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International Consultant implementation Malaria match Box for malaria programme in South Sudan( Lead Consultant Open to Non- South Sudanese)

Juba

  • Organization: UNICEF - United Nations Children’s Fund
  • Location: Juba
  • Grade: Consultancy - Consultant - Contractors Agreement
  • Occupational Groups:
    • Project and Programme Management
    • Malaria, Tuberculosis and other infectious diseases
    • Managerial positions
  • Closing Date: Closed

South Sudan received Global Fund Malaria Grant to respond to malaria situation in the country. Malaria is endemic across the country and nearly half (44%) of all children who seek medical attention will have malaria — many more will be infected but have minor symptoms. Malaria, diarrhoea, and pneumonia constitute about 77% of the total out-patient attendance diagnoses (OPD) for children under five years

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1. BACKGROUND AND OBJECTIVES:
South Sudan received Global Fund Malaria Grant to respond to malaria situation in the country. Malaria is endemic across the country and nearly half (44%) of all children who seek medical attention will have malaria — many more will be infected but have minor symptoms. Malaria, diarrhoea, and pneumonia constitute about 77% of the total out-patient attendance diagnoses (OPD) for children under five years.

Overview of the Malaria Epidemic and the National Response
Malaria is endemic across South Sudan with year-round transmission peaking at the end of the annual rainy season from September to November. Transmission is higher in the southern parts of the country compared with the northern parts. It is the leading cause of morbidity and mortality by a significant margin placing 100% of the population at risk. Although comprehensive data remain limited, what are available indicate significant variations in the malaria burden, by geography, age, sex and socio-economic status.

In 2019, the malaria incidence (all ages) was estimated at 246 per 1,000 population (239 per 1,000 for children under-five -years) representing 5,067,464 cases. This was significant increase (43%) from 2013 when incidence stood at 171 per 1,000 population. Over this same period, malaria mortality (all ages) increased marginally from 45 per 100,000 to 49 per 100,000 population. Incidence varies significantly by county; however, a more detailed analysis of why this occurs has yet to be completed.

Part of the increase in incidence was attributed to improved reporting following the introduction of the District Health Information System (DHIS) 2 in 2019. However, these increases are also due to the limited quality and reach of malaria interventions which are significantly affected by the COE context. These factors include the resurgence of armed conflict in 2016 which suspended a number of malaria programme activities, blocked access to health facilities or destroyed them, and increased the problem of regular stock outs of antimalarial medicines. While there has been a recovery of the programme since that time, a number of serious challenges remain that create ongoing gaps. Areas in the north-eastern part of the country, for example, remain insecure, significantly limiting what can be achieved in terms of malaria prevention and control.

In 2017, the Malaria Indicator Survey (MIS) showed a national prevalence for children 6-59 months of 32%, as compared to 30% in 2013. This was at some distance from the country target of 25% for that year. The MIS also stratified endemicity into hypo, meso, and holo levels (Figure 3). This analysis showed a shift in transmission intensity from the southern part of the country in2013 to the northwest part in 2017. The migration of the intensity of transmission from the southern and central parts of the country to the north and eastern regions have been attributed to several factors, including flooding, poor access to health services, comorbidity with acute severe malnutrition, and low coverage of malaria interventions in those areas.

Like other countries in East Africa region, the malaria burden is highly seasonal (Figure 4) peaking annually during rainy seasons. The impact of these changes is to push most counties to exceed epidemic thresholds for malaria cases during the July to November period on an annual basis.

Vector Control
Long lasting Insecticidal Nets (LLINs) are the main vector control intervention in South Sudan. LLINs are distributed free of charge and to through both mass campaigns and continuous distribution, largely through Antenatal Care (ANC), the Expanded Programme on Immunisation (EPI) interventions, and nutrition treatment sites. There are not current data on coverage; however, for 2017, the MIS found that only 27% of households had at least one net for every 2 residents, and that only 42% of children under 5 and 51% of pregnant women slept under a net the previous night. There are significant logistical and socio-behavioural challenges for reaching universal LLIN coverage, including insufficient supplies of nets themselves, challenging terrain for distribution and logistics management, insufficient data to monitor usage, and low levels of knowledge regarding correct and consistent use of nets, partially due to high level of illiteracy and inadequate coverage and continuity of linked social and behaviour change communication (SBC) interventions.

