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Purpose of the consultancy

To provide support on introducing and scaling up safe and affordable surgery services (SAS), infection prevention and control (IPC), and on strengthening aspects of reproductive, maternal, newborn and child health (RMNCH).

Background

The consultant works with the Maternal and Child Health, and Quality Safety Unit of the WHO Regional Office for the Western Pacific (WHO WPRO) and Country Office focal staff, team leaders and WHO Representatives in priority countries (Cambodia, China, Lao PDR, Mongolia, Papua New Guinea, Philippines, Vanuatu, Viet Nam and up to 8 additional Pacific Island Countries (PICs)) on introducing and scaling up safe and affordable surgery services (SAS), infection prevention and control (IPC), and on strengthening aspects of reproductive, maternal, newborn and child health (RMNCH).

Safe and Affordable Surgery

The Action Framework for Safe and Affordable Surgery in the Western Pacific Region (2021–2030) was adopted by Member States at the seventy-first session of the Regional Committee for the Western Pacific in 2020. Cambodia, Fiji, Mongolia, and Vanuatu have conducted grounds-up surgical data reviews to identify key system gaps. Six-month safe surgery planning was supported by WHO WPRO in Cambodia, and Mongolia (April and May 2022), Vanuatu (November 2022) and Solomon Islands (September 2023). Fiji, Cambodia, Mongolia and Solomon Islands began bottom-up sterilization assessment and planning in 2022 and 2023 – with good progress towards improving sterilization systems and developing local facilitator teams to continue implementation and scale-up.

A SAS monitoring and evaluation framework was completed in 2023; and reviewed by national and district hospital staff in Cambodia in July 2023; this will form the basis for all ongoing program actions and will be introduced and adapted in other implementing countries in 2024. Multi-stakeholder hospital assessment and planning for SAS is scheduled in all early implementation countries in 2024 to collect baseline data, identify program priorities and plan actions. Kiribati, Samoa and Tonga have expressed interest in beginning sterilization assessment, planning and programme strengthening activities in 2024. Safe and Affordable Surgery is therefore beginning a phase of rapid scale-up that requires considerably more support than in previous years.

Infection prevention and control (IPC)

Infection Prevention and Control (IPC), as a cross-cutting and crucial component in healthcare provision, will be integrated into ongoing country implementation of SAS approaches, especially strengthening of sterilization services; improving practices around surgery to reduce rates of SSIs; and development of surveillance approaches for HAIs.

RMNCH

In response to the challenge of continued high rates of newborn mortality, the WHO Western Pacific Regional Office (WPRO) developed an Action Plan Towards Healthy Newborns in the Western Pacific Region (2014–2020). The Regional Action Plan outlines an approach for implementing and scaling up an Early Essential Newborn Care (EENC) package of interventions delivered to the mother and newborn between delivery and the first three days after birth. Implementation of EENC has focused in eight countries with the highest rates of newborn mortality (Cambodia, Lao PDR, Mongolia, Papua New Guinea, Philippines, Solomon Islands, Viet Nam) and the highest number of newborn deaths (China). A ninth country (Vanuatu) was added in 2019. WHO/WPRO is supporting improved quality and reach of EENC by improving routine health systems. Implementation and systems improvements for EENC (using EENC coaching and health the facility strengthening approach) are underway in all nine priority countries – in these countries emphasis on beginning EENC with Caesarean section and introduction of Kangaroo Mother Care (KMC) is needed. The next phase of implementation will in addition work to institutionalize hospital-based HMIS tracking of EENC indicators and tablet-based methods for collecting and aggregating EENC AIR data to improve accuracy and ease of data management; and to improve pre-service training and allocation of midwives to ensure that skills match job requirements. A Regional Independent Review Group (IRG) meeting to validate progress with data, followed by the fourth Regional EENC country consultation, will be conducted in 2024 to review progress, identify strengths and weaknesses and identify directions for the future.

