The Clinton Health Access Initiative, Inc. (CHAI) is a global health organization committed to saving lives and reducing the burden of disease in low-and middle-income countries, while strengthening the capabilities of governments and the private sector in those countries to create and sustain high-quality health systems that can succeed without our assistance. For more information, please visit: http://www.clintonhealthaccess.org

Background:

Through the prioritized implementation of high impact public health interventions like immunization, access to safe drinking water, improved neo-natal and infant care and access to effective treatment for pneumonia and diarrhea, India has reduced its infant mortality rate (IMR) from 89 in 1990 to 32 in 2017 and Under-five Mortality Rate (U5MR) from 126 in 1990 to 39 in 2017[1]. India’s Universal Immunization Program (UIP) is one of the largest public immunization programs in the world. It caters to 26.3 million infants and 30 million pregnant women annually through 9 million planned sessions. The program provides access to vaccines against 11 Vaccine Preventable Diseases (VPDs)[2] at the national level and against two VPDs vaccines at the sub-national level[3].

Under the strong leadership of the Ministry of Health & Family Welfare (MoHFW) and state governments, the entire immunization ecosystem has demonstrated proactive commitment for achieving universal immunization coverage in the country in recent years. Strategic projects in this direction include but are not limited to introduction of new vaccines[4], rolling out of data systems[5], strengthening of national immunization centres such as Immunization Technical Support Unit (ITSU) and National Cold Chain & Vaccines Management Resource Centre (NCCVMRC) and successful piloting of initiatives for bolstering health worker capacity building[6]. Coupled with these initiatives, MoHFW launched Mission Indradhanush (MI) in 2014 and Intensified Mission Indradhanush (iMI) in 2017: catch up and system strengthening campaigns to target underserved, vulnerable, resistant, and inaccessible populations. iMI has resulted in an increase of 6.7% in full immunization coverage (FIC) after the first two phases in prioritized districts[7]. However, the government and partners recognize the need for further efforts in this direction to reduce the 802,000 infant deaths and 989,000 under-five deaths that occur annually in the country[8].

Uttar Pradesh (UP), the most populous state of India, contributes more than 20% (5.7 million) to India’s annual birth cohort. UP has the highest infant mortality (64 deaths per 1,000 live births) and under five mortality rates (78 death per 1,000 live births) in the country[9]. UP’s  FIC  went up from 51.1% in 2015-16, to 65.3% in 2018 through concentrated efforts and catch up campaigns (MI and iMI) in 60 out of 75 districts. However, wide variations in coverage exist across regional and social categories. In 2018, UP accounted for 25% of under-immunized children in India & 9.5% of world’s under-immunized children. Improvements in UP’s FIC are essential to national and global improvements in immunization coverage, as an increase in UP’s FIC from 65 to 90% could increase India’s FIC by 6 percentage points, and the global FIC by 1%. The government of Uttar Pradesh (GoUP) is currently rapidly implementing a new strategic roadmap for holistic improvement of immunization outcomes in the state.

Program Overview:

CHAI operates an immunization program in India to support the MoHFW’s UIP at the national level and in the focus states of Madhya Pradesh and Uttar Pradesh. CHAI provides catalytic support to the NCCVMRC, which is based out of National Institute of Health and Family Welfare (NIHFW), on national projects for improving availability and efficacy of vaccines and efficiency of vaccines systems by strengthening cold chain management and vaccines delivery & logistics. CHAI also supports national and state governments on broader operational aspects such as planning, capacity building and systems improvements for immunization service delivery. Supporting GoUP since 2013, the Uttar Pradesh Technical Support Unit (UP-TSU) works closely with the Department of Health & Family Welfare and the Department of Child Welfare of GoUP to improve the availability, quality and utilization of critical reproductive, maternal, natal, child and adolescent health (RMNCH+A) interventions and services and has a deep understanding of UP’s health systems, geography and demographics and opportunities.

Recognizing the vision and ambition of the GoUP on improving immunization coverage and equity outcomes in the state, CHAI and UP-TSU are undertaking a transformative project to provide support to GoUP at the state and district levels and in prioritized blocks. A purposely-formulated immunization project management unit (PMU) nestled within the UP-TSU will anchor this support to GoUP. The PMU will design and deploy catalytic support to GoUP based on the guiding principles of impact, integration, investment, and innovation. The PMU will support GoUP on the state’s plans for strengthening evidence-informed decision-making, enhancing state capacity to manage and govern immunization service delivery and augmenting immunization systems in prioritized blocks of the state.

