Terms of Reference
Consultancy support to UNICEF: eHealth Strategies to strengthen Health Systems
Senior Consultant
- Background
In collaboration with GAVI and the WHO, UNICEF is looking to support the strengthening of health systems (HSS). The initial entry point has been the drive to improve effective management of vaccines (EVM). But the ways in which this can be done by utilizing innovative ICT solutions is now seen to be part of the broader HSS agenda, and in particular can and should be aligned with the efforts that WHO (and the ITU) have been making to support the development and delivery of national eHealth strategies.
UNICEF is responsible for providing technical assistance to certain countries-beneficiaries of the GAVI HSS funding. Amongst them is Nepal. In August 2014, UNICEF discussed with WHO their intention to run a workshop in Nepal that could align work on the GAVI HSS grant application with the use of ICT and the development of an eHealth strategy. The outcome of the workshop was the development of a plan that sees the EVM Improvement Plan, GAVI HSS and eHealth Strategy initiatives co-evolve within the framework of the NHSP III. UNICEF’s GAVI Business Plan 2015 outputs/deliverables for Nepal are:
- Functioning EVM secretariat is available to enhance EVM IP implementation through technical support,
- Assessment report and plan of action for vaccine supply chain are developed,
- Implementation support: Government logisticiansare skilled to conduct EVM self-assessment.
In Lao PDR,at the request of the MoH, UNICEF also ran an eHealth workshop in October 2014. In conjunction with plans to support links between LMIS and DHIS2, this has been followed up with providing support for the MoH’s eHealth team to develop a five-month plan for developing an eHealth strategy, to begin in March 2015. This strategy needs to be developed in conjunction with plans to improve comprehensive EVM processes in Lao PDR. UNICEF’s GAVI Business Plan 2015 outputs/deliverables for Lao PDR are:
- Quarterly summary reports documenting progress towards expansion of CCIS system, key findings from assessment. Training materials developed/refined,
- Quarterly documentation on progress made towards EVM IP against targets and timelines.
UNICEF now wishes to see the foundations already laid in Nepal and Lao PDR being built on. This requires a programme of intensive work to support the country teams, both from the MoH and UNICEF (and their joint work with WHO). Experience after the initial workshops showed that monthly in-country support was needed to provide the necessary mentoring and momentum. The outcome of this first phase of the work is to learn the lessons for implementations that can be supported in a much larger number of other countries. The second phase of the work will then be to test the implementation of the guidance on the use of eHealth in support of Health Systems Strengthening for Immunisation, and to explore its relevance to other Health-related outcomes
In respect of all consultancy support, it is recognised that there will be time pressures and the need for flexibility. Nevertheless, what is set out below is a programme that should be adhered to as far as possible (yet adapted in the light of experience, in consultation with and on direction of respective Country and Regional Offices of UNICEF).
eHealth in support of Health Systems Strengthening (HSS) for Immunization Outcomes
The World Health Organization (WHO)has defined eHealth as “the use of information and communication technologies (ICT) for health“.
The WHO has also defined HSS as (i) the process of identifying and implementing the changes in policy and practice in a country’s health system such that the country can respond better to its health and health system challenges, and (ii) any array of initiatives and strategies that improves one or more of the functions of the health system, leading to better health through improvements in access, coverage, quality, or efficiency.
In an effort to strengthen Routine Immunization and Equity & Coverage, in close coordination with WHO, UNICEF is leveraging the HSS framework to:
a)Identify systemic bottlenecks through comprehensive Effective Vaccine Management (cEVM).
b)Address these systemic bottlenecks through comprehensive systems Improvement Plans (cIP) linked to GAVI HSS funding, paving the way to better immunization outcomes, increased vaccination coverage, and more equitable access to immunization.
Consultancy is needed firstly both to provide in-country support (to Lao PDR and Nepal) for these HSS for Immunisation Outcomes in general, and to supplement this with support on eHealth strategy development in particular. And then, secondly, to use the revised global guidance for the benefit of a larger number of countries.