Deliverables

Output 1: Support sterilization facilitator training and licensing for further introduction and scale-up in implementing countries; conduct follow-up assessments for documenting progress; support the development of scale-up plans.
Deliverable 1.1: Report: country sterilization facilitator training completed– including team training, logistics, data support
Deliverable 1.2: Sterilization follow-up assessments and development of country and MoH 6-12 month scale-up plan
Deliverable 1.3: Sterilization assessment and planning guidelines – final draft

Output 2: Support Hospital SAS assessment and planning in 4-6 countries
Deliverable 2.1: SAS hospital assessment and planning completed– including team training, logistics, data support
Deliverable 2.2: SAS hospital data analyzed, and written up as final report
Deliverable 2.3: Country and MoH 6-month action plans developed
Deliverable 2.4: SAS assessment and planning checklists, methods and guidelines sequentially updated after field tests

Output 3: Country support in the areas of SAS, IPC, RMNCH: policy and guideline development, clinical coaching, action planning, strategic planning, advocacy, review and strengthening of routine data systems, development of operational research protocols and support for implementation and scale-up; Fourth regional IRG review and Regional Progress Meeting.
Deliverable 3.1: Country policies, strategies, protocols, plans and guidelines reviewed with comments and references to support final documents, plans or strategies – as needed
Deliverable 3.2: Country annual or bi-annual action plans for SAS
Deliverable 3.3: IRG EENC data review: final schedule, data synthesis and summary report
Deliverable 3.4: EENC Fourth Biennial Regional Country progress review – final schedule, meeting format, summary report

Output 4: Finalize SAS assessment and planning approaches for sterilization and general quality of care after sequential test-revise cycles; finalize sterilization clinical coaching guidelines; review, edit and assist with method development – IPC OPD, IPD, ICU and HAI methods and tools.
Deliverable 4.1: Making hospitals safe: sterilization services – write/edit/revise/finalize drafts after each country field-test – final version completed
Deliverable 4.2: Making hospitals safe: Facility SAS assessment and planning – – write/edit/revise/finalize drafts after each country field-test
Deliverable 4.3: Making hospitals safe: clinical coaching for sterilization processing
Deliverable 4.4: Draft diabetes and diabetic foot screening and management coaching checklists and methods
Deliverable 4.5: Reviewed and edited IPC OPD, IPD, ICU and HAI methods and tools

Output 5: Generate implementation research articles/technical reports on SAS and RMNCAH in the region and in selected countries
Deliverable 5.1: Sterilization journal article – Regional progress 4 countries
Deliverable 5.2: SAS early implementation and testing of assessment and planning methods – 1 country
Deliverable 5.3: Communication pieces, technical reports SAS/sterilization

Qualifications, experience, skills and knowledge, and languages

QUALIFICATIONS

Essential: Advanced university degree in medicine, nursing, midwifery or public health.

EXPERIENCE

Essential: At least 11 years of experience in developing country settings and at least 15 years of practical experience supporting country and health facility level planning, implementation, scale up, monitoring and evaluation of newborn health programmes

Desirable: Extensive working experience in the Western Pacific Region, including experience in the eight priority countries: Cambodia, China, Lao PDR, Mongolia, Papua New Guinea, Philippines, Solomon Islands, Viet Nam.
Experience with SAS programming

TECHNICAL SKILLS & KNOWLEDGE

Expertise in the gathering, analysis and use of epidemiological data – particularly in the area of maternal, child and newborn health; and health systems/sterilization/SAS.
Knowledge and field experience with assessment, review, planning of IPC and sterilization services or SAS clinical services or systems
High level technical skill in core areas such as programme planning, management, monitoring and evaluation
Experience in planning and facilitation of meetings and workshops; writing and development of tools, methods and guidelines; publications in RMNCH topic areas; and advocacy and discussions with senior country staff about programme financing, policy and advocacy

LANGUAGES

English language; expert level required for reading – writing – speaking

Location

Off-site support will be provided. Duty travel to WHO WPRO will be scheduled as required by the Maternal Child Health and Quality Safety (MCQ) Unit, and to countries when requested by WHO country offices and Ministries of Health.

Travel

The Consultant is expected to travel according to the itinerary and estimated schedule below:

Travel date(s): March, May, June, October 2024
Location: Cambodia, Fiji, Mongolia
Purpose: SAS facility assessment and planning field test, development of hospital and national plans, Sterilization facilitator coaching/training/licensing, monitoring and evaluation framework review, SAS facility assessment/planning field test, follow-up visits for sterilization and SAS action plans

Remuneration and budget

Remuneration: TBD

Expected duration of contract: 10 months, 1 March to 31 December 2024

Additional Information

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