UNICEF Pacific Consultancy: Baby friendly hospital initiative (BFHI, Funafuti, Tuvalu, 32 days spready over 3 Months

UNICEF Pacific is in search of a dedicated and proactive Consultant. The consultancy is for a period of 32 days spread over 3 months. The consultant will provide technical assistance, capacity building support, and coordination for MHMS in Tuvalu to ensure successful BFHI introduction and implementation. The consultant will assess BFHI implementation in Tuvalu, focusing on delayed steps, bottlenecks, and capacity gaps, while adapting the Ten Steps to the local context. The consultant will work with MoH to address bottlenecks and develop a tailored capacity-building plan for Tuvalu. This may include on-site sessions, training, and establishing a trainer team for ongoing professional development. Coaching and mentorship will be integrated to ensure lasting impact, and health workers will be trained in internal assessments.

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For every child, the right to health. 

Promotion of Breastfeeding is a high impact intervention that plays a crucial role in ensuring children receive adequate nourishment. Breastfed children have a significantly reduced risk for both wasting and later childhood overweight or obesity.

In Tuvalu, approximately 5% of children under the age of five experience stunted growth, a figure that is relatively low compared to other countries in the region. The rate of childhood wasting is 3%, placing Tuvalu among the lowest in the Pacific Island Countries and Territories (PICTs). Additionally, issues such as underweight children and low birth weight are not major concerns in the country (UNICEF, 2024).

On the other hand, rising rates of obesity and related non-communicable diseases are becoming a significant public health issue. About 4% of children under five are overweight, and nearly half of school-aged children (13–15 years) are classified as overweight, with 21% falling into the obese category. Exclusive breastfeeding for infants under six months has increased to 44% from 35% in 2017. Despite this improvement, Tuvalu still has one of the lowest rates of exclusive breastfeeding in the PICTs region. In 1991, UNICEF and WHO jointly launched the Baby Friendly Hospital Initiative (BHFI), which consolidated evidence on promoting breastfeeding within health facilities. The BFHI included “Ten Steps to Successful Breastfeeding”, which were subsequently updated and superseded by guidelines published in 2018. These guidelines, titled, "Protecting, promoting and supporting breastfeeding” are anticipated to be used in facilities providing maternity and newborn services to attain "Baby Friendly" status.

Currently there are several gaps in BHFI implementation in Tuvalu. Most notably, lack of an institutionalized mechanism to routinely train all health care staff, including obstetricians, pediatricians, and nurses providing antenatal care (ANC) services; lack of hospital management’s engagement for enforcement of the steps as part of quality-of-care improvement; and lack of community actions to support mothers upon discharge from hospitals. Currently the Ministry of Health is working on developing a breastfeeding policy. UNICEF and WHO launched the Baby-Friendly Hospital Initiative (BFHI) to address such gaps globally. Tuvalu has not yet integrated BHFI Ten Steps into maternity care at the nation’s single hospital, Princess Margaret Hospital or any other health facilities. There is no standardized hospital policy guiding BFHI introduction. To address this, UNICEF proposes engaging a consultant to support the Ministry of Health (MoH) in:

• Analyze the current breastfeeding practices, policies, and facility readiness in implementing BFHI Review existing ‘Tuvalu Breastfeeding and Infant Feeding Policy for Health Workers’ and update if necessary
• Aligning BFHI efforts with MoH’s preferred monitoring and scale up approach.
  • Integrating of the BFHI Ten steps into MoH existing standards for quality of care as well as setting up a system for internal assessments of hospitals.
  • Capacity building of health workers on the Ten steps including establishing a team of ToT for continuation of training and internal assessments.
• Supporting policy revision and development of a prototype hospital policy to guide BFHI adoption.
• Coordinating with WHO for technical support and UNICEF for implementation.

This initiative aligns with Tuvalu’s broader health goals and the UNICEF Pacific Multi-Country Programme Document (2023–2027), which emphasizes equitable access to quality nutrition and health services, especially during emergencies.

How can you make a difference? 

The overall objective is to provide technical assistance, capacity building support, and coordination for MHMS in Tuvalu to ensure successful BFHI introduction and implementation. More specifically, the assignment includes:

1. Review and identify bottlenecks in BFHI implementation:

The consultant will review the current implementation status of BFHI in Tuvalu. The focus will be on identifying the steps that are lagging behind and their bottlenecks, including capacity gaps. As part of the review the adaptation of the Ten-Steps to the country context will be undertaken.