Case Management
Malaria case management is delivered through a mixed approach, including through hospitals, primary health care units (PHCUs), community interventions through the Boma Health Initiative (BHI), and the through private sector. The diagnosis and management of malaria places a huge burden on the health sector. By November of 2019, according to the weekly Integrated Disease Surveillance and Response (IDSR) reports (with 54% of facilities reporting), malaria accounted for 67% of all reported incidents (outpatient consultations) for the year. It also accounted for 30% of all inpatient admissions and 20% of all-cause mortality cases.

According to the same data, in September 2019 (at the peak of the rain season), malaria accounted for nearly 70% of morbidity and more than 50% of mortality cases reported during that month. The main factors attributed to these trends were flooding, poor access to services, ineffective vector control interventions due to poor LLIN quality and insecticide resistance, delayed LLIN replacement, and the broader humanitarian crisis. As a result, pregnant women and children under-five, particularly those in IDP camps and hard-to-reach areas, were most affected and most-at-risk for malaria acquisition or death.

A modest but significant proportion of the population (11% in 2013, there are no more recent data) seeks treatment for malaria through the private sector, particularly in major towns. Poor linkages between the NMCP and private practitioners persist with one major consequence being the ongoing use of oral monotherapies which are currently prohibited under national treatment guidelines. There are no mechanisms at present for the NMCP to provide quality assurance and oversight for malaria services in the private sector. The represents a key gap to be addressed to improve the quality and accessibility of effective interventions for the population.

SBC interventions
To effectively respond to and mitigate impact of malaria in South Sudan, sufficient investment in SBC is needed to improve the understanding and commitment of communities to malaria prevention and control, and to improve the overall effectiveness and outcomes of interventions. Initially SBC activities were not sufficiently prioritised or were not fully implemented. These included planned activities during LLIN distribution campaigns as well as community level activities to improve health seeking behaviour. A limited number of SBC activities were implemented annually, primarily during World Malaria Day, or as part of LLIN distribution cycles. As a result, health seeking behaviour in relation to malaria remains low, there is wide-spread misuse of LLINS, and entrenched misconceptions and negative cultural meanings attached to malaria prevention and control across many regions of the country. In the additional funding, SBC interventions were included as integrated components under the vector control and case management modules, as well as cross-cutting interventions. Funding has also been prioritised to improve the capacity of the NMCP and its partners to design and implement effective SBC interventions. SBC within this project will therefore focus on three main themes: (i) Prevention (ii) Response (iii) Special Prevention Interventions (SPI).

Human rights, gender, and equity barriers to malaria services
There are important human rights, gender-related and equity barriers that compromise the effectiveness and impact of malaria programmes, as well as health interventions more broadly in South Sudan. For example, South Sudan has a very high incidence of sexual and gender-based violence (SGBV) and widespread impunity for those who perpetrate these human rights violations going un-sanctioned. It is impossible to obtain national level estimates due to chronic under-reporting. A 2017 study in Bentiu, Juba and Lakes States by the International Rescue Committee reported that 65% of women had experienced physical and/or sexual violence in their lifetime, and some 51% had suffered intimate partner violence IPV. Thirty-three percent of women had experienced sexual violence from a non-partner, primarily during communal violence. Gender inequality, discriminatory and traditional/cultural practices, such as girls being a source of family wealth (bride price) and unpaid labour, poverty and the ongoing conflict, are drivers of SGBV and child/forced marriage, and limit access to opportunities, resources and participation for women. They also have spill on effects for children as seen by the elevated burden of malaria in this population and the high level of morbidity and mortality that results.

