State RMNCHA - Maternal & New Born Care, Chennai, Tamil Nadu
1.1 The global movement ‘A Promise Renewed’ for Child Survival was launched in Washington almost a year ago, by UNICEF and USAID, to advance child survival in countries with the largest child mortality globally. India being one of the countries with the largest burden of Child Mortality, Government of India launched “Call To Action” for Child Survival and Development in early February 2013, calling every state in the country to set clear objectives for significant reduction in child mortality within a three year horizon to be able to reach the global targets (MDG 4: U5MR of 38).
Over a two decade period, the country also saw a 63 point decline in child mortality from 118 to 55, between 1990 and 2011. India has seen no polio cases in the past 2 years. However, the progress is not shared by everyone in the country. Despite India's impressive progress, disparities remain between States, within States, between districts and between different castes and religions with a particular disadvantaged situation for Scheduled Castes, Scheduled Tribes and Muslim communities.
GoI has elaborated a comprehensive RMNCH+A strategy (Reproductive, Maternal, Neonatal, Child Health + Adolescent Strategy) to guide action to accelerate reduction of maternal and child mortality, with focus on the most deprived population.
Call to Action envisages that all children in high priority districts will have full access to Water and Sanitation, Nutrition, HIV and Health Services.
Call to Action also prioritizes catalysing and ensuring improved Household Practices to increase uptake of the above services. A key thrust would be around changing social norms and social practices, empowering the most at risk communities to realize their right to quality services and practices.
Call to action envisions three continuum of care themes for action:
• Along the life cycle- Adolescents, Mother, Neonate and Child.
• Community- Outreach-Facility Continuum
• Continuum of Care- (Promotive-Preventive- Curative Interventions)
According to SRS 2010 data Tamil Nadu has Under five mortality rate of 27 , while the Maternal Mortality Ratio is at 97 per 100,000 live births and Infant Mortality Rate is at 21 per 1000 live births as per SRS 2012 data. It is important to understand Child Survival components are dependent on the Infant and Neo Natal Mortality as well as Maternal mortality.
Tamil Nadu and Kerala have shown considerable progress in the key Maternal, infant, newborn and child mortality indicators compared to other high focus states in India. However, there are disparities within the states with the presence of back ward tribal blocks and poor performing districts. ; For instance as per Vital Events survey 2008 TN and DLHS 3- the IMR is as low as 7 per 1000 live births in Erode and 27.5 per 1000 live births in Kanyakumari. Similarly MMR is as low as 42 and 149 per 100,000 live births in Perambalur.
There is a need to further bring down the neo natal and perinatal mortality rates by improving quality and coverage of services to most deprived populations and addressing tribal and back ward blocks.
In Tamil Nadu and Kerala, 10 districts have been identified as High Priority Districts under Call To Action.
The 7 High priority districts in Tamil Nadu are: Krishnagiri, Madurai, Vellore, Tiruchirappalli, Thirunelveli, Thiruvannamalai and Virudhunager.
At RMNCHA state launch held on 22nd November 2013 the trifurcated districts of Trichy- Ariyalur and Perambalur have also been added as they meet the criteria of HPDs.
These districts have been selected based on key indicators from the National Child Survival Score Card, Health Management Information System (HMIS) data on maternal, infant, neonatal, and Under five mortality, performance of key antenatal, Intrapartum and post natal, family planning and adolescent health and nutrition services for Maternal and Child Health (MCH) Care and presence of blocks with hard to reach areas, most vulnerable populations and pockets of multiple deprivation in terms of access, coverage of services and quality of services.
1.2 Ministry of Health and Family Welfare (MOHFW), Government of India (GOI) has developed the Strategy document for Reproductive Maternal New Born Child Health plus Adolescent (RMNCH+A). Under Call to Action the states need to ensure the implementation of RMNCH+A strategy across the state with focus on the Key high Priority districts. UNICEF is responsible as a lead partner to provide technical assistance to 81 high priority districts in 10 states in the country. UNICEF office for Tamil Nadu and Kerala is the lead partner to provide technical assistance to the 10 High priority districts in the states. Furthermore MOHFW has provided the states with detailed guidance notes on following key steps for the state to ensure the implementation of the RMNCHA strategy in the high priority districts. These include:
i. Development of State and District RMNCHA Unit(SRU)
ii. Development of State Unified Team (SUT) including participation from Academia, Development Partners and State and district counterparts.
iii. Conducting District Level Gap Analysis in all High Priority Districts (HPDs).
iv. Developing District profiles and identifying high priority blocks.
v. Conducting quarterly block monitoring and supportive supervision for key MCH care services at facility and community level.
vi. Developing district and block level score cards based on HMIS data on a quarterly basis.
vii. Fostering intersectoral convergence under the leadership of district collector to achieve key indicators for the districts and blocks for Health, Nutrition, HIV and Water and Sanitation programmes.
viii. Identifying and fostering partnerships with Development partners active in the state to be part of State and district monitoring units.