1. Propose actions to address bottlenecks:

The consultant will propose approaches to addressing the identified bottlenecks in consultation with MoH. For identified capacity gaps, the consultant will develop a capacity building plan with approach tailored to Tuvalu’s context. This may involve through on job site sessions, on job site trainings, and development of a team of trainers for continuous professional development to address longer term needs. Coaching and mentorship mechanisms should be embedded in the capacity building approach to ensure that knowledge and skills obtained through training will translate into the lasting practices. Capacity-building efforts should also ensure that the relevant health workers are additionally trained in internal assessments.

1. Provide support for integration and institutionalization:

The consultant will collaborate with MoH to integrate the BHFI’s 10 steps into quality of care assessments / continuous quality improvement mechanism within health facilities or other existing initiatives/frameworks. The consultant will also ensure that there is a mechanism set up to facilitate self- and internal assessments of hospitals. The consultant will also support efforts to include BHFI in pre-service training of health workers or other similar capacity building platforms.

Please refer to the  TOR Tuvalu Final for Signatures.pdf for further information on the deliverables and the timelines. 

GUIDANCE FOR APPLICANTS:  

Please submit a separate financial offer along with your application. The financial proposal should be a lump sum amount for all the deliverables and should show a breakdown for the following:

Please submit the following application documents:

• A cover letter explaining suitability for position
• Curriculum Vitae (CV)
• Technical proposal
• Financial offer in a separate attachment, stating a lump sum amount for all the deliverables with a break down for the following: Daily fees– based on the deliverables in the Terms of Reference
  • Travel (economy air ticket where applicable to take up assignment if in country support is required, as well as any in country travel)
  • Living allowance for international consultant that will need to relocate to PICTs, for the duration of in-country assignment
  • Miscellaneous- to cover visa, health insurance (including medical evacuation for international consultants), communications and other cost.

To qualify as an advocate for every child you will have… 

Minimum requirements:

Education:

• A medical or advanced university degree in one of the following fields: nutrition, midwifery, public health, pediatric health, family health, or other related disciplines.

Experience & Skills:

• A minimum of 5 years of professional experience in breastfeeding related work including in clinical contexts.
• Experience in conducting BFHI training and mentorship. Preferably a certified trainer and BFHI Assessor with certification issued by IBFAN or a recognized lactation management certification.
• Work experience serving in a developing country is required. Work experience in the Pacific Islands region is an asset.
• Experience working in UNICEF or a UN system agency is an asset.
• Able to work effectively with people - internal and external stakeholders
• Excellent pedagogical skills for training
• Communicates clearly and concisely
• Excellent analytical and conceptual skills
• Proven ability to work independently under difficult conditions
• Health care systems, the BFHI approach.

Language:

• Fluency in English is required, and knowledge of a local language would be an asset.

For every Child, you demonstrate...

UNICEF’s Core Values of Care, Respect, Integrity, Trust and Accountability and Sustainability (CRITAS) underpin everything we do and how we do it. Get acquainted with Our Values Charter: UNICEF Values

The UNICEF competencies required for this post are…

(1) Builds and maintains partnerships

(2) Demonstrates self-awareness and ethical awareness

(3) Drive to achieve results for impact

(4) Innovates and embraces change

(5) Manages ambiguity and complexity

(6) Thinks and acts strategically

(7) Works collaboratively with others  

Familiarize yourself with our competency framework and its different levels.

UNICEF promotes and advocates for the protection of the rights of every child, everywhere, in everything it does and is mandated to support the realization of the rights of every child, including those most disadvantaged, and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, minority, or any other status.

UNICEF encourages applications from all qualified candidates, regardless of gender, nationality, religious or ethnic backgrounds, and from people with disabilities, including neurodivergence. We offer a wide range of benefits to our staff, including paid parental leave, breastfeeding breaks and reasonable accommodation for persons with disabilities. UNICEF provides reasonable accommodation throughout the recruitment process. If you require any accommodation, please submit your request through the accessibility email button on the UNICEF Careers webpage Accessibility | UNICEF. Should you be shortlisted, please get in touch with the recruiter directly to share further details, enabling us to make the necessary arrangements in advance.

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Remarks:  

As per Article 101, paragraph 3, of the Charter of the United Nations, the paramount consideration in the employment of the staff is the necessity of securing the highest standards of efficiency, competence, and integrity.

UNICEF is committed to fostering an inclusive, representative, and welcoming workforce. For this position, eligible and suitable candidates are encouraged to apply.

Government employees who are considered for employment with UNICEF are normally required to resign from their government positions before taking up an assignment with UNICEF. UNICEF reserves the right to withdraw an offer of appointment, without compensation, if a visa or medical clearance is not obtained, or necessary inoculation requirements are not met, within a reasonable period for any reason. 

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