TERMS OF REFERENCE FOR INDIVIDUAL CONTRACTORS/ CONSULTANTS/ SSAs PART I Title of Assignment To provide support to the evidence based scale up of the 3 feet work across select provinces and linking the SDGs with the national strategies and target setting for the next five to ten year plans Section Health and Nutrition Location Pretoria not office based Duration 10 days per month for a period of 12 months Start date From: 01/03/2016 To: 28/02/2017 Background and Justification The National MNCWH&N strategy 2012-2016 and South Africa s response to the Campaign for Accelerated Reduction in Maternal and Child Mortality outline key strategies and targets for the country. There have been substantial strides made in addressing maternal and child health outcomes over the last few years and efforts have likely contributed to increased life expectancy, but more still needs to be done to reduce avoidable causes of death of mothers and children. Building on the Millennium Development Goals that were adopted in 2000, at the United Nations Sustainable Development Summit on 25 September 2015, world leaders adopted the 2030 Agenda for Sustainable Development that include 17 Sustainable Development Goals (SDGs) and 169 targets. The SDG on health addresses the risks children face, from under-five mortality to non-communicable diseases while supporting strengthening of country health systems and social safety nets. The Nutrition goal calls for an end to malnutrition, which threatens the lives of children and undermines health and physical growth and education. Universal and equitable access for water and sanitation goal underscores a special focus on women, girls and vulnerable people. South Africa has adopted these SDGs and is committed to continue the scale up of the specific interventions to reduce maternal, neonatal and child mortality as outlined in the Countdown report for MDGs 4 and 5 in 2014. Concurrently, the Call to Action - 3 feet model implemented in select districts in the country (Nelson Mandela Metro, Gert Sibande, Waterberg and O R Tambo), is supporting the operationalization of the recommendations of the maternal, newborn, women and child health and nutrition programmes midterm review and the implementation of the countdown interventions is facilitating the strengthening of the district health system by setting up monitoring and response units as well as facility level dashboards to support target setting and accountability, enhancing the provision of basic infrastructure and equipment, and generating synergies between different stakeholders through the development of information streams and cascades of referrals. The process is also being linked with the 90-90-90 roll out for HIV and TB and involves working closely with the provincial and district managers, District Clinical Specialist Teams and partners supporting the process of the program design, facilitating consultations, documentation as well as providing an oversight to the progress across these four districts. For SDGs and the 90-90-90 goals to be realized by 2030, as well as specific improvements in maternal, newborn and child health indicators, attention will have to be given to strengthening the weak health-system 1
performance, improving investment in the health sector, maximizing use of existing resources and strengthening monitoring and evaluation capabilities. Sequential MNCWH national, provincial and district 5-year targets leading to 2030 will need to be aligned closely with the SDG commitments and these must translate into health facility targets and be fully aligned to the 3 feet work. UNICEF is a lead technical partner working closely with the National department of health and the respective provincial departments and district management teams towards supporting the roll out of the decentralized evidence based program action for results related to maternal and child health and nutrition programs, and the HIV/AIDS and TB program. It is proposed to hire a consultant to support the above working closely with the national working group on the 3 feet work and the respective provinces and district teams and partners, towards strengthening the district health systems to address maternal, neonatal and child health priorities aligned closely with the 3 feet scale up. Scope of Work Goal and Objective: Under the supervision of the Chief of Health and Nutrition, the consultant will build on the ongoing 3 feet work in 4 districts and support the district health systems strengthening process towards improving maternal, newborn and child health outcomes. There is specific focus on alignment with the SDGs and the scale up process of the 3 feet work in select provinces across all districts. The initial focus will be for scale up across 2 provinces in the country (to be selected based on consultations with the NDoH and the provinces). 1) Provide details/reference to AWP areas covered: The assignment aligns with output 5 of the AWP. The Call to Action - 3 feet model is being implemented in select districts in the country (Nelson Mandela Metro, Gert Sibande, Waterberg and O R Tambo). For SDGs and the 90-90-90 goals to be realized by 2030, as well as specific improvements in maternal, newborn and child health indicators, attention will have to be given to strengthening the weak health-system performance, improving investment in the health sector, maximizing use of existing resources and strengthening monitoring and evaluation capabilities. Sequential MNCWH national, provincial and district 5-year targets leading to 2030 will need to be aligned closely with the SDG commitments and these must translate into health facility targets and be fully aligned to the 3 feet work. 2) Activities and Tasks: The specific tasks are: 1. Develop and finalize a scale up plan including a monitoring mechanism to track progress with implementation for the provincial and district scale up of the 3 feet work incorporating all components the MRU and facility dashboards 2. Review and explore the integration of the community component in the 3 feet work 3. Support districts and the province to set up functioning monitoring systems towards regular tracking of progress and actions linked or improving existing systems for improving maternal, newborn and child health outcomes including nutrition 4. Support review of targets and goal setting in alignment with the SDGs working closely with the national and provincial departments of health 5. Support the linkage of the 3 feet work with the finalization of the District health plans and the district health expenditure reviews in the 3 feet districts 6. Support the documentation of best practices and lessons learned working closely with the agency and persons involved in documentation including the identification of these practices. 7. Explore the possibility of setting up a national reference group on public health implementation science support to district and provincial managers linking academics in public health with implementers to be done in close collaboration with the national working group at DoH. 2
