of the Sukhumi Medical College in Abkhazia, Georgia.

Background

Public health, including maternal and child healthcare, in Georgia’s Abkhazia, Georgia region remains poor, which was confirmed through a number of the Mother and Child Health (MCH) assessments conducted for UNICEF by a team of an obstetrician, a neonatologist and a midwife in 2012, 2014 and 2017. Though there is a clear progress in the quality of services provided, to a great extent due to UNICEF’s health interventions in the recent years, there are still gaps and bottle-necks in adopting modern evidence-based medical practices. This is mainly due to the poor level of knowledge and skills of the health professionals, including nurses and midwives.

There are no medical universities in Abkhazia, Georgia, and all doctors in local medical institutions have degrees from outside of Abkhazia, Georgia, mainly from Georgia or Russia. At the same time, nurses and midwifes in Abkhazia, Georgia mainly graduate from Sukhumi Medical College, and some from the much smaller Gagra Medical College. Although the Sukhumi Medical College is part of health system in Abkhazia, Georgia, financial support to this educational facility is very limited and its budget mainly comes from the fees of the students. Teaching methods in these institutions are outdated, teachers don’t have means to improve their qualification and skills and access to modern medical methodologies for the students is almost non-existent. On average there are 400-500 students studying annually in the Sukhumi Medical College, out of which 200-300 nurses and 20-30 midwives. Around 100 nurses and 10 midwifes are graduating every year.

At the same time, Abkhazia, Georgia has no established programme of continuous medical education or on-the-job trainings for health professionals and only few medical professionals attend refresher trainings on an ad hoc basis on their own initiative outside the region. Due to limited resources, nurses and midwifes hardly have any chance to attend courses and trainings outside of Abkhazia, Georgia.

Against this background, UNICEF over the last years carried out capacity building activities for health professionals of the MCH sector in Abkhazia, Georgia in the form of training courses, seminars and study tours. These activities were to a large extent covering rural and MCH nurses, as well as midwifes. In these capacity building activities and in its advocacy work with the de facto Ministry of Health in Sukhumi, UNICEF is promoting the introduction of modern, evidence-based medical practices to replace the often outdated medical practices dating back to Soviet times and equip medical college students, as well as practicing nurses and midwives with modern knowledge and skills in line with WHO and UNICEF standards. Main focus will be on improving education level in the Sukhumi Medical College and establish on its basis a continuous medical education programme for nurses and midwives in Abkhazia, Georgia.

Objective

In order to assist in systematic and sustainable capacity building for nurses and midwives in Abkhazia, Georgia, UNICEF intends to carry out an assessment of the current education process and curriculum in the Sukhumi Medical College in the primary healthcare (including IMCI, immunization, home visiting, nutrition, etc.) and effective perinatal care, mainly focusing on midwives. The aim of the assessment is to better understand how the current curriculum and education process in the Medical College reflect evidence-based knowledge and medical practices, as well as modern teaching methodologies, discuss and suggest introduction of modern teaching methodologies, and develop recommendations and guidance on how UNICEF could assist in improving the curriculum and education process in the Medical College to reflect evidence-based knowledge and practices, as well as modern teaching methodologies in the fields of antenatal and postnatal care, IMCI, home visiting, primary healthcare and nutrition. The assessment is supposed to provide an analysis of the situation and recommendations for assistance of UNICEF in the improvement of the education process and curriculum, as well as in the development of continuous education programmes for nurses and midwives. The recommendations should suggest a concrete action plan aiming at developing and introducing modern training packages for antenatal and prenatal care, IMCI, immunization, home visiting, primary healthcare and nutrition into the education process and curriculum of the Sukhumi Medical College. UNICEF is expecting that new teaching methodologies will be introduced during the follow up visit(s) in 2017, so that IMCI curriculum for nurses and WHO perinatal care guideline are partially integrated in the education process from September 2017 and fully integrated from September 2018.

The assistance to the Medical College will be an integral part of other UNICEF initiatives in Abkhazia, Georgia, such as the strengthening of immunization practices, health promotion and communication, primary healthcare and perinatal care.