- Purpose:
The purpose of the first stage of this programme of work is to show both how national level strategic plans and policies, in particular concerning eHealth, can be formulated, and how support for cEVM and LMIS can best be related to the use of key information systems and standards, such as DHIS2, and to focus on the use of ICT to engage CHWs and communities in information systems that promote accountability and responsiveness for immunization services.
The second stage is to take the lessons learned and support a larger number of other countries with guidance that delivers improvements in their GAVI/HSS plans as well as explore the relevance of the approach to other areas, such as MCH, nutrition, education, etc.
- Objective of this Consultancy
The primary objective of the first stage of this consultancy is to provide strategic guidance, technical support, and to facilitate the change process on behalf of UNICEF and WHO in support of (initially) two countries, Nepal and Lao PDR,toguide them to co-evolve their plans to develop their eHealth strategies and strengthen their health systems for immunisation outcomes.
There are four sub-objectives:
- Provide in-country and remote technical and mentoring support and best practice sharing in the development of eHealth strategies and DHSS
- Contribute expertise and guidance to the development of immunization supply chain management information systems, to inform their design in the context of eHealth and DHSS synergies
- Share lessons learnt via publication of co-authored article(s)
- Contribute to the global perspective on developing the collaborations between UNICEF, WHO, the GAVI Secretariat and those countries concerned with developing their strategies for HSS.
The primary objective of the second stage is to take the lessons learned and use them to meet the following sub-objectives:
- Test over a period of six months the applicability of the guidelines to support demonstrable improvements in the cEVM + key elements of eHealth strategy development process in six countries
- Explore refinements of the process in Lao PDR and Nepal, in particular concerning:
- Human capacity building and eLearning
- Community outreach support and monitoring for MNCH, nutrition and education
eHealth/HSSConsultant:
Stage 1
- Ensure Ministerial and CO endorsement (with WHO and UNICEF) of the approach proposed as required
- Support, via workshops and mentoring, the engagement with key stakeholders to inform the development of the eHealth strategy. This is to include:
- MoH policy
- Other Government Departments
- Development Partners
- District and Community level staff
- Infrastructure and ICT services suppliers
- Facilitate synthesis of findings and the development and refinement of:
- Vision for eHealth
- Associated Action Plans
- Specific proposals for 2016
- Integrated Action Plans for 2016-2020
- Assist Country Teams to improve:
- cEVM assessments and associated IPs
- Develop the linkages to information and ICT standards
- Advise on steps to integrate CCIS solutions with other vertical MIS, eg DHIS2
- Align activities with global guidance and support available throgh UNICEF HQ regarding information systems issues
- Facilitate in-country solutions with University of Oslo for DHIS2
- Develop use of ICT to enable community engagement with immunisation outreach programmes
- Use of mobile technologies to facilitate
- Record of EPI outreach services
- Reporting of health outbreaks, e.g. measles
- Training and Recording of good practice
- Produce reports and guidance
- eHealth strategy development, in conjunction with MoH and others supporting the process
- guidance documentation on eHealth in support of HSS for immunization outcomes for use by other countries
- guidance documentation to UNICEF country programmes on the operationalization and long-term sustainability of work in eHealth
Stage 2
- Replicate and test the guidance in 6 countries. This may require 2 visits each (though these should also be capable of being developed with input from another consultant if required because of time conflicts).
- On-going work in Lao PDR and Nepal to explore:
- the relationships between the existing programmes and relevant capacity building initiatives for HSS, in particular where eLearning may be required
- Community outreach support and monitoring for MCH, nutrition and education.
- Facilitate the development of support networks between countries engaged in the process.
- Produce summary reports and proposals for next steps.
- Duration: Start date: 1 April 2015End date: 28 February 2016
- Duty station: Consultant will work remotely, however, needs to travel periodically as indicated above.
