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International Consultancy to review and update the framework on immunization in Abkhazia, Georgia

Sukhumi (Georgia)

  • Organization: UNICEF - United Nations Children’s Fund
  • Location: Sukhumi (Georgia)
  • Grade: Consultant - Contractors Agreement - Consultancy
  • Occupational Groups:
    • Public Health and Health Service
    • Malaria, Tuberculosis and other infectious diseases
  • Closing Date: 2020-07-18

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International Consultancy to review and update the framework on immunization in Abkhazia, Georgia

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, Health

Introduction

Since 2011 UNICEF has been actively supporting an Extended Programme on Immunization (EPI) in Abkhazia. The programme has supported the establishment of an immunization monitoring database software, introduction of an immunization calendar based on WHO standards and recommendations, introduction of key vaccines to the calendar, procurement of vaccines, capacity building of health professionals and improvement of immunization coverage of children, including those from vulnerable groups.

Despite UNICEF's efforts, many remaining challenges continue to negatively impact the quality of services provided to the local population through EPI due to complex contextual and systematic constraints. Subsequently, the immunization coverage rates are lower than the regional average: for the 2016 birth cohort, just over 40 percent received the third doses of DTP, viral hepatitis B and polio and for the 2015 birth cohort only 40 percent received a second MMR dose.

A Program Review of Immunization and Vaccine Preventable Diseases in Abkhazia was concluded in June 2018 and determined that the main reasons for low coverage and delay of vaccinations are vaccine safety concerns, false contraindications, hesitancy of the medical community, inertness of parents and some concerns over the vaccine supply chain. The number of refusals is increasing, with the main reason being more hesitancy among the medical community and the general population who increasingly ask to postpone vaccination, particularly in urban areas. In most of the local primary healthcare points (FAPs), nurses are afraid to take any responsibility, even to promote immunization services and address resistance to immunization. The situation is aggravated by structural, financial and human resources limitations that continue to affect immunization. There is a lack of paediatricians and nurses have limited capacities. The system is also hampered by informal payments; poor infrastructure and quality of services; a lack of comprehensive and credible vaccination registration and reporting system; and an absence of a well-coordinated communication platforms.

The routine immunization schedule in Abkhazia is mainly in line with WHO recommendations, with the exception of a few divergences (e.g. no birth dose of Hep.B, BCG 2nd dose for tuberculine-negative children at the age of 7 years). The presence of the Hexavalent vaccine allows a reduction of the number of injections. In terms of hesitancy of the medical community, too many false contraindications for immunization are still applied and not in line with WHO recommendations. The main reasons are that doctors don't want to face problems (e.g. spacing out injections or different antigens; sometimes sending children to neurologist) or don't want to take the risk of adverse event following immunization (AEFI). In that regard their knowledge on AEFI for WHO prequalified vaccines is sub-optimal. There are limited epidemiological capacities due to the lack of competent staff in Abkhazia. Limited access to postgraduate and continuing education is also a challenge for epidemiologists.

The current framework covering immunization is also not sufficient, as it does not fully define and manage immunization and vaccine preventable disease (VPD) surveillance activities. Several orders issued in recent years are regulating aspects of immunization, including the introduction of the immunization calendar and the introduction of new vaccines. However, Soviet-era practices in the area of health are still applied and referenced by the medical personnel, including job description and distribution of competences, and this limits the advancement of public health in Abkhazia.

The Program Review of Immunization and Vaccine Preventable Diseases in Abkhazia highly recommends for the medical community and decision-makers to upgrade and/or develop practices to establish an environment for implementing a high-quality immunization program which also prioritizes immunization and VPD surveillance. 

Objective  

UNICEF seeks to engage an external international consultant to review and update together with responsible medical professionals the existing framework on immunization, including routine immunization and immunization calendar, contraindications, job descriptions of medical workers, and immunization planning and its overall adaptation as for approved guidelines based on international standards and contextual requirements.

Deliverables and Timelines

1. Key Actions: Desk review of the existing framework on immunization. The consultant is expected to carry out a home-based review of the Communication Strategy for Immunization, the KAP survey on Immunization in Abkhazia, Rapid Review of Key Elements of Primary Health Care. Based on familiarization with these guiding documents as well as online briefing consultations with UNICEF staff and local EPI manager to gain a good understanding of the context in Abkhazia, the expert is to review the existing immunization calendar, existing SOPs on AEFI, formal guidelines on contraindications and draft recommendations on routine, delayed and postponed immunization, review existing job descriptions of medical workers involved in immunization and prepare handout materials and presentations as well as agendas for working sessions.

Deliverables:

  • Short report with identified gaps, summary of recommendations as well as proposed agenda of the trainings and working sessions to improve the local framework on immunization. (key topics: development of immunization plan, job descriptions, supervisory visits, routine, delayed and postponed immunization, AEFI, approved contraindications list etc.);
  • Prepare drafts of recommendations to improve the framework, including key missing SOPs based on international existing standards and policies;
  • Develop a draft strategic plan on immunization and draft EPI operational plan for one year. Drafts will be a basis for working sessions to develop the strategic plan on immunization and the operational immunization plan for one year together with the local medical professionals.

Delivery Period: By September 2020

Number of Working Days:  10

Location: from home

2. Key Actions: Deliver online workshops to facilitate introduction of key Immunization related guidelines. Evidence showed that despite the ability to refer to key recommendations and guidelines on such topics as Adverse Events Following Immunization (AEFI), false and actual contraindication etc. the local community of relevant medical professionals requires guidance in formalizing such recommendations and requirements for strict adherence to it by all involved medical workers as well instruction and briefing of parents and caregivers on existing rules. The attracted expert is expected to support the medical workers in introducing relevant guidelines approved at the decision-making level. 

