community engagement low in addition to weak surveillance of this disease.

Humanitarian emergencies that occurred in the Far North (Boko Haram), Adamawa and East (Central African refugees) regions have been associated with epidemics of measles, which can be prevented through vaccination if anticipated by timely intervention.

In 2014, 49 health districts faced Measles outbreaks in Cameroon. The most affected population was among 1-15 years old. Only 14 (out of the 49) received adequate response.

In order to provide continuous technical, financial and material assistance for the development of cMYP and integrated country annual operational plan, UNICEF country office is requesting the support of two (2) national consultants who will be helpful to ensure UNICEF great support for a good preparation and implementation of measles SIAs.

The 2 national consultants will support country punctually to improve the quality of their SIAs that will contribute to reduce the morbidity and mortality of the disease.

2.    Purpose and Objective

-       The purpose is to ensure that the country is engaged, mobilized, informed and well equipped with necessary planning tools and implementation strategies that will result in a successful and quality SIAs implementation;

-       The objective is to give technical support to the Ministry of Health in collaboration with UNICEF country office for the preparation and implementation of quality measles SIAs.

3.     Methodology and Technical Approach

-       Desk review to analyse the country EPI situation;

-       Meetings and interactions with the Ministry of Health and others immunisation partners;

4.    Activities, Tasks, Outputs and Deliverables

-       Support the coordination of SIAs activities in collaboration with the national focal point;

-       Prepare and contribute to political and administrative authorities advocacy for a better involvement;

-       Provide technical support for micro planning, modules and SIAs management tools elaboration, training of national, regional and district level actors;

-       If needed, conduct a training needs assessment prior to SIA.  Use findings to organize competency-based training with pre- and post-tests that focuses on the areas that need strengthening (e.g., injection technique of all antigens, contraindications, vaccine management, AEFI and side effects, etc.);  

-       Include in training information on, and reporting standards for, priority notifiable diseases.  Include interactive discussion on surveillance in training sessions at all levels;

-       During SIA training, strengthen health worker capability in AEFI management.  Provide equipment, supplies, reporting forms for the SIA and at least the next 6 months;

-       Update health worker knowledge and skills on common side effects. Include skill practice on how to communicate effectively with caregivers. A job aid or communication material on addressing side effects could be developed to support this;

-       Develop and disseminate standardized supervision checklists that include questions on whether RI messages were given;

-       Produce job aids to reinforce knowledge and skills that are important for both SIAs and RI;

-       During initial training/planning workshops for SIAs with national and regional staff, provide an overview of the current status of routine immunization and surveillance.  Task participants with identifying a short list of 3-5 RI strengthening objectives to address through the SIA to improve performance and quality.  Incorporate planning to address these issues into tools for the SIA; 

-       Review immunization policy as part of SIA planning and update policies as needed (e.g. providing routine vaccination to children >12 months or switching to use of 5-dose measles vials for RI.);

-       In SIA microplanning, map the catchment areas for health centers using Google Maps and use these data to revise RI microplans;

-       Utilize house to house visits to inform parents on where and when to go for routine immunization services;

-       Realize pre-campaigns supervisions to ensure a high quality SIAs preparation and implementation;

-       Support Districts to identify low level immunity communities (routine and SIAs data) and propose solutions to reach unreached children;

-       Use supervision checklists to review processes and address routine immunization issues e.g., stock-outs, drop out, injection waste management, etc.

-       Use supervision during SIA to strengthen AEFI reporting, response, and proper use of AEFI management kits;

-       Ensure that after the SIA, health workers still have supplies needed for reporting and managing AEFI;

-       Reinforce health workers capability in interpersonal communication about normal effects and AEFI and steps required to handle them; 

-       In health talks with community, address side effects.  Clarify that fever following immunization is much less severe than the symptoms and consequences of the disease;

-       Revise training content and supervision checklists for RI to include problem areas identified during SIA;

-       Conduct rapid convenience assessments for assessing RI coverage and identify VPD cases;

-       During RI, use two-level supervision with standard checklists.  Supervisors can conduct rapid convenience assessments (RCAs) for routine immunization coverage and ask village leaders if any cases of notifiable diseases.

-       Follow logistic & cold chain, vaccines and injection materiel distribution for activities implementation;

-       Participate to the SIAs supervision and link with communities;

-       Participate to the SIAs evaluation activities;

-       In places where local head counts for SIAs (disaggregated by age group) are more accurate than official estimates, use them to revise target populations for microplanning for RI and other services;  

-       Use SIA monitoring data to identify specific obstacles to immunization and prepare plan to address them in RI;

-       Use data on expenditures incurred during SIA to develop realistic budgets for vaccine delivery and other operational costs for RI;

-       Review data on numbers of children reached at vaccination posts during the SIA to identify those with greatest numbers. Use this information to revise siting of outreach locations for RI;

-       Per the WHO Position Paper (2009) recommendation, screen and record doses of measles vaccine given to children under two years of age in campaigns. Record separately doses given to children two years and older;

-       Adapt SIA microplanning templates for use in RI microplanning;

-       Conduct coverage surveys that are used to assess both SIA and RI coverage levels.

