Uganda: Technical support for scaling up the iCCM programme in Uganda

Project Assignment:

Technical support for scaling up the iCCM programme in Uganda with emphasis on the districts of Abim, Kiruhura, Lyantonde and Rakai and support for the continuity of the iCCM programme implementation in the eight central region districts of Wakiso, Mpigi, Butambala, Gomba, Masaka, Bukomansimbi, Kalungu and Lwengo.

Objectives

Overall objective: To contribute to reduction of under-five mortality and morbidity through implementation of integrated community case management of Malaria, Pneumonia and Diarrhoea in 12 districts in Uganda

Specific objectives:

To plan and carry out sensitization of the district and community leaders on iCCM programme in all the four districts of Abim, Kiruhura, Lyantonde and Rakai by August, 2014

To plan, coordinate, collaborate with, and provide technical support to, the DHOs /DHTs and facility based health workers to ensure that by Feb, 2015 capacity of VHTs is built for iCCM implementation in all the four new districts of Abim, Kiruhura, Lyantonde and Rakai

To provide technical support to DHOs/DHTs and health workers on supply quantification, ordering, distribution and ensuring appropriate utilization and accountability on a quarterly basis for the four new districts and eight central region districts with effect from Jan, 2015

To coordinate and collaborate with the DHOs/DHTs and participate in monitoring, supervision and incentivizing VHTs in quarterly VHT meetings for progress review starting Jan, 2015 for both the four new districts and the eight central region districts after the PCA with Malaria Consortium expires in Dec, 2014

Background

The iCCM strategy was launched in Uganda in 2010 in line with the Uganda Child Survival Strategy, Health Sector Strategic Investment Plan (HSSIP) and Village Health Team (VHT) Strategy. To date, the iCCM programme has been rolled out in a total of 34 districts of which UNICEF is supporting 15 mainly in Karamoja, Central, Western and South-Western regions.

The purpose of the iCCM program is to bring lifesaving treatment to the household level to ensure children under five suffering from malaria, diarrhea and pneumonia receive treatment within 24 hours of onset of the illness to promptly effect cure and or avert/reduce complications. Malaria, diarrhea and pneumonia are jointly responsible for up to 56%[1] of the causes of deaths of children under five years of age. Besides loss of lives, the three major childhood killer diseases also do cause significant economic loss

The evaluation of the ICCM programme after two years of implementation in eight of the UNICEF supported districts showed a 5% reduction in under five mortality compared to 7% increase in mortality in the comparison districts. The VHTs improved access to treatment for the pneumonia, diarrhoea and malaria from 44% before the ICCM programme began to 73%. Care seeking behaviour was also significantly improved by the programme from 59% to 81% of caregivers of sick children seeking care in time[1]. During the year 2013, the proportion of malaria, diarrhoea and pneumonia cases among the children under five who received timely and appropriate treatment in 14 UNICEF supported districts was 66% and this surpassed the 60% target[2].

Further local evidence of the benefits of the iCCM programme shows that there is increased demand for iCCM, reduction of OPD and in-patient admissions of U5s for malaria, pneumonia and diarrhea, reduced workload at health facilities and positive testimonies from caregivers seeking treatment from VHTs for their U5 children[3].

UNICEF has signed MoU with DFID and will receive £7,583,595 grant (about 12m USD ) to scale up iCCM in 4 new districts (Abim, Kiruhura, Lynatonde, Rakai) and consolidate implementation in 14 districts (the 8 central region and 6 Karamoja districts) for the next three years, 2014–2017. Rolling out iCCM in the new districts entails planning with district and lower level local governments, district and community sensitizations, training VHTs in basic package and iCCM, refresher training of health workers in IMCI and orienting them in iCCM programme, and ensuring commodities are distributed to the VHTs for implementation and thereafter embark on monitoring including end-users monitoring, supervision, data analysis and reporting. Executing these roles requires much more time at district and community levels, and this cannot be adequately covered in the routine staff roles and responsibilities. It is therefore essential that UNICEF hires a consultant to provide technical support to roll out iCCM in the new districts, and further more support continuity of implementation of the iCCM programme in the 8 in central region districts currently implementing the programme. The consultant’s support to the eight central region districts will commence in Jan, 2015 when PCA with Malaria Consortium will have expired in Dec, 2014.

Purpose of Assignment and Scope of work: Specific issues to be addressed, including expected boundaries of the assignment.

To provide technical support in rolling out iCCM in the districts of Abim, Kiruhura, Lyantonde and Rakai from July 2014 and with effect from January 2015 provide technical support to the eight central region districts to sustain implementation of the iCCM programme (Wakiso, Mpigi, Butambala, Gomba, Masaka, Bukomansimbi, Kalungu and Lwengo).

Deliverables:

Tasks

The consultant will:Plan, organize and orient the four district leaderships on VHT and iCCM programme; then plan with the respective DHOs/DHTs implementation schedules.