Scope of work

Under the direct supervision of the Sukhumi-based UNICEF Health & Nutrition Officer and in close collaboration with other relevant UNICEF staff in Sukhumi and Tbilisi, the team of two consultants, one for primary healthcare, including IMCI, immunization, home visiting, nutrition, and one for effective perinatal care will:

• Conduct an assessment of the curriculum, the education infrastructure, equipment and materials, as well as the teaching practices of Sukhumi Medical College in primary healthcare, including IMCI, immunization, home visiting, nutrition and effective perinatal care;
• Conduct consultations with the management and teachers of the Sukhumi Medical College and ensure initial steps for the introduction of modern PHC and EPC approaches into the curriculum;
• Provide recommendations for UNICEF assistance in improving the curriculum, the education infrastructure, equipment and materials, ensuring availability of proper handouts and text-book, as well as the teaching practices of the Sukhumi Medical College in 2017–2021 with the main focus on primary healthcare (including IMCI, immunization, home visiting, nutrition, etc.) and effective perinatal care;
• Suggest the role and tasks of the Sukhumi Medical College in continuous medical education system  in Abkhazia, Georgia in 2017–2021 with the main focus on primary healthcare (including IMCI, immunization, home visiting, nutrition, etc.) and effective perinatal care;
• Provide an action plan for the implementation of these recommendations in the timeframe of 2017–2021.

Deliverables and Timelines

Key Actions

1. Preparation of the assessment methodology and agenda

Deliverables: assessment methodology and agenda developed

Delivery Date, number of working days: two working days per consultant (before departure to Abkhazia, Georgia)

1. Assessment of curriculum, education infrastructure, equipment, materials, and teaching practices of the Sukhumi Medical College:

• primary healthcare (including IMCI, immunization, home visiting, nutrition, etc.)

• effective perinatal care

  Deliverables: assessment conducted

Delivery Date, number of working days: by 31 July, 2017 (two working days per consultant)

1. Conduct consultations with the teachers of the Sukhumi Medical College and ensure initial steps for the introduction of the modern approaches into the curriculum in:

• primary healthcare (including IMCI, immunization, home visiting, nutrition, etc.)
• effective perinatal care

Deliverables: consultations conducted and initial steps taken

Delivery Date, number of working days: by 31 July, 2017 (three working days per consultant)

1. Preparation of the Assessment report, including:

• Findings;
• Recommendations for UNICEF assistance  in improving the curriculum, the education infrastructure, equipment and materials, as well as the teaching practices of the Sukhumi Medical College and in the development of post-graduate and refresher education initiatives;
• Action Plan for the implementation of the recommendations between 2017-2021

Deliverables: good quality assessment report with findings, recommendations and action plan

Delivery Date, number of working days: two weeks after the return from the on-site visit (three working days per consultant)

Supervision and Reporting Responsibility

Direct supervision of the consultants will be provided by the Sukhumi-based UNICEF Health and Nutrition Specialist under the overall supervision of the UNICEF Chief of Field Office in Sukhumi. In case of need, support will also be provided to the consultants by the Tbilisi-based UNICEF Health Specialist.

The consultants will have to submit the final assessment report within 2 weeks after completion of the assessment visit in Abkhazia, Georgia, including recommendations and the proposed action plan.

Eligibility Criteria

• Relevant university degree;
• Minimum 10 years of work experience in teaching and/or practicing PHC and/or EPC, including in medical educational institutions,
• UN experience in CIS countries would be an asset;
• Proven experience in conducting health education system assessments and curriculum reviews, preferably in CIS countries, especially the South Caucasus or Central Asia;
• Fluency in English is required.

• Ability to communicate freely in Russian language.

   

Consultancy period

The duration of the consultancy will be ten working days for each of the two consultants, out of which five working days in Abkhazia, Georgia for the actual assessment and consultations with the local medical professionals and health authorities, two working days from home before the visit to Abkhazia, Georgia for preparations and the development of the assessment methodology and agenda, as well as three working day after the visit for writing the mission report and recommendations.

In case of satisfactory performance, the consultants might be asked to carry out one or several follow-up consultancies resulting from the recommendations and action plan provided as a result of this assessment, e.g. for capacity building for local medical professionals and further curriculum/training methodologies revision in the Sukhumi Medical College. These would take place during 2017-21.

Remuneration

Applicants are required to submit a financial proposal for the requested services including the consultancy fee and travel costs. The remuneration will be negotiated between the applicant and UNICEF Georgia on the basis of the applicant’s proposal and will be paid to the chosen consultants upon submission of a satisfactory quality assessment report including recommendations and an action plan for UNICEF.