International Consultancy - Understanding barriers to acces health and nutrition services for children less than 5 years old in Rwanda" Kigali-Rwanda

Understanding barriers to acces health and nutrition services for children less than 5 years old in Rwanda.

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. To save their lives. To defend their rights. To help them fulfill their potential.

Across 190 countries and territories, we work for every child, everywhere, every day, to build a better world for everyone.

And we never give up.

For every child, 

In Rwanda, tremendous progress has been made in improving child survival. The under-five mortality rate has declined by two thirds since 1990 (from 152 deaths per 1,000 live births in 1990 to 50 deaths per 1,000 live births in 2014/15).

The Government has achieved this reduction by strengthening both facility and community level health systems.  As a result, 91% of all deliveries were conducted in health facilities and 93% of children aged 12-23 months have received all basic vaccines. Though these achievements are commendable, there are substantial gaps like, 81% of newborns have not received postnatal care in the first 2 days after birth, over one-third of children estimated with severe acute malnutrition did not receive appropriate treatment, and considerable proportion of children under age 5 who had symptoms of acute respiratory illness (46%), diarrhea (56%), and fever (51%) have not received advice or treatment from a qualified provider. Only 55% of children under 15 years of age living with HIV were on antiretroviral therapy. In order to increase the coverage for these interventions it is essential to understand the barriers that prevent access to health services.

Access is more than simply the opportunity to use healthcare services.  It is a multidimensional concept based on the interaction between healthcare systems and individuals, households and the community. Access can be seen to have several core dimensions: availability; affordability; approachability; appropriateness; and acceptability.

How can you make a difference?

The primary objective is to understand the barriers for children under 5 years of age and their care givers to access health care services for various health and nutrition interventions.

The purpose of this assignment is to design, collect data, analyse data, make qualitative follow-up and write a report to address the objective defined above. The end product will be a final report that is approved by Ministry of Health (MoH).

This assignment will be carried out through a desk review, a household survey, qualitative assessment of health workers, post-survey discussions with target communities, and discussions with UNICEF, MOH and other key partners.

The main tasks involved are to:

1. Discuss and confirm the scope of the assignment with UNICEF and MOH. This particularly includes the purpose of the study and the structure/content of the Deliverables (see below).
2. Review relevant documents, other related health research and documents from Rwanda, and examples of similar research from other countries and the research tools used to inform the development of the design.
3. Draft the design (see Deliverable 1) and agree with UNICEF and MOH before moving on.
4. Develop tools and protocols for desk review, household survey, and qualitative assessments among healthcare workers and target communities (see Deliverable 2).
5. Conduct a desk review of available quantitative and qualitative data from Rwanda, including data from DHS and health management and information system (HMIS).
6. Conduct a household survey from one cell in each of four provinces and city of Kigali.
7. Conduct qualitative assessment of healthcare workers, basic health facility assessment and post-survey focus group discussions in target communities.
8. Analyze the data and provide a draft report for initial feedback from UNICEF and MOH (see Deliverable 3).
9. Share a revised draft report with UNICEF, MOH and partners, revise based on feedback, and validate the findings through a consultative forum and produce a final report that is approved by MOH (see Deliverable 4)

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

• Other than surveyors, the consultant should at least hold a Masters' degree in public health, research and related subjects.
• Experience with conducting surveys on barriers to access services and analysis among children under 5 years of age.
• Experience with barriers to access services and analysis in Rwanda.
• Capacity with a professional team able to carry out the scope of work with similar complexity
• Demonstrable experience producing similar documents
• The consultant should have excellent English writing/communication skills. Taking into consideration, according to the specific areas of intervention, the necessity of communicating in Kinyarwanda.
• 10 years minimum experience in coordinating and participation in similar assignments
• Public Health expertise with minimum of 10 years experience in works like this in Rwanda will be an added advantage
• Research expertise, both quantitative and qualitative, with at least a basic understanding of statistical and sampling techniques, including interview and focus group discussion experience
• Data analysis expertise with a minimum of 10 years of experience, preferably in health
• Data collection expertise with at least five years experience
• Strong writing skills in English with a clear, straightforward writing style
• Familiarity with academic research on health issues in Low and Middle Income Countries, such as morbidity/mortality and access to services
• Exceptional analytical, quantitative and summarizing skills
• Hands-on experience with the implementation capacities and constraints of governments in developing countries, particularly Low and Middle Income Countries in Africa
• Experience with WHO, UNICEF or other international health bodies

• Fluency in written and spoken English is required.
• Knowledge of French and Kinyarwanda is an asset

For every Child, you demonstrate…

UNICEF’s core values of Commitment, Diversity and Integrity and core competencies in Communication, Working with People and Drive for Results.

The technical competencies required for this post are….

View our competency framework at

http://www.unicef.org/about/employ/files/UNICEF_Competencies.pdf

UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization.

Remarks:

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.