As already noted, a substantive proportion of the population of the country live in conditions defined as humanitarian emergency, including deeply entrenched poverty. This includes IDPs and refugees living in POCs and camps, but also the significant number of families and communities that remain on the move across the country, either because of ongoing intercommunal violence and displacement, or due to changing environmental conditions and natural disasters that force migration for the purposes of seeking food, shelter, livelihoods and other basic necessities for survival. Malaria prevention and control remains a low priority for these groups for evident reasons, in addition to the fact that areas of the country where some of these groups migrate are inaccessible for health service provision or have no available or functional health facilities. Confinement in camps and forced migration create challenges for the health sector to reach these populations for malarial prevention and control and for other equally important primary health care interventions. Overall, however, there is a lack of adequate disaggregated data, by sex, age or population group, to more fully identify gender and equity barriers for the malaria programme. As a result, interventions have been prioritised within this funding request to begin to address these gaps.

To better ensure that identified disparities and inequities are considered in national malaria programming, Malaria Matchbox will be implemented. The implementation of the Malaria Matchbox will offer the opportunity to address the Malaria responses in an integrated manner, driven by evidence.

Malaria Matchbox
The malaria matchbox is relevant for South Sudan given the extreme social economic, political, environmental, stigma and security which may hinder both access and use of services as well as the adoption of appropriate practices and behaviours. Others include high poverty levels, low education status - worse so for girls and women - seasonal flooding and mass displacements with women and children worst affected, incessant inter-clan and faction fights, stigma (HIV/AIDS) and mass raids. The matchbox survey will help identify Behaviour and sociocultural factors; Information accessibility and health literacy; Financial; Geographical accessibility; quality, of service delivery issues and barriers to accessing services as well as the bottlenecks to providing equitable services. It will amplify how these factors are impacting each of the populations assessed while at the same time increasing multi-factorial inequities and exclusion of marginalized, vulnerable populations including those living with HIV/AIDS, disabilities, and minorities. The match box will therefore illuminate the distribution of benefits and burdens of the malaria response in order to identify where there are gaps and inequities and why this occurs. The match box results will then inform a national action plan to address and remove the inequities.

2. SCOPE OF WORK:
UNICEF will contract an international consultant to lead in the planning and desk review of the malaria situation and context. The consultant will prepare research tools and lead in information collection, analysis, finding presentation and report writing. The consultant will be guided by UNICEF institutional experts on planning, equity, disability, risk analysis, communication, social research, and in a human centered approach. UNICEF, in close technical coordination with the Ministry of Health (MOH), the National Malaria Control Programme (NMCP), and the Malaria technical working group will provide overall oversight of this survey.

The survey is aimed at identifying gender, socioeconomic, cultural, human rights, and other equity barriers to malaria interventions and proffer community led solution to addressing them. From the findings, the consultant will develop an action plan to address identified human rights, gender, and equity-related barriers.
The survey will be qualitative and quantitative in nature. The survey methodology will include desk review, administered questionnaires, key informant interviews as well as focus group discussions.
During the inception, both methodology and detailed workplan will be discussed, refined, and agreed upon with the consultant. As indicative, the following are outlined:
a) The consultant will propose the methodology s/he will apply to collect and analyse data as well as report presentation. The consultant will develop data collection tool which will be pretested, shared and agreed between UNICEF and the MOH and endorsed by the ministry of Health. The data collection tools will include qualitative questionnaires, FGD guide and key informant guiding questions. NMCP will facilitate clearance of the tools by the relevant authorities.
b) Upon recruitment, the consultant will work with UNICEF team and the MOH-NMCP to identify 7 supervisors who will be deployed in the 10 study locations to provide overall supervision to the data collection. The consultant will design and present a training module for the supervisors. A five-day training will be conducted at Juba level for the supervisors.
c) A total of 40 Field interviewers will be identified and trained for 5 days. The training will be at state level in 7 selected states plus 3 Administrative Areas. The supervisors will be responsible for training the data collectors. The consultant will design and present a training module for the supervisors.
d) The field interviewers will be deployed to specific counties within the states for data collect. As much as possible the Data will be digitally collected and relayed including GPS information. Field supervisors will provide overall supervision so ensure smooth process and to address concerns that may arise during data collection. Supervisors from the MOH as well as UNICEF officers will also visit the locations.
e) A total of 10 data entry clerks will be recruited and trained on basic SPSS and data entry. The consultant will design and present a training module for the data entry clerks. The consultant will manage the data entry as well as data cleaning process.
f) One international consultant and one national consultant will be recruited to assist the lead consultant in data analysis and report generation. These two will work directly under the supervision of the lead consultant.
g) A validation workshop will be organized in Juba and virtually for field participants. This meeting will provide feedback and validate the report.
h) A launching and dissemination meeting will be organized at Juba level. About 50 key personnel will participate in this meeting.