Collaborate with the DHOs/DHTs and MOH National iCCM Trainers in building capacity of the VHTs in basic VHT package and iCCM

Collaborate with DHOs/DHTs and participate in some of the district and community sensitizations to raise awareness and generate demand for the iCCM programme

Support the district and health workers in iCCM commodity quantification, ordering from UNICEF/NMS and ensure distribution to the VHTs in each facility catchment area

Coordinate with UNICEF Health Specialist -iCCM / Supervisor to plan, quantify and follow up procurement of iCCM commodities and logistics; prepares distribution list and ensure timely delivery of iCCM commodities to the four new districts and subsequently include all the 8 central region districts

Support implementation through monitoring and supervision of the district, health facility and community level activities

Collaborate with the DHOs/DHTs to establish a strong support supervision framework at district, HSD, S/C and community level defining clear roles and responsibilities for all the different players including DHT members, HSD team, health assistants, health unit in -charges, and peer supervisors

Coordinate with, and support the DHOs/DHTs, to ensure that district level monthly/quarterly VHT review meetings are conducted to review VHT performance by analyzing data, interpreting and sharing the information with stakeholders through DHIS2

Monitor funds utilization and accountability at district and community level for VHT roll out in the four districts and ensure value for money in all programme activity implementation

Overall, support the national scale up of the iCCM programme through capacity building (trainings, etc) and support continuity of implementation in the 8 central region districts and to some extent, participate in upstream activities

End Product/ deliverables

Four District Rreports on orientation showing number and cadres of district officials oriented on the VHT and iCCM programme. Availability of implementation schedules for the four districts of Abim Kiruhura, Lyantonde and Rakai.

Availability of Training reports from the four districts on Basic VHT package and iCCM

District and community level VHT and iCCM sensitization reports for all 12 districts

Monthly reports indicating availability of iCCM commodities with VHTs and stock outs reduced to less than 5%

Quarterly reports on iCCM commodities procured, distributed and delivered to the end-users at health facilities and community level (VHTs)

Monthly and quarterly supervision reports including VHT monthly performance review / meetings reports

Supervision Framework with clear roles and responsibilities available and being used for supervision at all levels in each district

Analyzed data showing VHT Performance in each of the four districts in treatment of Malaria, Pneumonia and Diarrhoea within 24 hours

Timely utilisation and accountability of the funds and to ensure no outstanding accountability with the four districts for more than 6 months

Quarterly Reports on the scale up of iCCM programme in any other new districts, reports on technical support to continuity of implementation in the 8 central region districts and various upstream activities

Supervision:

The Health Specialist–iCCM, based in Kampala, will provide oversight management of the programme and will be responsible for amongst others; planning with the consultant the implementation of the scale up activities, coordinate upstream activities with MOH and other national and sub-national stakeholders, ensures disbursement and accountability of funds, ensures commodities are quantified, ordered, received, distributed, accounted for and replenished; monitor activity implementation, approving consultant’s activity reports against TOR deliverables, reviewing and providing guidance on tools for the various parts of the overall assignment and updating Alive team and stakeholders on progress of the programme.

Reporting requirements:

The consultant will be required to submit monthly, quarterly and annual progress reports and minutes of meetings for activities conducted at community, district and national levels. The consultant will follow the UNICEF reporting format in Dev Trac when sharing information from the field for purposes of follow up by recommended UNICEFstaff. Using electronic or hard copies, the consultant will share the reports with stakeholders more especially with other Alive team members, DHOs/DHTs, VHTs, MOH-Child Health Division, etc.

Qualification Requirements:

The following are the basic minimum requirements: At least two years of progressively responsible experience in ICCM programming
Medical degree and experience in public health
Should command respect from district officials and should have experience in community based health programmes
Should have a good understanding of the power related dynamics at district and community levels
Should have good logic and analytical skills
Should have good writing and reporting skills
Should have the ability to work under pressure and meet tight deadlines.

The consultant will be provided with a contract of 11 months at NOB level. He/ She will be expected to spend at least 85% of his/her time working in the 4 new districts and the eight central region districts, while 15% of the time will be spent in Kampala for upstream activities with supervisor, MOH / Child Health Division and other stakeholders.

The consultant will be paid monthly salary through direct transfer to his/her account on condition that the deliverables are satisfactory and in line with the TOR.

Duty Station: UNICEF Kampala Head Office with frequent field travels to the 4 new districts and 8 central region districts.

To apply, send a letter of interest accompanied by P11, CV and two of your most recent performance evaluations to ugderecruit@unicef.org , by 30 June 2014.

· UNICEF is committed to gender equality in its mandate and its staff; qualified female candidates are strongly encouraged to apply.

· Applications will be considered only if accompanied by an updated CV and P11 form, as well as the most recent performance evaluation reports.

· If applications are sent by email, please clearly indicate the position applied for and use this order to name your file attachments: Firstname_Lastname followed by document e.g. Gold_MukasaP11 or Gold_MukasaCV or Gold_MukasaApplication.

· UNICEF is a smoke free environment.

· Only Short listed candidates will be contacted.