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UNICEF Zimbabwe in partnership with Ministry of Health and Child Care and UNFPA are inviting proposals from Individual national or international consultants for the Provision of Technical Support in National Community Based Health Strategy

Harare (Zimbabwe)

Overall objective is to support the development of the national community based health strategy for Zimbabwe through a consultative process.

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Background

Community health is gaining prominence in Zimbabwe and many other countries. At the core is the provision of basic health services to rural and urban communities with full participation and ownership by the community. The ultimate goal of the community health system is to achieve improved health outcomes by simultaneously building the capacity of community actors and strengthening their role in broader service provision at the primary care level. Every dollar invested in community health results in $7-$10 in economic gains, driven by increased productivity from healthy people, insurance against disease outbreaks and higher employment. Globally, community health is a critical contributor towards achievement of the Sustainable Development Goals (SDGs); in particular, SDG 3 on universal health coverage, alongside the attainment of other SDGs including eradication of hunger, quality education, gender equality, clean water and sanitation, innovation and infrastructure, reduced inequities and partnerships. Therefore, achieving these goals demands comprehensive approaches that focus on building a strong and responsive community health system.

 

The government of Zimbabwe adopted the Primary Health Care approach in 1980 and the health delivery system has since been operating in a decentralized way. Over the years, community health has significantly contributed to improvements in health outcomes however, this critical level of service delivery has not been institutionalised and neither has the community health worker cadre been professionalized. Zimbabwe’s community health system faces resource constraints, inconsistencies around quality of service and weak coordination which have a negative impact on health outcomes. The National Health Strategy (NHS) 2016-2020 underscores the importance of strengthening community systems for improved health outcomes in Zimbabwe. The NHS reports that “for the Primary Health Care approach to be implemented effectively, strong community systems are essential. Although community structures exist to assist in both health promotion and provision of health services, they need to be strengthened beyond supporting the Village Health Worker (VHW). There is need to strengthen local governance and accountability structures to support integrated/linked multisectoral community-based sytems to deliver effective, sustainable and high quality services at community level. Communities play a major role not just in receiving the services they need, but also in co-production of these services and their funding and governance.

 

The country therefore requires a comprehensive, costed national community health strategic plan that encapsulates the vision, values, policy directions, strategy and implementation plan for the delivery of quality, integrated community health services which are affordable, appropriate, culturally acceptable, patient centred and accessible to every household through meaningful community participation. The comprehensive strategy will respond to priority needs, challenges and expectations and implement policy directions for each of the health system building blocks including community engagement, multi-sectoral collaboration, resource implications and an investment strategy.

 

Rationale

 

It is against this background that the proposed National Community Based Health Strategy (NCBHS) consultant is required to develop the first ever national community health strategy for Zimbabwe to harmonize community based initiatives in the country. The strategy will be guided by broader global and national frameworks including the National Health Strategy 2016-2020, the VHW strategic direction and Community Systems Strengthening framework that underscores community based approaches, community participation and ownership as critical for effective implementation of the primary health care approach. The strategy will guide delivery of the services within the community health ecosystem and assist in filling in the gaps while also addressing challenges such as proliferation of multiple cadres, unstandardized payment system and supervision, lack of standard selection criteria of community health workers and non inclusive core package / essential health package at community level. The strategy will also establish standards to ensure consistency and quality of community health and is expected to play an expansive role in ensuring that health services are accessible, affordable, and culturally acceptable while setting a five-year agenda for community health.

 

The process of development hinges on consensus building of all stakeholders integrating community health, nutrition, WASH, HIV/AIDS including other social determinants of health etc. A multi-sectoral strategy is envisaged and hence brings together stakeholders from different sectors for a common vision and community health service delivery strategy. Broad consultation processes with government and non-governmental partners inclusive of civil society will be required coupled with active management of the process leading to high level endorsements of policy directions and strategic plans. Thus, the strategy development presents the best opportunity to look at structural changes and coordination mechanisms required, which includes a  multi-sectoral task force on community health from relevent departments, line ministries, development partners and private sector among others and consideration of high level champions for community health.

 

Furthermore, with increased recognition of value addition of community health in Zimbabwe, the introduction of health posts and continued efforts to decentralize health services; the NCBHS becomes vital for programme managers, development partners, implementing partners and the government as a core reference document for planning, implementing, monitoring and evaluating community health services. It will also be used as an advocacy tool for resource mobilization.

 

 

Objectives

Overall objective is to support the development of the national community based health strategy for Zimbabwe through a consultative process.

 

Specifically, to:

  1. Guide a broad consultative process to establish a common view and consensus on the goals, values and overall policy directions leading to the strategy building, planning and decision-making for the national community health system with national and subnational stakeholders
  2. Review existing documents, identify and analyze gaps of the community health system in Zimbabwe building on the CSS framework, VHW Strategic Direction document and guide discussions on solutions.
  3. Make strategic recommendations to address key challenges/bottlenecks emerging from stakeholder consultations
  4. Guide formulation of the multi-sectorial community health technical working group or task force
  5. Compile a complete and coherent costed NCBHS  strategy document that includes thematic areas, a Theory of Change (TOC), Proposed Coordination Structure, harmonized renumeration package, resource mapping, gap analysis and financing mechanims, leadership and governance, medium to short term implementation plan and M&E and learning framework

 

