National Consultancy to support to the implementation of the Last Mile to eMTCT: a programming guide developed by UNICEF and partners, to facilitate the adoption of evidence-based approaches towards the achievement of eMTCT in Kenya.

The overall role of the nationally recruited consultant will be to facilitate the introduction and implementation of the Last Mile to eMTCT programming guide at select counties of Kenya. This will enable the adoption of evidence-based step by step approaches towards the achievement of eMTCT. It is expected that the consultant will work closely with the national and county governments of health.

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                                                                               TERMS OF REFERENCE

Purpose of Activity/Assignment:

Important gains have been made in the HIV and AIDS response for women and children globally resulting in a significant reduction of paediatric HIV infections. According to the Kenya HIV Estimates 2020, there are approximately 1.5 million people living with HIV in the country including 106,500 children below the age of 15 years. The biggest contributor of new HIV infections among children has been the vertical transmission of HIV from mother-to-child. The current (2020) programme data indicate that Kenya is still far from eliminating this type of transmission with about 11 in every 100 children born to mothers living with HIV becoming infected, equating to approximately 6800 new infections recorded last year among children.
The Kenya Strategic Framework for the Elimination of Mother-To-Child Transmission (eMTCT) of HIV and Syphilis 2016-2021 target for Kenya was to reduce MTCT from 8% in 2016 to below 5% by 2019 and sustain this level for at least two years for the country to achieve eMTCT validation status. While considerable efforts have been deployed by numerous stakeholders, the MTCT rate has been fluctuating and is currently at 10.8% which is more than double the national target. In 2019, eight counties accounted for half of the total new infections among children – Nairobi, Kisumu, Homabay, Siaya, Migori, Nakuru, Uasin Ngishu and Mombasa. Moreover, rates of mother-to-child transmission have been climbing alarmingly in Arid and Semi-Arid land (ASAL) counties over the past three years, with rates as high as 28.5 per cent in 2020 which is more than double the national rate of 10.8 per cent. It is therefore imperative that targeted efforts are needed in these counties to bring down the national MTCT rate and realign Kenya’s efforts on its path to elimination.

The Last Mile to eMTCT provides a roadmap for programmes seeking to systematically evaluate and optimize maternal and child health services at national and subnational levels. The four-step approach is not intended to be prescriptive; rather, the Last Mile to eMTCT provides a framework that can be used to structure and facilitate discussions that will help programmes identify gaps at national and subnational levels and prioritize evidence-based policies and interventions to address these gaps. The Last Mile to eMTCT framework is a data-driven cyclical process that is highly local in practice and allows national programmes to address local priority areas and achieve eMTCT in an efficient and directed manner.
The Ministry of Health through NASCOP and NACC has recently revived the EMTCT momentum in the country led by Her Excellency First Lady of Kenya. The new effort to put Kenya back on the path to elimination has garnered the approval and support of many key stakeholders and partners. NASCOP has equally demonstrated its commitment through development of its domestic Last Mile Framework concept note and UNICEF has an important role to play in delivering high-quality technical support for the National LM framework implementation
In view of this, the overall role of the nationally recruited consultant will be to facilitate the introduction and implementation of the Last Mile to eMTCT programming guide at select counties of Kenya. This will enable the adoption of evidence-based step by step approaches towards the achievement of eMTCT. It is expected that the consultant will work closely with the national and county governments of health.

This will be accomplished through developing contextualized resource/orientation materials and programming tools on the use of the eMTCT Last Mile framework in collaboration with a team from the University of North Carolina (UNC). In addition, the consultant will provide technical assistance through regular workshops to support Kenya’s Ministry of Health to plan and implement strategies that address critical gaps identified using context specific national and sub-national data sources. The consultant will also be responsible for documenting and disseminating the approaches for further implementation of cross-country experience sharing.

Scope of Work
The consultancy is aligned to the UNICEF country programme 2018 – 2022 under outcome 1 and to UNDAF outcome 2.4.

UNICEF outcome 1 seeks to ensure that by 2022 there is reduced mortality and stunting through increased proportions of vulnerable children, pregnant and lactating women, including adolescent girls; they have equitable access to and use quality WASH, Nutrition, Health and HIV/AIDS services to reduce their risk of mortality, preventable diseases, stunting and other forms of malnutrition, and improve their birth outcomes.

