Roster Nurse Consultant

1.Purpose of consultancy

The purpose of this consultancy is to have a roster of senior experts in nursing, able to provide technical support to strengthen the nursing component in the different levels of care, specifically in Primary Health Care (PHC) and thus the quality and continuum of care.

2.Background

Country context

Lebanon has been impacted by multiple crises; these include a major economic crisis followed by a historic devaluation of the Lebanese pound, the COVID-19 pandemic and recovery from it, a cholera outbreak, the Beirut port explosion, and continuous civil unrest. Currently, Lebanon has also been heavily impacted by the political and military situation in the region and is dealing with frequent bombardments and displacement in the southern areas, while facing a potential war threat that may expand to its entire geography.

Lebanon was reclassified by the World Bank as a lower middle-income country. In 2021, a report from ESCWA, utilizing household data sources, revealed that 82% of the population experiences multidimensional poverty, with 40% facing extreme levels of such poverty^[1].

The multi-layered crises have been significantly impacting the determinants of health and affordability of health care. Communities have become increasingly vulnerable to poor health outcomes. With increasing poverty and unemployment rates, vulnerabilities among people are increasing, leading to more reliance on the public health system for accessing health care. Many people have turned to the public sector relying on MOPH support to access even basic care. Data from Primary Health Care (PHC) shows an increase in consultations and requests for medications.

Primary health care

There are around 310 PHC centres that are part of the MOPH network and that are bound by a contractual agreement with the MOPH whereby they benefit from in-kind support such as essential medications for acute and chronic diseases, vaccines and training, amongst others. Following the Beirut Port explosions in 2020, the MOPH has worked on unifying basic benefit packages, to be subsidized at PHC level – the Long-term Primary health care Subsidization Protocols (LPSP), covering noncommunicable diseases, reproductive health, other common diseases, and coupled with a M&E framework and a communication and outreach strategic plan (focusing on health promotion and community engagement).

Burden of NCDs

Non-communicable diseases (NCDs) pose a substantial public health challenge in Lebanon, contributing to elevated rates of both mortality and morbidity. 91% of the population's mortality is caused by NCDs. NCD issues and areas of work are fragmented, with no dedicated NCD program or unit within the MOPH to ensure proper multisectoral coordination. The high level of fragmentation in the health system weakens the NCD prevention and management. There is an urgent need for a department for NCDs within the Government or at least an NCD Unit with a dedicated focal point within the Ministry to raise the priority accorded to NCDs. Establishing a multisectoral coordination mechanism for NCDs is highly needed.

While most PHC centres follow some standardized approach for NCD screening and management on paper, challenges persist, and the level of compliance seems to differ across the centres. Due to suboptimal alignment to the national algorithms, a key challenge to providing standardized NCD care through the PHC is that services are delivered through different models based on the diverse educational background of doctors and health professionals, with no regulatory or quality oversight from the MOPH.

WHO response

WHO has been working on strengthening the health system to ensure continued access to essential services including at primary health care level; several initiatives have been taking place, addressing quality of care, provision of essential medications including chronic and mental health medications, health information system, capacity building, among others. In addition, WHO implemented a project in Lebanon’s largest central prison where inmates with noncommunicable diseases received comprehensive care based on the LPSP that were adapted to prison context. At the same time, WHO is adapting the LPSP to the context of long-term residential facilities, mainly mental health residential facilities and elderly homes. This effort aims to harmonize and strengthen the quality of primary healthcare in the different types of facilities.

In terms of health quality services at the PHC, WHO piloted the integration of the people-centred primary health care approach in 4 PHC centres in addition to the PHC at Roumieh Central Prison. This project aimed at reprofiling the core care team (physician, nurse, social worker) and providing training and on-the-job coaching, as well as establishing people participation groups.

The MOPH is planning on building on the efforts done especially in NCDs, PCPC and other PHC interventions. In addition, the MOPH is prioritizing the review of the basic benefit packages (LPSP), in line with WHO guidelines and ongoing interventions.

To strengthen the quality and continuum of care, we propose to recruit a senior nurse to provide expert opinion and support in the implementation of WHO interventions especially at PHC level.

3.Work to be performed

Output 1: Review and adaptation of essential health benefit packages and related guidelines especially for NCDs, with focus on vulnerable contexts.

-Deliverable 1.1: Conduct situation analysis including desk review, field visits, key informant interviews and focus group discussions with relevant stakeholders, PHC staff, and beneficiaries as needed and prepare a report summarizing the findings and recommendations.