1.3 UNICEF Office for Tamil Nadu and Kerala provides Technical Assistance to the governments of Tamil Nadu and Kerala in various sectors to improve the quality of life of children in the two states. The Health RWP 2013-14 reflects TA to the governments for MNCH continuum of care, specifically under the Call to Action Agenda for Child Survival. This includes supporting the state in conducting District and Block Level Gap Analysis, Block monitoring visits, developing district level profiles and HMIS based score cards.
1.4 As part of the Rolling Work Plan 2013 and commitment to Government of India, Health Section UNICEF India Country office New Delhi has approved the recruitment of State and District Level Consultants to monitor the progress of RMNCHA implementation where UNICEF is the Lead partner as per email from Mr. David Mcloughlin Deputy Director Programmes –UNICEF dated 24th October 2013 (Annexed).
1.5: With the above background in mind UNICEF office for Tamil Nadu will be recruiting a consultant for Maternal and New Born Care including Routine Immunization for the state of Tamil Nadu to monitor progress under RMNCHA strategy in the 7 high priority districts in Tamil Nadu.
2. Duty Station & Travel involved:
a. State Level Consultant – Maternal New Born Health including Routine Immunization.
b. To be recruited in the State RMNCHA Unit (SRU) to be set up at NRHM/DPH Chennai, Tamil Nadu and jointly monitored by UNICEF and NRHM
Travel for State consultant within the state of Tamil Nadu to the 7 High Priority Districts (HPDs) of Madurai, Krishnagiri, Vellore, Virudhunager, Thirunelveli, Thiruvannamalai and Tiruchirappalli (including Ariyalur and Perambalur) to monitor RMNCHA implementation in 7 HPDs of Tamil Nadu.
3. Supervisor: Health Specialist UNICEF office for Tamil Nadu & Kerala located at Chennai (for technical issue of Health & Nutrition) and PCR 1 Manager/ Chief of office UNICEF Chennai. To be jointly monitored by UNICEF and NRHM.
4. Basic Project Objectives:
The consultancy will support the following at the state level and High Priority Districts (HPDs) under RMNCHA with focus on maternal and new born care and Routine Immunization.
• Coordinate with UNICEF, NRHM, DPH/ DHS in Tamil Nadu and other development partners to organise and document the quarterly meetings for State RMNCHA Unit (SRU) and State Unified Team (SUT) in Kerala under leadership of NRHM and UNICEF for state level Facility and Community based Maternal, New Born health interventions including Routine Immunization.
• To develop state and district level score cards and profiles on a quarterly basis using State using state Health Management Information System (HMIS) and Pregnancy Infant cohort Monitoring and Evaluation (PICME) data in coordination with all key stakeholders with focus on maternal, new born health and Routine Immunization interventions.
• To facilitate and develop need based and capacity building at district and block level for RMNCHA guidelines with focus on Maternal, Newborn care including Routine Immunization in 7 High Priority Districts.
• Facilitate the facility & community level gaps analysis in collaboration with NRHM, DPH and civil society partners based on GOI guidance to identify key gaps in the Maternal, newborn and routine Immunization interventions in 7 High Priority Districts (HPDs).
• To conduct Gap analysis, in 7 HPDs to understand the situation of facility and community based maternal and new born care including Routine Immunization including Maternal Death Review (MDR), Infant Death Review (IDR) and Perinatal death reviews, RI coverage, monitoring of Adverse Effects following Immunization (AEFI) and Cold Chain Monitoring and Supportive supervision.
• To coordinate with UNICEF, DPH/NRHM and district level consultants for conducting district and block monitoring of Maternal, Newborn and RI interventions including Maternal Death Reviews (MDRs), Infant Death Reviews (IDR) and Perinatal death audits, Cold Chain Monitoring, AEFI monitoring, surveillance of vector borne diseases and RI coverage in 7 HPDs.
• Develop need and evidence based block and district specific action plans based on Gap analysis findings to strengthen Facility and community based maternal new born care interventions including routine Immunization in 7 HPDs.
• To support the state for implementation of evidence based maternal and newborn care interventions including RI across the continuum of care for improved maternal and infant survival in 7 HPDs under RMNCHA.
• To improve quality of Facility based; Antenatal, Intrapartum Perinatal and Post -Partum care based on MNH standard guidelines and tools of GOI for improving maternal and infant survival in 7 HPDs.
• To conduct desk review and develop evidence based strategies of IDR and MDR data and generate evidence on still births, Low birth weights, Respiratory distress and neonatal sepsis, pre-maturity and congenital defects in 7 HPDs of TN.
• To advocate for evidence based block / district specific action plans to be incorporated in to the NRHM state Programme Implementation Plan (PIP) based on key evidence generated during gap analysis for Maternal, New Born Health including Routine Immunization.
• To conduct quarterly monitoring and supportive supervision for improved facility based care in New-Born Care Corners (NBCC), New Born Stabilisation Units (NBSU) and Specialised New Born Care Units (SNCUs) in 7 HPDs.
• To develop capacity of 7 HPDs to pilot and upscale the tracking and monitoring of new-borns post discharge through Home and community based new born care.