8. Any other tasks linked with the district health systems strengthening for improved service delivery platforms as needed (as per discussions with supervisor) 3) Work relationships: The consultancy involves working closely with the national department of health, provincial and district managers, District Clinical Specialist Teams and partners supporting the process of the program design, facilitating consultations, documentation as well as providing an oversight to the progress across these four districts 4) Outputs/Deliverables: Deliverables Inception report with outline of plan for meeting the deliverables during the consultancy giving a baseline status for each district with regards to progress with 3 feet work Draft scale up plan for the 3 feet work available and shared with national and respective provinces and districts for review and feedback Report outlining the discussions and terms of reference for the national reference group on public health implementation science if set up and the process documentation in this regard Progress report outlining progress with scale up of the 3 feet work in at least 2 provinces and expansion to other districts within the province Report outlining the monitoring mechanisms set up at provincial and district level towards regular tracking of progress and actions for MNCH and nutrition Duration (Estimated # of days or months) Timeline/ Deadline Schedule of payment 1 month 1 month Month 1 2 month 2 months Month 2 3 months 3 months Month 3 4 months 4 months Month 4 5 months 5 months Month 5 Final scale up plan for the 3 week work available 6 months 6 months Month 6 Progress report outlining progress with scale up of the 3 feet work in at least 2 provinces and expansion to other districts within the province 7 months 7 months Month 7 Report on the integration of the community component of the 3 feet work with challenges and highlights, lessons learned and next steps included Documentation of reports outlining the process undertaken with key steps for the scale up of the 3 feet work Draft Report outlining the progress with target setting (draft) and the final agreed targets (5 years) set for the province, and respective districts aligned with the national and SDG targets Report outlining the linkage of the 3 feet work with the DHPs and the DHER processes Final report highlighting progress across all deliverables and progress with key monitoring indicators (Agreed mutually) with regards to Maternal and child health and nutrition in the 3 feet districts 8 months 8 months Month 8 9 months 9 months Month 9 10 months 10 months Month 10 11 months 11 months Month 11 12 months 12 months Month 12 3
Payment Schedule As outlined above linked with deliverables. Desired competencies, technical background and experience a) Education: An individual with any of the following - medical degree, masters degree in public health, social sciences, nursing and allied sciences b) Indicate the length of relevant work experience that is required in the technical area for this consultancy: a minimum of ten years experience in the public health sector. c) Competencies: The individual must have demonstrated ability and experience in supporting work related to health systems strengthening. Previous experience with specific health system strengthening with a focus on maternal, newborn and child health programmes is needed. An understanding of the South African health system, the different levels of health care service delivery, current policies and strategies, its challenges, as well as prior experience with developing, implementing and monitoring results driven frameworks for public health programs is required. Field experience with maternal, newborn, child health and nutrition programmes in South Africa with an understanding of field level challenges is an added advantage. Prior experience with working with the national department of health, provinces, districts and development partners will be an added advantage. An understanding or exposure to the 3 feet work in the 4 districts will be an added advantage. d) Languages needed: English. Working knowledge of the languages spoken in South Africa is an added advantage. Administrative issues Focal point: Chief of Health and Nutrition Conditions - The contractor will work on its own computer(s) and use its own office resources and materials in the execution of this assignment. The contractor s fee shall be inclusive of all office administrative costs - Local travel (outside Gauteng) and airport transfers (where applicable) will be covered in accordance with UNICEF s rules and tariffs. - Flight costs will be covered at economy class rate as per UNICEF policies. - Any air tickets for travel, will be authorized by and paid for by UNICEF directly, and will be for the attendance of meetings and workshops (if contractor is from outside Gauteng) - The candidate selected will be governed by and subject to UNICEF s General Terms and Conditions for individual contracts. - As per UNICEF DFAM policy, payment is made against approved deliverables. No advance payment is allowed unless in exceptional circumstances against bank guarantee, subject to a maximum of 30 per cent of the total contract value in cases where advance purchases, for example for supplies or travel, may be necessary Risks Risk: The provincial scale up plan is dependent on the commitment and support from the respective provincial management. Mitigation measures: discussions and agreement for scale up has already been done with the Limpopo and Eastern Cape provincial management and the national department of health. There is full support presently. UNICEF will continue to engage with the respective stakeholders for supporting the scale up 4
How to Apply Qualified candidates are requested to submit a cover letter, CV, and signed P11 form (which can be downloaded at http://www.unicef.org/about/employ/index_53129.html to safpretoriavacancy@unicef.org with subject line the 3 feet work across select provinces and linking the SDGs with the national strategies by 01 February 2016. Please indicate your ability, availability and rate (daily? Monthly?) to undertake the terms of reference above. Applications submitted without a fee/ rate will not be considered. 5