-Deliverable 1.2: Participate in meetings and panel discussions to present findings, gather feedback, and discuss potential improvements and adaptations of the health benefit packages and guidelines.

-Deliverable 1.3: Support in coordinating the meetings with stakeholders.

-Deliverable 1.4: Support in finalizing the review of the essential health benefit packages, relevant guidelines and forms, and standard operating procedures where relevant, incorporating feedback from stakeholders and ensuring alignment with best practices and local context requirements.

Output 2: Provide technical support for the implementation of priority interventions at PHC facilities including for training, coaching and piloting of the PCPC approach with focus on NCDs and mental health.

-Deliverable 2.1: Draft and review training materials as needed, including for PCPC materials.

-Deliverable 2.2: Prepare needed training material such as job aids, presentations, etc.

-Deliverable 2.3: Conduct training and coaching sessions, with focus on the nursing component especially in the management of NCDs and mental health.

-Deliverable 2.4: Support coordination with MOPH and relevant stakeholders.

-Deliverable 2.5: Draft and submit needed reports including feedback and recommendations on the training and coaching highlighting successes, challenges, and areas for improvement to inform ongoing and future efforts.

Output 3: Provide technical support for the monitoring of quality of care at PHC level including automation of the medical records.

-Deliverable 3.1: Review key performance indicators used at PHC level.

-Deliverable 3.2: Provide technical advice on the dashboards and the automation of medical files at PHC.

-Deliverable 3.3: Prepare report with recommendations.

4.Qualifications, experience, skills and languages

Educational Qualifications:

-University degree in Nursing.

-Desirable: Master’s degree in Nursing, Public Health, or other relevant field.

Experience:

Required:

-5 years relevant work experience in nursing.

-Experience in working in public health settings.

-Experience in developing training curriculum and adult learning packages.

Desirable:

-Experience working in vulnerable contexts such as prison, long-term facilities, etc.

-Experience of supporting community health workers to improve the quality of their work.

-Experience in accreditation systems.

Skills/Technical skills and knowledge:

-Understanding of health system in Lebanon is required, knowledge about primary health care and packages of health services.

-Knowledge of UN systems is a plus.

-Strong communication, interpersonal and organizational skills.

-Research and analytical skills.

-Facilitation and training skills and experience in coaching.

-Computer Skills: Good knowledge of the Microsoft Office including Word.

Languages and level required:

-Arabic, English (read, write, speak)

-French is desirable

5.Location

Beirut, Lebanon; with frequent visits to the field as needed

6.Planned timelines

To be determined later.

7.Medical clearance

The selected Consultant will be expected to provide a medical certificate of fitness for work.

8.Travel

Not applicable

Additional Information

·This vacancy notice may be used to identify candidates for other similar consultancies at the same level.

• Only candidates under serious consideration will be contacted.
• A written test may be used as a form of screening.
• If your candidature is retained for interview, you will be required to provide, in advance, a scanned copy of the degree(s)/diploma(s)/certificate(s) required for this position. WHO only considers higher educational qualifications obtained from an institution accredited/recognized in the World Higher Education Database (WHED), a list updated by the International Association of Universities (IAU)/United Nations Educational, Scientific and Cultural Organization (UNESCO). The list can be accessed through the link: http://www.whed.net/. Some professional certificates may not appear in the WHED and will require individual review.
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The WHO is committed to achieving gender parity and geographical diversity in its workforce. Women, persons with disabilities, and nationals of unrepresented and underrepresented Member States (https://www.who.int/careers/diversity-equity-and-inclusion) are strongly encouraged to apply for WHO jobs.

Persons with disabilities can request reasonable accommodations to enable participation in the recruitment process. Requests for reasonable accommodation should be sent through an email toreasonableaccommodation@who.int

·An impeccable record for integrity and professional ethical standards is essential. WHO prides itself on a workforce that adheres to the highest ethical and professional standards and that is committed to put the WHO Values Charter (https://www.who.int/about/who-we-are/our-values) into practice.

• WHO has zero tolerance towards sexual exploitation and abuse (SEA), sexual harassment and other types of abusive conduct (i.e., discrimination, abuse of authority and harassment). All members of the WHO workforce have a role to play in promoting a safe and respectful workplace and should report to WHO any actual or suspected cases of SEA, sexual harassment and other types of abusive conduct. To ensure that individuals with a substantiated history of SEA, sexual harassment or other types of abusive conduct are not hired by the Organization, WHO will conduct a background verification of short-listed candidates.
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• Consultants shall perform the work as independent contractors in a personal capacity, and not as a representative of any entity or authority.
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