• To monitor the implementation of Facility and community based Integrated Management of Childhood Illnesses (IMNCI ) and support the pilot and upscale of HIV IMNCI plus in 7 HPDs
• To coordinate and engage with private sector and civil society partners in the 7 HPDs like IAP, IMA, FOGSI, health NGOs as well as departments of Nutrition , HIV and WASH for integrated action on improved maternal and infant survival through various programme interventions.
5. Major tasks to be accomplished- in line with the above:
Facilitate dissemination of RMNCH+A strategy, gap analysis and block monitoring guidelines at the state/ district level with focus on Maternal, new born care including Routine Immunization in HPDs.
To conduct district level gap analysis, strengthen supportive supervision and block monitoring of facility and community based Maternal, new-born and Routine Immunization interventions in 7 HPDs.
To foster convergence and linkages for key RMNCHA interventions between Health, HIV Nutrition and WASH programmes across the continuum of care in 7 HPDs for improved maternal and new born survival.
To provide a monthly & quarterly State RMNCHA Unit (SRU) and State Unified Team (SUT) meeting reports and key recommendations for improved maternal and new born care including Routine Immunization on a quarterly basis.
To coordinate with other development partners, stakeholders like Panchayati raj institutions, tribal welfare, CSOs, international and local NGOs, private sector IAP, IMA, FOGSI and ICDS working at state and in 7 HPDs for improved maternal and new born survival and RI coverage in consultation with UNICEF.
To conduct facility and community monitoring visits to monitor coverage and quality of services provided for Antenatal, Intrapartum, post-partum care based on national guidelines and standard protocols of SNCUs, NBSU, NBCC, HBNC, F-IMNCI and C-IMNCI, Cold Chain Monitoring, AEFI monitoring and disease surveillance in the state.
To review Maternal, Infant and Perinatal death review data and methodology and provide evidence based recommendations to strengthen the quality of services.
To provide technical support to the state to strengthen Perinatal Death Audits in 7 HPDs.
To coordinate between state and district level consultants under RMNCH+A, UNICEF Programme Specialists and DPH and NRHM programme managers at the state and district level for ensuring implementation of key actions on Maternal , New- Born Care and RI interventions.
6. Deliverables (End Product)/ Reports for Payment schedule:
8. Estimated duration of the contract: 11 months
9. Official travel involved (Itinerary and duration)
For state level consultants : Maximum of 7-10 days travel within Tamil Nadu to the 7 High Priority Districts including trifurcated districts of Ariyalur and Perambalur identified by GOI and if needed for cross learning to Kerala and India Country Office.
10. Qualifications/Specialized knowledge/Experience required
• Bachelors of Medicine and Surgery (MBBS) along with Advanced degree in Community medicine, Paediatrics, Obstetrics, Masters in Public Health. Additional fellowship in Health Management, RCH Programme management, research and evaluation will be an asset.
• A minimum of 5 years of experience at state level on programme management of Maternal, New Born Health including Routine Immunization and HIV care and support programmes for mothers and infants.
• Additional experience of working with/ or inter-sectoral coordination with Child Development and Nutrition and Water and Sanitation programmes at state level with key nodal departments, communities and civil societies would be an asset.
• Experience on coordination with district level officials, nodal departments of health, nutrition, HIV and WASH, tribal departments, district collector, and communities and civil society is an asset.
• Knowledge of key national and state level guidelines for implementation of maternal, newborn health including Routine Immunization under RMNCHA is desirable.
• Knowledge and experience of evidence based programme interventions and operational guidelines on Facility and community based maternal and new born care and Routine Immunization including FIMNCI and C-IMNCI.
• Knowledge of national and state level guidelines on Maternal, Infant and Perinatal death audits is a must.
• Knowledge of national guidelines on Routine Immunization, Cold Chain Monitoring and AEFI monitoring and disease surveillance is a must.
• Knowledge and understanding of research methodologies, situation analysis in MCH Care and Immunization will be an asset. Knowledge of Epi-Info and SPSS will be an asset.
• Good track record demonstrating managerial skills and experience in administration of Public Health programs.
• Good analytical skills and ability for evidence based planning and monitoring would be an desirable.
• Good knowledge of the programme scenario in Tamil Nadu and Kerala
• Excellent participatory training and capacity building skills.
• Excellent inter personal communication and advocacy skills.
• Excellent documentation and reporting skills.
• Excellent knowledge of computer MS office and data management skills. Knowledge of local language – Tamil will be an asset.
(1) Qualified female/male candidates are requested to please indicate their ability and availability to undertake the terms of reference above.
(2) Your application should be sent to firstname.lastname@example.org by COB 29 January 2014 with subject line " State RMNCHA - Maternal & New Born Care, Chennai, Tamil Nadu " in separate files:
a) An application letter, CV and P11 form in PDF format (which can be downloaded from our website at http://www.UNICEF.org/india/overview_1440.htm)
b) A financial proposal in PDF format indicating deliverable based fee as per template attached. (Download)
(3) The financial proposals of only those candidates, who are found technically responsive, will be opened.
(4) Only short-listed candidates will be called for test/interview (if applicable). Any attempt to unduly influence UNICEF’s selection process will lead to automatic disqualification of the applicant.
(5) Joint applications of two or more individuals are not accepted.