International Consultancy on Immunization and Health System Strengthening Support to the UNICEF Ukraine CO (Kyiv)

International Consultancy on Immunization and Health System Strengthening Support to the UNICEF Ukraine CO (Kyiv)

Background

The performance of Ukrainian National Immunization Programme (NIP) has declined over the two recent decades. From early 2000s, the immunization coverage dropped significantly to 80% in 2008 and further to 50% in 2013. A combination of public mistrust in vaccinations, poor vaccine supply, and overall issues with the health system have left Ukraine with the lowest rates of immunization in the world. These weaknesses were manifested in the polio outbreak in 2015, when two cases of circulating vaccine-derived poliovirus type 1 were confirmed in young children in the Western Ukraine. Already prior to polio, Ukraine had experienced several outbreak of vaccine-preventable diseases including measles in 2012: measles cases were up from less than 100 in 2010 to more than 12,700 in 2012. Furthermore, since 2009, pertussis incidence has increased significantly and few cases of diphtheria have been reported in recent years.

In 2015, several multi-partner missions were conducted to assess different functions of NIP and provide recommendations on immunization system strengthening and accelerated diseases control. Major weaknesses identified at the national level include fragmented and uncoordinated programme management, an absence of comprehensive strategic planning and advisory mechanisms. Effective programme management was further complicated by weak management capacity at the sub-national level and ineffective use of data in programme planning and monitoring. Jointly with the partners in the health sector, UNICEF has supported the Ministry of Health (MoH) in restoring the immunization system in the country and through its Supply Division, is temporarily procuring vaccines for routine immunization on behalf of the MoH.

Preventing a repetition of the events of 2015 depends largely on sustained political commitment to the fight against polio and infectious disease in general, and more broadly to much-needed health systems strengthening in Ukraine. As part of the current health care reform process, the MoH is strengthening the application of the public health approach and has established a new Public Health Center to support these efforts. To address challenges related to stock outs and lack of vaccines and essential medicines, a national agency for procurement is under development. Within its first phase, the reform will target the primary health care level, which provides an opportunity for strengthening the integration of maternal and child health interventions and enhancing the quality of services through improved focus on health management and data.

UNICEF envisions a strong health system that includes preventive and promotive services and curative care, supports family practices, and produces equitable health outcomes for mothers and children. Building on the existing initiatives and lessons learnt from 2015-6 polio outbreak response, UNICEF seeks to use immunization as an entry point for wider health system strengthening that contributes to improved maternal and child health. While addressing the weak data and information systems, and procurement and supply chain management, the ongoing health care reforms provide an opportunity to build linkages across programme areas in maternal and child health including immunization, PMTCT and nutrition.

Purpose of the Assignment

The polio outbreak in 2015 in Ukraine revealed serious weakness of the health system that require large interventions on strengthening immunization system including procurement services. The main focus of the UNICEF Health programme activities has been on supporting the MoH in increasing the coverage of the routine immunization by high-level advocacy efforts; capacitating medical experts on national, oblast and district levels; procuring vaccines for routine immunization; and increasing demand through communication. Building on these activities, UNICEF Ukraine seeks an individual consultant to provide technical support for the Country Office in development of a strategy with an action plan for immunization in the context of national health care reforms that will inform the programme activities within the new Country Programme for 2017-2022. Furthermore, to ensure integrated approach to maternal and child health, technical support is required to build linkages with the immunization programme and wider maternal and child health services on the primary health care level. As the ongoing crisis in the eastern Ukraine most likely continues to have adverse impact on maternal and child health, the consultancy is to provide Country Office with recommendations for health system strengthening including immunization across the development-humanitarian continuum. The assignment includes senior level technical advice, advocacy and engagement with the MoH and other relevant stakeholders on national and local levels and liaising with the UN and key partners including WHO and UNDP.

Key Tasks:

1. Advises UNICEF CO on engagement in the national health care reforms including support to development of public health and procurement functions/institutions. Provides recommendations for the programmatic scope, actions, partnerships and resource mobilization. Provides technical inputs to formulation of strategic approaches, programme plans and other relevant documents/discussions.