Deliverables:

  • Guide the local responsible medical professionals in introducing formalized recommendations/SOPs on AEFI, false and actual contraindications and related topics through thematic working sessions delivered online.

Delivery Period: By September 2020

Number of Working Days:  4 (2 briefing days and 2 practical workshop days)

Location: from home 

3. Key Actions: Online workshop on the revision of the immunization calendar and formalization of approaches on routine delayed and postponed immunization. Following the requirements to update the immunization calendar and an identified need to attract international expertise to lead the community of local relevant medical professionals in formalizing the approaches in routine, delayed and postponed immunization based on WHO recommendations and contextual features, the workshop will intend to discuss identified gaps in immunization programme and define clear recommendations/guidance on routine, delayed and postponed immunization to be followed across all medical institutions involved in the immunization programme (including introduction of definitions, algorithms, contextualization of approaches based on the local profiles and types of vaccines used etc.). The expert is expected to become familiarized with the local data base software on immunization and recommend possible adjustments to reflect intended changes within the calendar and immunization framework.

Deliverables:

  • Develop recommendations to improve the data collection and reflection of the data within the Immunization DB accordingly;
  • Review the immunization calendar and formalize the approaches in routine, delayed and postponed immunization based on WHO recommendations and contextual features;
  • Thematic tailored workshop for leading paediatricians at the level of MLM (mid-level managers).

Delivery Period: By September 2020

Number of Working Days: 5 (1 day for familiarization with key documents, 2 days for the DB revision and briefings, 2 days for the workshop)

Location: from home

4. Key actions: Conducting thematic workshops and working sessions for medical workers at the level of MLM. Joint guided workshop on immunization plan will allow for immediate and supervised practical realization of theoretical knowledge. A job description related working session will finalize efforts of the local medical community in introducing relevant up-to-date tailored job descriptions for all medical workers involved in immunization. Under supervision and guidance of the international expert, final recommendations on JD will be elaborated for further approval at the level of the decision-making.

Deliverables:

  • Guide a practical workshop with MLM/key paediatricians on development of a strategic plan on immunization and operational immunization plan for one year;
  • Working session on joint review and elaboration of JD for immunization related health workers.

Delivery Period: By October 2020

Number of Working Days: 4 (1 briefing day, 2 practical workshop days, 1 day on JD related revisions)

Location: from home 

5. Key Actions: Generate a comprehensive report on key assigned deliverables, including analytical overview of carried out deliverables. (training and working sessions outcomes, lessons learned, recommend on job descriptions adjustments, formalization/SOPs for AEFI, false and actual contraindications, update of the national immunization calendar, introduction of comprehensive immunization plan, provide with concrete recommendations on improvement of EPI based on topics discussed with local professionals (immunization planning, AEFI, routine, delayed and postponed immunization, contraindications etc., data collection and management of the DB), explicitly define key constrains and recommendations on further actions). 

Deliverables: Report. 

Delivery Period: by November, 2020. 

Number of Working Days:  2

 Location: from home 

 

TOTAL Number of Working Days

 25 working days, from home

Total: 25 working days  

Qualifications/experience required

  • Advanced university degree in public health, development studies, social sciences;
  • At least five (5) years of professional experience combining formal expertise in Public Health with experience of applying Immunization related expertise to specific developmental programmes; experience of work in similar contexts and in Health will be an asset;
  • At least three (3) years of professional work experience at the national and international levels in planning, programming, implementation, monitoring and evaluation of Immunization programmes;
  • Proven experience in developing training materials and delivering trainings on health, immunization related programming;
  • Ability to communicate ideas in a manner conducive to their practical application;
  • Good working level of English and Russian; 
  • Work experience in the ECA region is an asset.

Supervision and Reporting Responsibility:

The selected consultant will work under the direct supervision of UNICEF's Chief of Sukhumi Field Office, in close cooperation with the National Project Officer.

Remuneration:

Applicants are required to submit a financial proposal for the requested services. The remuneration will be negotiated between the applicant/s and UNICEF on the basis of an initial applicant’s proposal. The consultancy fee will be paid in one installment upon the completion of the assigned deliverables, submission of good quality reports with recommendations and their approval by UNICEF.

UNICEF will issue a consultant contract in USD. The payment will be made in USD by bank transfer and in instalments upon deliverables as per contractual agreement.

The funding source will be GAVI PTE - SC 180904

Conditions of Work

The consultant/s shall use their own facilities to manage the work. Probable differences in time will be taken into consideration in planning online sessions to the convenience of beneficiaries, UNICEF team and the consultant/s.

Reservations: UNICEF reserves the right to terminate the contract without a prior notice and/or withhold all or a portion of payment if performance is unsatisfactory, if the rules and the regulations regarding confidentiality, ethics and procedures of UNICEF and the project partners are not followed, if work/outputs are incomplete, not delivered or for failure to meet deadlines. 

The candidate will be selected based on "best value of money" and will be governed by and subject to UNICEF's General Terms and Conditions for individual contracts.

For every Child, you demonstrate UNICEF's values of Care, Respect, Integrity, Trust, and Accountability (CRITA) and core competencies in Communication, Working with People and Drive for Results.

 

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.

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.

 

Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures, and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws.

We do our best to provide you the most accurate info, but closing dates may be wrong on our site. Please check on the recruiting organization's page for the exact info. Candidates are responsible for complying with deadlines and are encouraged to submit applications well ahead.
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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