6. Timeframe:218 working days
Deliverables / Duration(Estimated # of days) / Deadline
Material developed on the links between EVM, HSS and eHealth for inclusion of eHealth in HSS Guidance / 11 days / By end April 2015
Nepal – eHealth Strategy Stakeholder consultations held and findings/conclusions agreed with MoH team / 5 days / By end April 2015
Briefing note and consultation with UNICEF Regional Office for South Asia - ROSA (in Kathmandu) and UNICEF Regional Office for East Asia and Pacific -EAPRO (in Bangkok) including recommendations on lessons learned and next steps at the regional level. / 10 days / By end June 2015
Internal paper for UNICEF to seek support for extending eHealth for EPI work to other areas (e.g. Health (DHIS2); MCH, nutrition, education ) and assess its merits for enabling realtime accountability and responsiveness and also community engagement. / 11 days / By end June 2015
Lao PDR eHealth Strategy Stakeholder consultations held and findings/conclusions agreed with MoH team. / 10 days / By end June 2015
Nepal – eHealth strategy, and associated Action Plan completed / 8 days / By end July 2015
Lao PDR – eHealth strategy, and associated Action Plan completed / 7 days / By end July 2015
Lao PDR - Support for cEVM and associated bottleneck analyses. DHIS2-30DTR resolution; DHIS2-Birth Registration / 11 days / By end August 2015
Nepal - Support for cEVM: liaison within context of NHSPIII (including GAVI HSS) with other vertical information systems, e.g. DHIS2, HR, eLearning. / 11 days / By end August 2015
Lao PDR - realtime reporting by Village Chiefs on delivery (initially) of outreach EPI services / 6 days / By end August 2015
Nepal – assessment report of realtime community engagement in communities involved with VaxTrac / 6 days / By end August 2015
Co-authored paper on the eHealth Strategy development process with learnings from Nepal and Lao PDR / 12 days / By end August 2015
Development of guidance documentation for eHealth in support of HSS for immunization outcomes / 20 days / By end September
Document overall outcome of the programme and review potential requirements with UNICEF HQ with / 10 days / End January 2016
Support 6 countries (2 visits each) to develop their eHealth for HSS for Immunisation Outcomes strategies, and prepare summary reports / 50 days / End February 2016
Support Nepal and Lao PDR (2 visits each) to develop their current programmes in particular the relationships between HSS and Immunisation with respect to
a)Human capacity building and eLearning
b) Community outreach support and monitoring for MCH, nutrition and education / 30 days / End February 2016
Trip Report provided after each country visit and final summary report of activities undertaken. / --
TOTAL / 218 Days
7.Key competences, technical background, and experience required
The successful candidate shall meet the following minimum requirements:
Competencies
- Proven track record of thought leadership in eHealth
- Strong analytical, oral & written communication skills
- Proven track record in building and influencing complex multi-stakeholder partnerships
- Proven track record in project management
- Demonstrated ability to work in a multi-cultural environment
Technical skills and knowledge
- PhD level education in public health or related field
- Proficiency in public health systems strengthening, and expert knowledge of public health programs a requirement
- Proficiency in use of WHO/ITU toolkit on eHealth Strategies an advantage
- Proficiency in the use of the Microsoft Office applications including Excel, Word and PowerPoint
Work experience
The Senior Consultant is expected to be seasoned players in the field of eHealth and HSS.
- At least 15 years of relevant professional experience including a combination of senior information policy positions in a national department of health as well as positions in international health services programme management
- Extensive experience of working with Ministers of Health
- Proven wide-ranging expertise in strategic planning in multi-stakeholder settings
- Experience in writing large and complex proposals
- Extensive knowledge of global health trends and GAVI HSS requirements
- Experience in training, planning and delivery of technical assistance
- Understanding of the EVM process an advantage
- Experience of private sector perspectives on eHealth an advantage
Languages
- Written and spoken fluency in English
How to Apply:
Qualified candidates are requested to submit a daily rate, cover letter, a CV and P 11 form (which can be downloaded from our website at with subject line “Senior Consultant - eHealth Strategies to strengthen Health Systems “, by February 20th, 2015, 5:00 PM EST.