3. SURVERY DELIVERABLES AND MILESTONES:
Action Outputs Expected result Timeline
(workdays)
Consultant contracted Desk Review and inception report produced

Study methodology proposed (for data collection and analysis as well as report presentation.)

Data collection tools shared, pretested and agreed between UNICEF and the MOH and endorsed by the ministry; Approved by relevant authorities. (semi structured Questionnaires, FGD guide, key informant guiding questions.) Where applicable, the tools will be translated into local languages. Study methodology approved

Data collection tools approved 10 days
Supervisors identified and trained
10 supervisors (to be deployed in the 10 study locations) identified and trained.
(These are from SSNBS, MOH/NMCP, States and from Administrative Areas). Training module for the supervisors developed and approved
A five-day supervisors TOT training conducted 5 days
Field interviewers identified and trained 40 Field interviewers identified and trained for 5 days. (The training will be at state level in 7 selected states plus 3 Administrative Areas.)
The data collectors deployed to specific counties within the states to collect data. Training module for the supervisors developed and approved
A five-day supervisors TOT training conducted
Data collected from the counties 25 days
*To be discussed at inception
10 data clerks identified and trained 10 Data clerks hired and trained for 5 days on data cleaning
Data clerks support data cleaning Training module for the data clerks developed and approved
A five-day training for data clerks conducted
Data clerks clean up the information collected by data collectors 5
Report writing consultants hired and working One international consultant and one National Consultant recruited to support with report writing

5. APPLICATION PROCESS:
Each proposal will be assessed first on its technical merits and subsequently on its price. In making the final decision, UNICEF considers both technical and financial aspects. The Evaluation Team first reviews the technical aspects of the offer, followed by review of the financial offer of the technically qualified applications. The proposal obtaining the highest overall score after adding the scores for the technical and financial proposals together, that offers the best value for money will be recommended for award of the contract.

PLEASE ENSURE TO SUBMIT THE TECHNICAL AND FINANCIAL PROPOSAL SEPARATELY
If financial information is found to be included in the technical proposal, the entire proposal will be disqualified.
Expression of interest must be submitted in in English

The Technical Proposal should include but not be limited to the following
• Cover letter
• Curriculum vitae of principal consultant (Where applicable, at most two of team members)
• Evidence of similar work/assignment by the consultant
• Two references with respective contact information
The Financial Proposal should include but not be limited to the following:
• Financial proposal (daily rate)

Education requirement and experience 

Master’s Degree or equivalent in social science, human rights, community development, international law, political science, or related fields.
Fluency in English is required.
Knowledge of United Nations policies and practices is an asset.

A minimum of 5 years of work experience in development research and/or Social research.
Excellent writing and analytical skills (in English).
Social scientist
Demonstrated expertise in qualitative research methods and approaches
Knowledge and experience in Human Centered Approach to community behavior change communication and engagement.
Prior experience with similar projects, with demonstrated ability to write clearly and accurately in an accessible style on community communication issues.
Analytical and conceptual thinking, communication, decisiveness, influence, networking, and technical knowledge.

 All applications Must be accompanied by a detailed technical and financial proposal.


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UNICEF's values of Care, Respect, Integrity, Trust, and Accountability (CRITA).

 

To view our competency framework, please visit here.

 

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.

 

Remarks:

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

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.

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. The candidate may also be subject to inoculation (vaccination) requirements, including against SARS-CoV-2 (Covid).

This vacancy is now closed.
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