Role Overview:

CHAI is seeking a highly motivated individual with outstanding credentials and demonstrated immunization experience for the role of Review & Capacity Officer. The Officer will report to the Strategy & Insights manager within the Immunization PMU. The officer will be responsible for providing field level capacity building & advisory support to district and block immunization program managers. The officer will enable government program managers to improve their program’s performance by driving relevant interventions at the district/block level. The officer will be responsible for lending support to GoUP in designing and executing capacity building initiatives as per their plans for enhancing capacity of immunization functionaries. The ideal candidate should have exceptional analytical skills, problem-solving ability and communication skills. The Review and Capacity Officer must be able to function independently, be comfortable with travelling across UP extensively, be flexible, and have a strong commitment to excellence.  CHAI places great value on relevant personal qualities: resourcefulness, responsibility, tenacity, independence, energy, and work ethic.

[1] Unicef on behalf of UN IGME (2018). Level and Trends in Child Mortality Report 2018 Estimates developed by the UN Inter-agency Group for Child Mortality Estimation. New York

[2] diphtheria, pertussis, tetanus, polio, measles, rubella, severe form of childhood tuberculosis, rotavirus diarrhoea, hepatitis B, meningitis and pneumonia (caused by hemophilus influenza type B)

[3] pneumococcal pneumonia and Japanese Encephalitis

[4] Rotavirus Vaccine, Pneumococcal Conjugate Vaccine, Measles Rubella vaccine, Injectable Polio Vaccine, Tetanus Diphtheria vaccine

[5] electronic Vaccine Intelligence Network (eVIN), National Cold Chain Management Information System (NCCMIS), ANM Online (ANMOL), Surveillance and Action for Events Following Vaccination (SAFE-VAC)

[6] Rapid Immunzations Skills Enhancement (RISE)

[7] Gurnani et al (2018). Improving vaccination coverage in India: lessons from Intensified Mission Indradhanush, a cross-sectoral systems strengthening strategy. BMJ 2018; 363; k4782

[8] Ibid1

[9] National Family Health Survey-4, MoHFW, GoI

• Provide advisory support to immunization program managers at the district/block levels on effective immunization program performance monitoring, action plan creation and follow up
• Support the strengthening of GoUP-led immunization review meetings in select districts and blocks in UP on a continuous basis
• Work closely with GoUP state RI cell to identify key training needs for different levels of immunization functionaries, design targeted training content, define the training calendar and deliver trainings effectively
• Undertake targeted capacity building activities at the state level and in select districts/divisions with the aim of building sustainable processes and capability
• Disseminate and socialize easy to use tools, templates and approaches for immunization program management including automated HR rosters, key performance trackers etc.
• Enable cross-learning amongst districts and blocks on program performance review mechanisms by identifying and disseminating best practices
• Undertake primary and secondary research and create data-based insights to provide credible evidence for formulating coverage improvement strategies and decision making at the district and block levels
• Build and maintain trust-based relationships with district and block officials and other health functionaries
• Travel extensively to various parts of the state
• Undertake any other duties as requested by the supervisor

• Master’s/Bachelor’s degree in public health, medicine, public administration, management, economics or allied areas
• 5+ years of relevant field level work experience in immunization in the public sector including engaging with district and block officials on immunization challenges, conducting multi-stakeholder workshops and undertaking capacity building for public health functionaries
• Exceptional interpersonal skills, demonstrated ability to build strong professional relationships with a range of stakeholders in a challenging, multi-cultural environment
• Excellent analytical (qualitative and quantitative) and communication (written and verbal) skills
• Entrepreneurial mind-set, including ability to work independently, self-motivate, and propose and implement new initiatives
• Motivated to travel frequently to meet the needs of the program and deliver impact effectively
• Proficiency in Microsoft Office, particularly Excel, PowerPoint and Word
• Fluency in English & Hindi

Preferred:

• Strong understanding of public health/immunization context in UP
• Experience of developing and customizing multi-faceted tools and aids in a public-sector context

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