The work being proposed will be conducted in four phases. The expected overall outcome will be the implementation of the Last Mile framework at 5 select counties of Kenya.

Based on the above, the following scope of work is proposed:
Phase 1: Through a consultative process, in collaboration with the UNC team, draft and test a contextualized orientation package and operational tools including specific steps on the approach to programming for the Last Mile of eMTCT to guide Kenya in selecting and implementing strategic interventions that address evidence informed gaps.
Phase 2. With support of the Programme Specialist at UNICEF Kenya Country Office, convene and facilitate physical and virtual task team meetings (as much as possible working with existing government structures). The consultant will convene
1. One meeting per county to build consensus on the priority interventions to be implemented based on the steps proposed in the Last Mile documents and informed by the epidemiology, the spectrum stack analysis, national and sub-national surveys, program data and relevant studies.
Phase 3: Conduct regular meetings with the 5 select county task teams to provide technical assistance for the programme planning, implementation, and monitoring of eMTCT Last Mile work plans.
Phase 4: Document the approaches used by the county teams to implement the Last Mile framework and the lessons learned in the programming approaches which will serve as a resource for cross-country learning.

Methodology
Each phase of this consultancy will require the engagement of a wide range of stakeholders as guided by NASCOP to ensure the quality and buy-in of the Last Mile to eMTCT framework. The earmarked priority interventions should align with Kenya’s policy on eMTCT as well as the Last Mile concept note (by NASCOP).

The outlined processes on introduction and implementation of the Last Mile to eMTCT framework are subject to change in anticipation of NASCOP’s potential inputs and recommendations. For this reason, the national consultant is expected to maintain flexibility and responsiveness throughout the entire process.

Reporting Lines
Under the supervision of the, Chief HIV section (UNICEF Kenya CO) the consultant will deliver the following:

a. A contextualized orientation package, slide decks and operational tools including specific steps on the approach to programming for the Last Mile of eMTCT in Kenya.
b. Finalized five county analysis reports highlighting eMTCT gaps and consensus on key prioritized interventions.
c. Periodic implementation reports highlighting progress on the Last Mile to eMTCT framework as per the agreed workplan and timelines; and,
d. A finalized case study for Kenya highlighting lessons learned in the programming approach as a resource for cross-country learning.

Requirements

Technical evaluation criteria will be based on the following:
a. Overall response, completeness, and concord on the requirements of the Terms of Reference (15 points)
b. Overall work experience of the Candidate (20 points)
c. Technical skills, relevance to requirements of the proposed assignment (15 points)
d. Proposed methodology/time frame (20 points)
e. Financial proposal (30 points)

Financial proposal will include:
• Daily/monthly rate (in KES) to undertake work proposed as indicated in the terms of reference:
o Availability (dates)
o Travel costs and daily subsistence allowance is required as per TOR.
o Any other estimated costs: stationery and printing costs of resource materials.
• At the time the contract is awarded, the selected candidate must have in place valid health insurance coverage.
• Payment of professional fees will be based on submission of agreed satisfactory deliverables. UNICEF reserves the right to withhold payment if deliverables do not meet highest standard and timelines are not respected.

It is expected that the individual consultant will have the following skills and experience:
1. Advanced degree in public health, HIV pediatric health, family health, health research, global/international health, health policy and/or management, epidemiology, or other health-related sciences.
2. At least 5 years professional experience in HIV and AIDS programming and/or research at national and sub-national levels
3. Strong facilitation skills and proven ability to interpret new technical knowledge on HIV and AIDS considering the current knowledge on children and AIDS and trends in the field.
4. Prior experience in developing tools and guidance for HIV programmes.
5. Prior experience with the United Nations, or a multi-lateral or international health and development agency.
6. Proven ability to communicate technical knowledge on AIDS in terms that are accessible to programme professionals, including non-specialists.
7. Ability to work independently and in consultation with the UNICEF team.
8. Ability to use good judgement incorporating feedback from various team members and partners.
9. Punctual turnaround of work and ability to multi-task.
10. Previous experience working with UNICEF and other UN agencies an asset.
11. Cultural and gender sensitivity.

How to Apply

Interested candidates should apply online using the button below.  As part of their application, candidates should provide:

1. A cover letter that specifies how you meet the desired competencies, technical background and experience (no more than 2 pages)
2. A short CV (no more than 4 pages)
3. A fee structure that should include: daily rate in KES and total fee

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 the organization.