UNICEF Technical Support for Strengthening of Services for the Prevention of Mother-to-Child Transmission of HIV Infection Terms of Reference

UNICEF Somalia 
 

Vacancy Announcement Ref: UNICEF-SOM/2014/052
 

Terms of Reference (TORs) for Technical Support for Strengthening of Services for the Prevention of Mother-to-Child Transmission of HIV Infection

Vacancy: PMTCT and EID Consultant
 

Category and Grade Level: P4/NOD  Equivalent 
 

Type of Contract: Special Service Agreement
 

Length of Contract: 60 days 
 

Organization Unit: HIV/AIDS Global Fund Unit–Health
 

Duty Stations: Nairobi with regular travel to Somalia
 

Date of Issue: 21 October 2014
 

Closing date of Application: 30 October 2014
 

Background: The dominant mode of HIV transmission to children is mother-to-child. Without preventive interventions, between 25-50% of the women living with HIV will pass the infection to their children; 5-10% during pregnancy, 10-20% during delivery and 10-20% during breastfeeding.  Ensuring that no baby is born with HIV is an essential step towards achieving an AIDS-free generation.

An intervention known as “prevention of mother-to-child transmission of HIV,” or PMTCT, provides drugs, counselling and psychological support to help mothers safeguard their infants against the virus. Ensuring PMTCT is provided to all women that need it is the most effective way of eliminating new HIV infections among children and keeping their mothers alive by 2015. 

Early diagnosis of HIV in infants provides a critical opportunity to strengthen follow-up of HIV-exposed children, assure early access to ARV treatment for infected children, provide reassuring information to families of uninfected children, aid evaluation of PMTCT programs, and increase capacity to use laboratory technology.
 

HIV prevalence among the 15-49 years in Somalia in 2012 was estimated to be low at 0.54%. Structured full package PMTCT programs commenced in late 2010 and early 2011 throughout the three zones. As of early 2013, 34 health facilities, mainly maternal/children health centres (8 in South Central, 6 in Puntland, and 20 in Somaliland), were providing a full package of PMTCT services.  

At the end of 2013, 1,728 mothers/babies were in need of PMTCT services, however only 57 (3.2%) received ARVs. 

As PMTCT coverage is low and not fully integrated in MNCH, the mother to child transmission rate is estimated at 34% in 2014. Overall HIV testing remains low and ANC attendance by pregnant mothers’ is estimated at 25% only. 

Moreover, despite there is no availability of rapid syphilis tests in MCH and HTC sites where a majority of the STI screening occurs, syphilis prevalence among ANC in Somalia is about 1%.
 

The newly endorsed Somali National Strategic Plan (NSP-2015-2019) for HIV/AIDS, aims to reduce HIV infections and HIV related mortality and morbidity among Somalis. The NSP, is focused on achieving two key results at the impact level to reduce new infections by 30% by 2019 and reduce mortality among men, women and children living with HIV by 30% by 2019. 

PMTCT is a priority objective articulated in the “Strategic Framework for the Somali AIDS Response (2015‐2019): Intensifying Integrated Prevention, Treatment, Care and Support for HIV towards Universal Access in Somali Populations” and one of the six core programme of the “Essential Package of Health Services (EPHS)”. 

Furthermore, based on its core mandate on children and being Principal Recipient (PR) for GFATM Somalia HIV grant, UNICEF, in collaboration with local authorities and implementing partners, and as part of the national strategy to fight HIV and AIDS in Somalia and in the Horn of Africa’s region, is supporting the development of PMTCT and EID interventions in Somalia. 
 

The country has a PMTCT guideline and scale up plan. This technical assistance is requested to develop Early Infant Diagnosis guidelines and costed scale up in line with the EPHS roll out. 
 

Objectives of the consultancy:

1. To develop Early Infant Diagnosis (EID) guideline
2. To formulate time bound and costed scale up plan and result framework for EID
3. To review and incorporate EID aspects in the existing PMTCT training materials
4. To facilitate workshops for MoH and partners in the 3 zones to achieve buy in and consensus for the PMTCT and EID

Methodology and Technical Approach
 

The consultant will work under the overall supervision of the Chief-Global Fund Section and direct supervision of the HIV programme manager, and in close collaboration with UNICEF health and nutrition sections and UNICEF zonal offices. 

In addition, the consultant will coordinate with national counterpart and other key stakeholders in HIV and AIDS response; in maternal and child health and laboratory services. 

