National Consultant – eMTCT Operational Plan in Rwanda
Kigali | Kigali
Position Title: National Consultant – eMTCT Operational Plan
Duration: 30 days
Start Date: Mid-June 2016
Reporting to: HIV and AIDS Specialist
1. Background and Purpose
The HIV prevalence in Rwanda has remained stable at 3% over the last ten years1. The principal mode of transmission of HIV in the general population is heterosexual intercourse and for children is vertical transmission from HIV infected mother to her child during pregnancy, child birth and breastfeeding period. Interventions for prevention of mother to child transmission (PMTCT) can reduce the risk of HIV infection in children. Since the launch of the national PMTCT Programme in 1999, embarked on a national scale up of PMTCT services by increasing access to HIV testing, antiretroviral drugs for pregnant women and HIV exposed infants. Following the global agenda to eliminate mother to child transmission of HIV and to keep mothers alive, Rwanda re-affirmed its commitment to the global agenda and developed a five year (2011-2015) national strategy for elimination of mother to child transmission of HIV (eMTCT) with the goal to reduce the rate of MTCT to less than 2%. To date, over 90% of the health facilities are offering PMTCT services, 93% of HIV infected pregnant women are utilizing the services and the MTCT rate by 18 months of aged has reduced to 1.8%.
An end term review of the eMTCT strategy for 2011-2015 has shown excellent level of implementation of the eMTCT strategy, so the observed programme coverage and impact is not a surprise. However, the review indicated that the implementation was not at the same level across the four outcome results areas and made recommendation tailored to address challenges:
Primary prevention of HIV - Gaps in accessing youth friendly services (knowledge and skills for positive behavior, HIV testing, medical male circumcision and condom use) at strategic entry points, limited routine program data for monitoring and evaluation of interventions for primary prevention other than national surveys like DHS, and low quality of HIV prevention services and limited mechanisms for linkages and referral between community based interventions and health facility for specialized HIV prevention services such as post-test. Prevention of unwanted pregnancy among HIV infected women - Low demand for utilization of modern family planning methods and challenges in reporting of indictors on FP among HIV infected women
Reducing vertical transmission from MTCT and HIV related deaths - Limited access to PMTCT service in private sectors and capacity of health care workers to deliver comprehensive HIV treatment and care services for HIV infected mothers and children at every step within the continuum of care and strengthen mechanisms for retention and adherence to treatment
Cross-cutting - Gaps in Programme coordination across the four prongs, monitoring and evaluation at national, subnational and community levels
According to spectrum estimates, approximately 10,000 HIV infected pregnant women are in need of interventions to prevent vertical transmission of HIV and over 450 new HIV infections through MTCT will occur in 2016 alone[i] if the current coverage and quality of PMTCT services remains the same. Primary prevention of HIV among young women of reproductive age and unmet family planning needs among HIV infected women have been identified as major’s challenges of the PMTCT programme. In addition, HIV infected mothers and HIV exposed children are lost to follow-up and are not receiving the range of services to achieve the desired impact. Furthermore, utilization of available PMTCT service is relatively low among vulnerable women including young women[ii] resulting in relatively higher MTCT rates. In order to reduce MTCT rate and work towards achieving eMTCT as per the WHO definition of less than 50 new case per 100,000 live births, RBC plans to develop operational plan for eMTCT to address challenge and key programmatic gaps that are an impediment to achieving eMTCT
To develop 2016-2018 eMTCT operational plan that is informed by analysis of the causes of the bottlenecks/barriers to achieving the set targets of main interventions for each of the outcome results, and outline priority activities to address the bottlenecks.
4. Methodological Approach and Expected Outputs
The consultant will conduct a desk review of Programme documents such as HIV national strategic plan 2013-2018, HIV national guidelines 2015, current national strategic plan for HIV EMTCT End term report, HIV annual report 2015 etc.; Will use the most recent validated national level data to determine baseline indicators on each of the EMTCT result outcomes. Barriers to achieving the desired coverage of key interventions will also be identified from the end term review report of the 2011-2015 eMTCT strategy and any other national documents. The consultant will then present the information to the national HIV prevention, care and treatment TWG as reference and work with them to set impact and outcome targets for 2018 and to discuss what needs to happen (determinants) to improving coverage and identify barriers/bottlenecks to be addressed in order to reach these targets. This information will then be presented to a larger stakeholders’ workshop to collectively discuss and agree on root causes of each of the barriers/bottlenecks and propose key corrective actions to effectively address them. In consultation with the TWG, the consultant will use the information obtained to develop output result statements, indicators and targets for 2016 and 2018 for each of the EMTCT outcomes, and develop a logical framework for 2016-2018. The consultant will consolidate the inputs and draft the operational plan and submit it to the TWG for inputs before validation by stakeholders.