Methodology

  • Extensive desk review of all relevant documents including policies, strategies and reports  including in-depth situation assessment to identify gaps
  • Multi-tiered key informant interviews with relevant technical staff, implementing partners and donors and identify and prioritise key issues related to community health system
  • Multi-tiered focus group discussions with identified groups of interest e.g. CSOs, PLWHIV, young people, community based committees etc. where necessary
  • Prepare and facilitate national and subnational stakeholders consultative meetings to build consensus, identify and prioritize activities that address key community health issues and make recommendations through provincial and national workshops
  • Conduct an overall costing of the strategy including cost analysis of the essential health package for community level, resource mapping, gap analysis and financing pathway

 

Expected Outputs/deliverable

  1. Inception report
  2. Situation analysis report on the community health system in Zimbabwe that includes an assessment of the social determinants of health, health needs and expectations; community health system performance and its capacity to respond to the challenges; community health system resources and stakeholder positions
  3. Stakeholder consultations report and establishment of a multi sectoral task force /community health technical working group
  4. A National Integrated Community Based Health Strategy that includes: i) key findings of the robust situation analysis; ii) vision, mission, values, guiding principles and Theory of change; iii) community health strategic objectives and interventions for each of the health system building blocks; iv) costed five year implementation plan and investment plan summary
  5. Resource mapping, gap analysis and financing pathway report
  6. Validation workshops reports
  7. Final costed strategy document

      

    Major tasks, Deliverables and Timeframe

     

No

Major Task

Deliverable

Timeframe

(man-days)

1

In consultation with the supervisors agree on specific timelines for the development of the various components of the National Community Based Health Strategy (NCBHS) as per the workplan of the consultancy, indicating the different types of support to be provided at different stages including an inception report

Inception report detailing understanding of TORs, methodology to be employed, activity plan and resource needs with a detailed workplan

2 days

2

Building on the VHW Strategic Direction Document and the CSS framework, identify gaps and draft the Situational Analysis Report based on desk reviews and consultations

Draft Situational Analysis, Resource mapping and Gap analysis  Report

7 days

3

Prepare and facilitate stakeholder consultations at national and subnational level and formulation of task force/ technical working group

 

Stakeholder consultations report and task force/ TWG

 

10 days

4

Presentation of progress report including the first draft Situational Analysis (SitAn) and Stakeholders consultations to the TWG for comments, and circulated to other stakeholders for further comments. Incorporate relevant comments into the draft SitAn.

Outline of the key chapters of report and SitAn

 2 days

5

Facilitate development of a TOC, proposed coordinating structure, costed implementation plan and M & E framework

Presentation of TOC, proposed coordinating structure, costed implementation plan and M & E Framework to TWG

5 days

6

Presentation of progress report and the first draft National Community Based Health Strategy to the TWG for comments, and circulated to other stakeholders for further comments

Progress Report

Draft NCBHS

2 days

7

Finalization of the draft strategy, incorporating relevant comments and inputs from the TWG. Presentation of the draft NCBHS to stakeholders, and further incorporation of relevant comments. Dissemination of the finalized NCBHS at a stakeholders’ validation meeting. Submission of final NCBHS report

Final write-up of the draft NCBHS,   PowerPoint presentation and final report

3 days

8

Costing of the finalized NCBHS

Costed NCBHS

5 days

 

Consultancy Timeframe

The consultant is expected to work for a total of thirty-six (36) days over a period of two (2) months. While the period for the development of the NCBHS document has been defined, the specific timelines for the development of the various components will be developed by the TWG considering the advice of the consultant. Based on the agreement, the consultant will develop his/her workplan indicating the different types of support to be provided at different stages.

The consultancy will begin on the 3rd of September 2018 and end not later than 23rd of October 2018.

 

Consultancy Requirements

The Consultant should have the following

  • At least 10 years of field experience in Primary Health Care and designing community based strategies, or responsible for community based health program management in the health sector especially in developing countries context.
  • Advanced university degree in public health, social science, health policy or health economics, health services management or related field
  • Demonstrated evidence on management, facilitation and coordination skills to communicate effectively with diverse partners at country levels
  • Experience in developing strategy documents; particularly community based health strategies in Africa will be an added advantage
  • Have good analytical and communication skills to develop standard technical reports, and presentation skills
  • Excellent understanding of health sector governance and management issues
  • Considerable experience in community health systems strengthening
  • An understanding of costs-benefit analysis of health sector interventions
  • Experience in working with multiple health sector stakeholders and workshop facilitation
  • Understanding of the Zimbabwe health system.

 

Application Procedure

If interested and available, please submit your application letter, CV, Technical and an all-inclusive financial proposal detailing daily professional fees and DSA for estimated 5 field travel days and any other miscellaneous expenses.

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.

 

Before applying, please make sure that you have read the requirements for the position and that you qualify.
Applications from non-qualifying applicants will most likely be discarded by the recruiting manager.
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  • Organization: UNICEF - United Nations Children’s Fund
  • Location: Harare (Zimbabwe)
  • Grade: Consultant - Contractors Agreement - Consultancy
  • Occupational Groups:
    • Public Health and Health Service
    • Social Affairs
    • Children's rights (health and protection)
    • Civil Society and Local governance
    • External Relations, Partnerships and Resource mobilization
    • Public, Private Partnership
  • Closing Date: 2018-08-21

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