National Consultant: HIV/ AIDS based in Jakarta

The purpose of this consultancy is to continue UNICEF assistance in supporting country response to HIV, in particular the Prevention for Mother to Child (PMTCT) and prevention and HIV control among Young Key Population (YKP).

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Title: National Consultant: HIV AIDS
Type of Contract: SSA (Special Service Agreement)
Duty Station: Jakarta with travels to several provinces as required
Duration: 11 months (June 2017 – May 2018)

BACKGROUND

It is estimated that nearly 600,000 people living with HIV/AIDS in Indonesia. Indonesia is one of the countries in the world reporting a rising number of new HIV infections in recent years and in a profile similar to other concentrated epidemics. In recent years, the primary driver of the HIV epidemic has shifted from transmission through the injection of drug to sexual transmission. The majority of HIV infections in Indonesia are concentrated in key populations; people who inject drugs (PWIDs), men who have sex with men (MSM), female sex workers (FSWs), male sex workers and transgender (Waria). According to Integrated Biological and Behavior Survey (IBBS) 2015, HIV prevalence among PWID (28.78%); MSM (25.80%), transgender people (waria) (24.82%%), and female sex workers (FSWs) (2.2 – 7.97%), continues to be high. Jakarta reports the highest concentration of HIV cases in the country. The majority of the at-risk populations are located in urban and peri-urban areas.
Adolescents: Indonesia had by far the highest number of new HIV infections among adolescents (aged 15 to 19) in the East Asia-Pacific region.  Between 2011 and 2015, new reported HIV infections increased by 13.1% annually among adolescents (aged 15 to 19) and by 11.8% annually among young people (aged 20 to 24). The 2015 IBBS found HIV prevalence among adolescent MSM, direct female sex workers* (DFSW) and indirect female sex workers* (IFSW) was 15.6%, 6.6% and 1.5%, respectively.
Prevention of mother-to-child-transmission: An increasing proportion of HIV cases are among women. In 2015 the Ministry of Health (MOH) reported that 32% of cases in 2011 were among women. Despite efforts to expand access to HIV testing among pregnant women, progress has been poor and access to ARVs for PMTCT among pregnant women in Indonesia ranks among the lowest in the region.  Major gaps remain in access to HIV testing – where just 10% of the estimated number of HIV positive pregnant women are tested for HIV.  Drop-offs in the cascade from testing through to ARV access, adherence and early infant diagnosis are similarly stark. Persistent challenges remain regarding program leadership between the HIV program and MNCH programs of the Ministry of Health.  If present trends continue, a near doubling of new infections among children under 14 years old is expected.

In  late 2013 Indonesia adopted Option B+– lifelong ART at the time of testing positive - which greatly simplifies ART administration to HIV positive pregnant women and obviates the need for CD4 testing. The implementation requires  a policy of integrating HIV services into the regular antenatal care package – an approach endorsed strongly by UNICEF..
Scale-up has been modest thus far, largely as a result of intra-ministerial coordination challenges between sub-directorates. The cascade diagram below shows national figures for the number of women tested for HIV in 2015. What is clearly evident is that the proportion of pregnant women tested for HIV is extremely low (10%); and the proportion of HIV positive women initiated on ARVs (42%) is similarly modest.  High-level coordination challenges are compounded by conflicting operational guidelines; the need for 3 rapid tests; poor implementation of provider-initiated testing strategies; late presentation of women at ANC clinics and in some cases refusal of women who were tested HIV positive to receive treatment. In some areas, there is limited accessibility to ARV treatment due to the lack of drugs or lack of capacity to administer treatment.