5. Major Tasks, Deliverables, & Timeframe
1. Conduct a desk review to determine baselines indicators for impact, outcome and key interventions for each of the eMTCT outcomes Deliverables : Report comprised of latest baseline indictors for eMTCT, 30th May to 3rd June
- Using the eMTCT end term review report and any other resources, consolidate barriers/bottlenecks to improved uptake/coverage of key interventions for each eMTCT outcome results (categorize the barriers into enabling environment, supply, demand and quality)
Deliverable : consolidated barriers/bottlenecks for each outcome results, 6-9th June
- Convene a meeting with TWG members to determine impact, outcome results for eMTCT by end 2018, determine outcome level result gaps and validate the barriers and bottlenecks
Deliverable: Programme coverage gaps and barriers/bottlenecks identified and documented, 10th June
- In collaboration with TWG, service providers, community members and beneficiaries of PMTCT, conduct a causal analysis of the barriers/bottlenecks observed to improved uptake/coverage of key interventions, identify corrective actions for each intervention and the ideal platform for delivery of services.
Deliverable: Corrective actions to address identified bottlenecks and ideal platforms for delivery of interventions identified and documented, 13-20th June
5.In consultation with the TWG, use the identified corrective actions for each of the interventions and develop output statements, indicators and target to be achieved by 2018. Include activities on surveys for intervention indicators that do not have baselines.
- Through application of the principles of Result Based Management, develop a logical framework for the eMTCT operational plan
Deliverable: Logical framework for the eMTCT operational plan developed, 21st -27th June6. 7. Draft the eMTCT Operational Plan, share with the TWG for feedback and incorporate their feedback
Deliverable: Draft Operational plan submitted to TWG, 29th June to 5th July
Support RBC to convene a national stakeholder meeting to validate the eMTCT Operational Plan Deliverable: Report on stakeholders validation meeting, 6th July
Finalize the eMTCT Operational Plan
Deliverable: 2016-2018 eMTCT Operational Plan, 11th July
6. Stakeholder Participation
RBC, Districts, One UN, CSO, communities, service providers and PMTCT beneficiaries, adolescent mothers and Organizations of people living with HIV
7. Qualification and Requirements
Technical competence in eMTCT programming and understanding of the global, regional and national commitments related to the AIDS response in general and eMTCT in particular relating to selected country/region.
Essential: Advanced degree in medicine preferably with experience in public health, advanced university degree in Public health; social science; demography or statistics.
Essential: 5 years of experience at national and/or international level of progressively responsible experience in HIV programing especially PMTCT and Pediatric HIV
Proven experience in working with government and development partners, monitoring and evaluation or program review
Demonstrated ability to analyse and interpret programme data
Experience in developing technical reports and documents in the field of PMTCT and Pediatric
Proven writing skills + computer literacy
Fluency in English and/or French
The consultant will be supervised by UNICEF HIV and AIDS Specialist and will receive technical guidance technical team composed of representatives from RBC HIV Division, UNJTA team (UNICEF, UNAIDS, UNFPA, UNESCO and WHO) and USAIDS/PEPFER development partners
9. Terms and conditions
· The Consultant will quote for an all-inclusive lump sum in RWF
· Payment conditions: in case of field trips, the consultant will be reimbursed based on incurred out of pocket expenses associated with the travel and the subsistence allowance will be based on DSA prevailing UN rate. As a non-staff, the consultant will not be issued a Travel Auhorisation. The claim will be based on submitted voucher approved by supervisor.
· UNICEF reserves the right to withhold all or a portion of payment if performance is unsatisfactory, if work/outputs is incomplete, not delivered or for failure to meet deadlines
· All materials developed by the consultant will remain the copyright of UNICEF and that UNICEF will be free to adapt and modify them in future.
[i] 2014 spectrum projections
[ii] Rwanda PMTCT Impact Evaluation Study, 2012
Qualified individuals are requested to submit their cover letter, CV and P11 form (which can be downloaded from: http://www.unicef.org/about/employ/files/P11.doc), to Human Resources at: firstname.lastname@example.org by 27th May 2016, quoting the indicative all-inclusive fee range and the consultancy with subject: “**National consultancy** – eMTCT operational Plan.”
You may also submit to: Human Resources Specialist, UNICEF Rwanda, and P.O. Box 381, Kigali, Rwanda.
Please note that applications submitted without an all-inclusive fee/ rate will not be considered. Only shortlisted candidates will be contacted.
Financial proposal should provide a budget and timeline, using the table below:
Number of person days
Inception report - Detailing methodology and action plan for the consultancy
Interim Report 1 - Literature review, latest baseline indictors for eMTCT, consolidated barriers/bottlenecks for each outcome results
Interim Report 2 - Comprehensive report on Output statements, key interventions and targets, priority activities and platforms of delivery
Interim Report 3: Draft eMTCT operational plan with a logical framework
Final reports including a presentation: - eMTCT operational plan with a logical framework
- Organization: UNICEF - United Nations Children’s Fund
- Location: Kigali | Kigali
- Grade: Mid/Senior
- Closing Date: 2016-05-27