-       Immediately use the data from the SIA in the areas of low coverage to rapidly plan and execute a mop-up that includes not only measles but all antigens;

-       In sharing SIA results with local government officials and community leaders following the campaign, also share information on the current status of routine immunization and actions and budget needed to strengthen it; 

-       Conduct follow-up survey or supervision of health worker skills to determine areas needing further reinforcement; 

-       Support and follow communication activities (availability of communication plan, early implementation of activities);

-       Follow financial resources transfer and distribution;

-       Support daily data collection & analysis and correctives actions taking during the SIAs;

-       Plan and implement convenience survey to immediately organize mop-up operation in low coverage;

-       Ensure AEFI and waste management during the SIAs;

-       Provide technical support for routine vaccination reinforcement in low coverage areas;

-       Formulate recommendations to ensure the preparation and implementation for high quality SIAs.

Deliverables

The consultant will have to submit to the supervisors (CO):

-       A weekly update on his activities to discuss progress related to this ToRs;

-       A first month activities report to allow the 1st monthly salary payment;

-       A draft of a final report on all his activities at least 2 days before the end of the contract to allow feedbacks and discussions;

-       A final report on all his activities taking into account all feedbacks 2 weeks after the end of the consultation with a summary report presented in PPT format & campaigns data under Excel format;

-       All deliverables must be presented to WCARO & CO on electronic support.

Output

-       Timely and accurate technical support is provided by the Country Office through the 2 consultants for a high quality SIAs preparation and implementation.

5.    Management, Organization and Timeframe

The 2 consultants will be positioned under the supervision of the Chief of Health sub-component located at the Cameroon country office in Yaounde and will also work closely with the Immunization Officer and country teams (C4D, CCL, Health, WASH and Nutrition). 

UNICEF will:

-       Organize an initial briefing for the consultant;

-       Make available guidelines, documentation on Measles & Rubella SIAs organization;

-       Ensure consultant direct supervision;

-       Final appreciation of the consultant work quality.

Full Time: Estimated total working days: 2 calendar months - On a base of 21 working days/months

The 2 consultants will be on contract through to the end of the 2 calendars months, and will implement the activities and deliverables as outlined in this document.

Duration of the assignment will be agreed upon prior to the start of each assignment, and the total contract will not exceed 2 calendars months - on a base of 21 working days/month.

Deliverables	Deadline
A weekly update on realized activities	Every Monday
A Monthly activities report	Every Month
A draft final report on all his activities on electronic support	At least 2 days before the end of the mission
A final report	At the end of the mission
A summary report presented in PPT format & SIAs data under Excel format	At the end of the mission

6.    ROMP Reference, Budget and Remuneration

WBS: 0690/A0/04/896/003/007                 Appui technique (missions)

Grant: XXX

§  Four 2 months (XXXX to XXX ) of work for 2 consultants: National Public Health/Epidemiology consultant, NOB professional

o   1^st month consultancy fees: 138.904$*2*21* working days: $US2,917*2 = 5,834$

o   2^nd month consultancy fees: 138.904$*2*21 working days: $US2,917*2 = 5,834$

o   Estimated/total salary fees= $US 5,834*2 = 11,668$ estimated for 2 consultants

§  Salary will be pay on monthly basis only after the submission and approval of the monthly activities report;

o   Perdiem for duty travels will be pay when consultant is on duty travel in the country outside the duty station (20 days per month for a total of 40 days for the duration of the contract).

§  Lumpsum for field missions (transport & perdiem for consultant & driver) to be use according to UNICEF rules: 7,500*2 = 15,000$ estimated for 2 consultants

        Total for the 2 consultants: 26,668$.

7.    Qualifications and Specialized Knowledge/Experience required

National consultant in Public Health/Epidemiology, NOB professional 

§  Education

o   A Medical degree with a master's degree in Public Health, Epidemiology or Biostatistics; or other relevant disciplines.
*A first university degree with a relevant combination of academic qualifications and experience may be accepted in lieu of advanced university degree

§  Work experience

o   At least 5 years’ experience dealing with immunization programme (Expanded Programme on Immunization mainly planning, implementation, monitoring and evaluation);

§  Competencies

o   Competencies in epidemiology;

o   Capacity to work in multicultural environment;

o   Knowledge of the social, political and economic environment of the country. A working experience in Cameroon related to immunization issues is an asset.

o   Knowledge of informatics techniques including web browsing;

o   Proven ability to develop and maintain relationships with multiple partners;

o   Excellent analytical, organizational and communication skills;

o   Good analytical and negotiating skills.

§  Language

o   Excellent knowledge of French and a good working knowledge of English;

8.    Conditions of Work

Full Time: Estimated Total Working Days: 2 months- On a base of 21 working days/months;

Duty Station: Yaounde with some travels in the country. Each consultant will be covering one of the priority Region.

Work place of consultant: UNICEF Cameroon country Office and Expanded Programme on Immunization Central Technical Group/Departments of Family Health & Health promotion teams.

9.     Anticipated travel

§  Travel to duty station

§  Travel inside the country for technical support, prospective visits and SIAs supervision

10. UNICEF recourse in case of unsatisfactory performance

§  Payment will only be made for work satisfactorily completed and accepted by UNICEF.

§  UNICEF reserves the right to interrupt the contract in case of unsatisfactory achievements.