Please indicate your ability, and daily/monthly rate and availability to undertake the terms of reference above. Applications submitted without a daily/monthly rate will not be considered.
General Conditionsof Contracts for the Services of Consultants / Individual Contractors
1. Legal Status
The individual engaged by UNICEF under this contract as a consultant or individual contractors (the “Contractor”) is engaged in a personal capacity and not as representatives of a Government or of any other entity external to the United Nations. The Contractor is neither a "staff member" under the Staff Regulations of the United Nations and UNICEF policies and procedures nor an "official" for the purpose of the Convention on the Privileges and Immunities of the United Nations, 1946. The Contractor may, however, be afforded the status of "Experts on Mission" in the sense of Section 22 of Article VI of the Convention and the Contractor is required by UNICEF to travel in order to fulfill the requirements of this contract, the Contractor may be issued a United Nations Certificate in accordance with Section 26 of Article VII of the Convention.
2. Obligations
The Contractor shall complete the assignment set out in the Terms of Reference for this contract with due diligence, efficiency and economy, in accordance with generally accepted professional techniques and practices.
The Contractor must respect the impartiality and independence of UNICEF and the United Nations and in connection with this contract must neither seek nor accept instructions from anyone other than UNICEF. During the term of this contract the Contractor must refrain from any conduct that would adversely reflect on UNICEF or the United Nations and must not engage in any activity that is incompatible with the administrative instructions and policies and procedures of UNICEF. The Contractor must exercise the utmost discretion in all matters relating to this contract.
In particular, but without limiting the foregoing, the Contractor (a) will conduct him- or herself in a manner consistent with the Standards of Conduct in the International Civil Service; and (b) will comply with the administrative instructions and policies and procedures of UNICE relating to fraud and corruption; information disclosure; use of electronic communication assets; harassment, sexual harassment and abuse of authority; and the requirements set forth in the Secretary General's Bulletin on Special Measures for Protection from Sexual Exploitation and Sexual Abuse.
Unless otherwise authorized by the appropriate official in the office concerned, the Contractor must not communicate at any time to the media or to any institution, person, Government or other entity external to UNICEF any information that has not been made public and which has become known to the Contractor by reason of his or her association with UNICEF or the United Nations. The Contractor may not use such information without the written authorization of UNICEF, and shall under no circumstances use such information for his or her private advantage or that of others. These obligations do not lapse upon termination of this contact.
3. Title rights
UNICEF shall be entitled to all property rights, including but not limited to patents, copyrights and trademarks, with regard to material created by the Contractor which bears a direct relation to, or is made in order to perform, this contract. At the request of UNICEF, the Contractor shall assist in securing such property rights and transferring them to UNICEF in compliance with the requirements of the law governing such rights.
4. Travel
If UNICEF determines that the Contractor needs to travel in order to perform this contract, that travel shall be specified in the contract and the Contractor’s travel costs shall be set out in the contract, on the following basis:
(a)UNICEF will pay for travel in economy class via the most direct and economical route; provided however that in exceptional circumstances, such as for medical reasons, travel in business class may be approved by UNICEF on a case-by-case basis.
(b)UNICEF will reimburse the Contractor for out-of-pocket expenses associated with such travel by paying an amount equivalent to the daily subsistence allowance that would be paid to staff members undertaking similar travel for official purposes.
5. Statement of good health
Before commencing work, the Contractor must deliver to UNICEF a certified self-statement of good health and to take full responsibility for the accuracy of that statement. In addition, the Contractor must include in this statement of good health (a) confirmation that he or she has been informed regarding inoculations required for him or her to receive, at his or her own cost and from his or her own medical practitioner or other party, for travel to the country or countries to which travel is authorized; and (b) a statement he or she is covered by medical/health insurance and that, if required to travel beyond commuting distance from his or her usual place or residence to UNICEF (other than to duty station(s) with hardship ratings “H” and “A”, a list of which has been provided to the Contractor) the Contractor’s medical/health insurance covers medical evacuations. The Contractor will be responsible for assuming all costs that may be occurred in relation to the statement of good health.