UNCEF support to HIV
UNICEF is supporting the country to end adolescent AIDS through a pilot known as LOLIPOP (Linkages of Quality Services for Young Key Populations) an adaptation of global All In initiative. The pilot, started in 2015 in Bandung city, has currently been expanded to three other cities i.e Surabaya, West Jakarta, and Denpasar. UNICEF continue to advocate for wider scale up through leveraging resources and working towards a more sensitive services to adolescent and YKP need.
Since late 2013, UNICEF with support from the Hong Kong NatCom, introduced four demonstration sites to pilot a more coordinated and comprehensive approach to EMTCT. The sites include West Jakarta, Kota Surabaya and Kota Sorong. Kota Bandung was then included with WHO’s support as was the additional District of Jayapura in Papua in 2015. These four districts are part of the 75 high burden priority districts identified by the Government of Indonesia in its national response to HIV/AIDS. They were selected to represent different typologies of the HIV epidemic in Indonesia and the diversity of approaches required to respond to the epidemic, with West Jakarta, representing a concentrated epidemic, and Sorong municipality and Jayapura representing a generalised epidemic. The program showed a significant improvement in increasing coverage and HIV testing in pregnant women that is 2-3 fold greater than national averages.

The purpose of this consultancy is to continue UNICEF assistance in supporting country response to HIV, in particular the Prevention for Mother to Child (PMTCT) and prevention and HIV control among Young Key Population (YKP).

This SSA are to focus on below tasks :
1) Serves as focal point for the YKP technical and program management for the development and implementation of result-based work plan and output(s) as well as for administration and monitoring of key activities.
2) Supports the Health Specialist/Output Manager to ensure Outputs and targets are timely achieved, through full coordination between activities and collaboration with implementing partners,
3) Providing high level technical assistance in the formulation, design, implementation, monitoring and evaluation of programs contributing to scaling up of HIV services, in particular for the young and adolescents group; local capacity development, in collaboration with the other health, nutrition, WASH and MNCH programs, as appropriate.
4) Undertakes field visits to monitor programmes, as well as participates in periodic programme reviews with government counterparts and other partners. Identifies necessary action for programme adjustments. Provides technical advice and support to government officials and implementing partners in the planning and management of the HIV interventions and ensures their sustainability.

WORK ASSIGNMENT & DELIVERABLES

1. Review the LOLIPOP initiative in four districts: Bandung, Surabaya, West Jakarta, and Denpasar.   Output: Report on initial visit to four LOLIPOP districts including latest situation of services, community action, and HIV situation among adolescent and YKP 
2. Support national and local initiative in building a more sensitive services to YKP and adolescent need through working inside existing system :
a. Assist districts and provinces in designing and implementing network of YKP/adolescent sensititve HIV services (including designated Health Centre/Hospitals)
b. Assist communities in designing and implementing YKP/adolescent outreach and communication strategy
c. Assist resource mobilization for YKP/adolescent HIV program
d. Assist development of policy and guideline in national level for YKP/adolescent sensitive services
e. Data review on YKP/adolescent HIV indicators (pilot  districts and national level)
Output: monthly report on the task assigned above.
3. Review HIV YKP/adolescent program in Indonesia. Output: Final report on HIV YKP/adolescent program in Indonesia

Qualifications of Successful Candidate

•  Medical practitioner or degree in health or health related subjects.
• Master’s degree in Public Health, International Health, Health Promotion and Disease Prevention, Youth/Adolescents Health and Social Science. Or Bachelor degree with 6 years of related experience.
• Advanced familiarity with government, health systems and the working of the Global Fund.
• At least 3 years of progressive experience in the field of public health. Experience in HIV/AIDS, Adolescents and PMTCT are essential.
• Experience in an international organization an asset, ability to work in an international and multi-cultural environment.
• Pro-active and resourceful, good communication skills in negotiating and liaising with counterparts and partners.
• Good knowledge of English and Bahasa Indonesia for drafting reports and communication with government counterparts and international staff;
• Good skills in computer applications; especially Word, Excel and Power Point

Please indicate your ability, availability and monthly rate (in IDR) to undertake the terms of reference above (including travel and daily subsistence allowance, if applicable).  Applications submitted without a 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. This consultancy is open for Indonesian national only.