International Expert to facilitate the assessment of PMTCT services in MCH facilities and documentation of the Early Infant Diagnosis within HIV prevention interventions (2013-2016) in the Kyrgyz Republic

VNC/KIRA/32/17. International vacancy. Consultancy to facilitate the assessment of PMTCT services in MCH facilities and documentation of the Early Infant Diagnosis within HIV prevention interventions (2013-2016) in the Kyrgyz Republic

Objective/purpose of the consultancy/services

• To contribute to the improvement of the organization’s accountability for its performance by defining and documenting key achievements as well as missed opportunities in its engagement with partners in support of improved PMTCT and Pediatric HIV care and treatment between 2012 and 2016;
• To generate evidence and learning to enhance the understanding of the UNICEF and other stakeholders on how the strategies and programmes related to PMTCT and Pediatric AIDS have evolved, what has worked, has not worked and why and make recommendations for UNICEF’s future engagement in PMTCT and Pediatric HIV care and treatment;

Background

During last 5 years Kyrgyzstan was in the process of scaling up PMTCT services with an aim of reducing of vertical transmission of HIV to <3% by the end of 2016. Country in its partnership with UNICEF and all of UN agencies, GFATM and civil society has committed to address HIV infection and recognizes the importance of focusing on reducing HIV transmissions among key populations, as well as the need to immediately address any challenges and barriers to prevent the spread of HIV infection from mother to child. This is one of the major focus areas in National health reform programme “Den Sooluk” for 2012-2016. “Den Sooluk” program focused on HIV/AIDS highlights with prioritization of the importance for elimination of the mother-to-child HIV transmission (EMTCT)and outlined an ambitious benchmark to be met by 2016: “reduction of the vertical transmission of HIV to 3% by 2016 in all born children”.

The program has been designed to achieve this goal consisted of the number of the activities including capacity building, improvement of clinical treatment standards, quality of the provided services, ensuring continued and uninterrupted supply of the drugs and commodities, as well as the continued improvement of available prevention and management services. There were many steps to take to reach the goals which were set through GFATM, UNAIDS/UNGASS and other large-scale donor-funded programs. To identify the baseline for programming, in 2012 UNICEF and partners conducted baseline assessment to understand the level of knowledge, attitudes and practices (KAP) at select facilities throughout Kyrgyzstan regarding to different interventions within PMTCT program. Assessment included desk review of information available from the countries of the Central Asian and Kyrgyzstan. The same assessment tool was applied to analyze the situation with PMTCT services at other regions, including Russia, Eastern Europe, The Caucasus and Africa. The summarized report with clear recommendations wasfinalized in 2013 and was a base for strategic planning of programs to address identified barriers and bottlenecks in the access of women and children to quality PMTCT services.

Currently PMTCT services are provided in compliance with clinical protocol approved by the MoH Decree #29 on 22.01.2015. The protocol was developed based on the latest WHO/UNICEF recommendations

In addition, Kyrgyzstan implements Antenatal Care testing, Anti  Retro Virals for pregnant women and babies, as well as infant feeding counseling. A “universal opt out testing policy in pregnancy and rapid testing is provided for women who arrives for delivery without ANC and/or without an HIV test. ARVs are prescribed according to WHO recommendations for women testing positive during pregnancy, delivery or before pregnancy and cesarean section is a preferred delivery option. ARVs are prescribed for newborns [per WHO recommendations] and replacement feeding is the preferred option and counseling is provided.

In terms of Polymerase Chain Reaction Testing for infants born to HIV positive women for early infant diagnosis in Kyrgyzstan, starting from 2013 Ministry of Health with support of UNICEF initiated development of guideline on provision of Early Infant Diagnosis for HIV among newborns and its implementation countrywide. Due to the resource mobilization and set of activities on capacity building of the staff, supply of test systems and kits for EID, rate of HIV exposed newborns covered with PCR testing at the age of 2 months increased from 3% in 2011 to almost 90% in 2016.

At this juncture, UNICEF is planning to conduct an assessment of the PMTCT provision in health care facilities of the Kyrgyz Republic and document achievements, lessons learnt of the implementation of Early Infant Diagnosis among HIV exposed newborns between 2013-2016, in order to measure impact of intervention within PMTCT and Pediatric AIDS interventions taken after the last assessment (2012).

Scope of work, deliverables and key task

Provide inception report with the content.

1. Analysis of existing documentation on PMTCT, including current policy, strategies and programs; standards/protocols, reports and statistics (will be provided). To revise reports on assessment of PMTCT from other countries (will be provided) and propose additional instruments if it is needed for conduction of current assessment and preparation of final report.
2. Preparation of protocol of survey, adaptation of questionnaires (senior management of medical facilities, medical workers, women). This questionnaires are available.
3. Perform preliminary data analysis and draft report to facilitate round-table discussion to present preliminary evaluation results and recommendations to key stakeholders and counterparts
4. Analysis and preparation of report on assessment of PMTCT situation (all information collected by survey team will be provided) with elaboration of recommendations addressing identified gaps in respect to regulatory framework, standards, access, quality and coverage to ensure a good quality comprehensive and sustainable provision of PMTCT services.
5. Review and prepare documentation report on EID implementation in the Kyrgyz Republic based on existing documentation in the area of Early Infant Diagnosis on HIV, data showing the impact of interventions of main stakeholders to widen the coverage with testing.  

Reporting and supervision

The Consultant will work under supervision of Cholpon Imanalieva, Health and Nutrition Specialist, and closely with Edil, Tilekov, HIV officer

Duration

This consultancy is envisaged for 8 working days in country and 7 working days out of the country within the period of September 2017

Duty station and official travel involved

Bishkek, Kyrgyzstan including travel to the fields in Osh province) (1 two-day trip to Osh).

Qualification/level requirements

I. Academic Qualifications:

This assignment will require a senior International expert with extensive experience of working in the Public Health, HIV/PMTCT, Advanced Degree in Medicine, Public Health and/or Anthropology

II. Professional Experience in the area of HIV/PMTCTPublic Health

Minimum 5 years of experience in the conduction/facilitation of the evaluation/assessment of the projects/programs in the area of HIV/PMTCT;

• Proven experience in the analyzing of programmes related to HIV/PMTCT is mandatory;
• Excellent management, communication, facilitation and inter personal skills;
• Previous experience of working in Kyrgyzstan is a strong asset;
• Experience of working with UNICEF is mandatory.

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.