1. Provides technical support to the MoH on restoring routine immunisation programme to ensure that all children in Ukraine are reached out starting from the priority risk groups. Supports the national working groups established by the Ministry of Health and mandated to develop the strategy and oversee its implementation.

1. Coordinates with WHO CO/RO and UNICEF, provides technical advice and supportive actions to the Government for development of health care reforms including restoring a functioning immunization programme, procurement and public health services.

1. Facilitates and leads the expert discussions on the national health care reforms and health system strengthening including procurement, financing, data and monitoring systems, development of standards and SOPs, and capacity strengthening (e.g. initiated within programmes on immunization, maternal health).

1. Provides technical support and advice on humanitarian response in conflict-affected areas of Ukraine with a focus on immunization/MCH.

Deliverables:

1. An action plan to inform UNICEF immunization and procurement activities in the context of wider national health care reforms and vis-à-vis key partners (5 working days).
2. A concept paper/brief review and a plan of action for UNICEF to define entry points, the role and programme activities in supporting the MoH in health care reforms/development of Public Health Center and procurement services (13 working days).
3. Three donor proposals based on the deliverables # 1-2 (6 working days).
4. Six country visits to provide technical support for the MoH and UNICEF (total 35 working days):
5. develop and deliver presentations /inputs/talking points in the high-level meetings (e.g. national WGs/committees, seminars and conferences in the areas of health care reforms, immunization, procurement, reporting in MCH);
6. provide recommendations on documents and technical papers developed by the MoH, WHO etc.;
7. support the development of training on immunization/MCH.
8. Field assessment reports and recommendations for actions based on the country visits including in humanitarian response/programming in conflict-affected areas (6 working days).

Details of how work should be delivered

In the first week of the assignment, a work plan will be developed and agreed. The consultant will conduct six country visits based on the actual needs, other deliverables will be provided online. Payment schedule to be agreed based on the deliverables.

Performance indicators for how work should be delivered

Evaluation of performance will be based on the following indicators:

• technical and professional competence;
• quality of work, including quality of developed feedback, recommendations, advise and on-going consultations;
• timeliness of submission of deliverables.

Such indicators as work relations, responsibility and communication will be also considered during evaluation of the consultants work.

Qualifications/specialised knowledge/experience required to complete the task

The expert selected for this consultancy should meet the following requirements:

• Excellent knowledge of the Ukrainian political situation, especially when it comes to the reforms of primary health care and public procurement of vaccines and medicines in Ukraine
• Excellent knowledge and previous experience of the health system in Ukraine
• Minimum of 10 years of related experience of which minimum 5 years with UNICEF
• Excellent English speaking and writing skills
• Ukrainian/Russian language is an asset
• At least Master's Degree in Health or other related area

Definition of supervision arrangements

The Consultant will work with the Health and Nutrition team in Ukraine CO under supervision of the Health and Nutrition Specialist.

Description of official travel involved

The consultant will undertake regular travels to Ukraine, mainly to Kiev/UNICEF CO with possible missions to the conflict-affected areas. The travel can commence upon the consultant's provision of certificate of completion of UN Basic (II) and Advance Security in the Field Course as well as Mine and Explosive Remnants of War Awareness if travelling to ATO zone. The consultant is to be responsible for insurance costs on their own, except MAIP insurance, which is added into the contract.

All travel costs of the consultant should be planned and included in the consultant's contract. The consultant is responsible for managing all travel plans, though UNICEF can provide some minimal administrative support for travel plans and coordination with the national consultants who will participate in this work. The consultant have his/her own computer and phone.

UNICEF recourse in the case of unsatisfactory performance

In the event of unsatisfactory performance, UNICEF reserves the right to terminate the Agreement. In case of partially satisfactory performance, such as serious delays causing the negative impact on meeting the programme objectives, low quality or insufficient depth and/or scope of the assignment completion, UNICEF is entitled to decrease the payment by the range from 30% to 50% of the contract value as decided jointly by the Contract Supervisor and Operations Manager.

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Please indicate your ability, availability and daily/monthly rate (in US$) to undertake the terms of reference above (including travel and daily subsistence allowance, if applicable).  Applications submitted without a daily/monthly rate will not be considered.

UNICEF is committed to diversity and inclusion within its workforce, and encourages qualified female and male candidates from all national, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of our organisation.