The consultant will review all relevant existing documents including the Essential package of health services – EPHS for Somalia, the HIV concept note, the PMTCT technical report and scale up plan to develop the EID strategy and guidelines according to the context of the three zones and to the new WHO 2013 ART guidelines promoting equity and gender equality for scaling up and integrating of PMTCT/EID services in maternal and child services in Somalia. 

Moreover, the technical assistance will involve travel within Somalia for frequent consultations with relevant government institutions, representative from stakeholders, NGO partners, UN, MOH, AIDS commissions and health workers in working groups in each of the three zones in Somalia and in Nairobi. 

In addition, the consultant will visit selected health facilities where PMTCT services is provided.

It will also be required that the consultant undertake consultations with some community structures and groups and local NGOs in order to obtain some insight on how to incorporate community engagement programmes into PMTCT. 

Feedback sessions will be set-up with various stakeholders, with debriefs in each of the zones but also to HSC, UNICEF, and other interested parties in Nairobi.
 

Specific Activities and Tasks
 

The activities are prioritized as follows:

• Submit a Technical proposal and work plan which should include highlights of relevant experience as well as a proposed methodology for the review work.
• Review all available documents relevant to EID/PMTCT: NSP, policy, guideline, data collection, strategy development and training curricula for the three zones of Somalia.
• In consultation with field working groups that includes key stakeholders, finalize the EID guideline and costed scale up plan and results framework in line with PMTCT guidelines and other child health services.

Expected outputs/deliverables

• Consultancy technical proposal and work plan;
• Finalized EID guidelines that also include components of effective linkage into follow up care and treatment;
• Costed EID scale up plan and result framework integrated in the  “PMTCT Core Intervention” of the EPHS services;
• Updated PMTCT/EID training material
• Validation reports with all stakeholders
• Final report of the consultancy highlighting the lessons learned recommendations and next steps for the continuation of implementation and scaling up of PMTCT in Somalia.

Timeframe: The assignment is for 60 days. The consultant will be expected to commit himself/herself to undertake the assignment on agreed dates. 

This is a task-based assignment and the consultant shall be expected to confirm availability within the agreed time frame. 
 

Conditions of work: The consultant will be based in UNICEF Somalia Support Centre in Nairobi but travel to Somalia is required according to agreed work plan to be developed at the beginning of the consultancy. Coordination and assistance for the consultancy will be provided by UNICEF. 

In Somaliland and in Puntland the consultant will stay in UN guesthouse or hotels and transport will be provided. In South-Central Somalia, arrangements will be done according to security. 

A working space will be available in Nairobi. Stationery and printing services will be provided. 

He/she is expected to have his/her own computer.
 

Payment: Consultancy’s fees will be negotiated and will be paid on satisfactory completion of all deliverables. 

UNICEF Somalia will be responsible to cover travel to/from and within Somalia.

Profile of the consultant and minimum qualification

• At least a Master’s Degree in Health Research, Public Health or related discipline.
• Over eight years working experience in the field of public health in developing countries, preferably with HIV/PMTCT programmes in conflict and post-conflict countries.
• Considerable experience in development of PMTCT, EID and/or MCH guidelines from other countries.
• Experience with integration of PMTCT/EID into MNCH in low prevalence epidemic
• Very good command of English language as well as excellent facilitation skills.
• The consultant should be knowledgeable about Global Fund policy and new funding model principles.
• Knowledge and understanding of the UN system and capacity to promote consensus and establish positive working relationship. Integrity, tact, discretion and demonstrated sensitivity to cultural differences
• Familiarity with health system strengthening and health economics is desirable.
• First-hand knowledge of the socio-cultural, economic and political situation in Somalia will be an added advantage.
• Experienced in liaising with public officials and capable of responding rapidly to ad hoc requests for meetings under tight deadlines.
• Willingness to work in difficult circumstances and travel to Somalia

Interested and qualified candidates should send their applications with updated UN Personal History Form P11, updated CV attaching copies of academic certificates to the email below. 

UN staff are requested to provide the last two Performance Evaluation Reports (PERs). 

Applications submitted without a duly completed and signed Personal History Form (P11) - CLICK HERE to download - will not be considered.  

Please indicate your expected fee for the assignment. 

Applicants must quote the vacancy number and post title in the subject line of the application. 

Email to: somaliahrvacancies@unicef.org 

Only short-listed applicants will be contacted

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.