State RMNCHA - Reproduction Child and Adolescent Health, Chennai, Tamil Nadu
Closing Date: 29 January 2014
1. Background and Purpose:
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 Less than 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 has 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.
Evidence also suggests that to reduce maternal and new born mortality it is also essential to focus on Reproductive and Adolescent health. It is essential to monitor and track the Teenage pregnancies, delay the sexual debut and early child marriage, strengthen school health, strengthen Family planning to delay first pregnancy and there-rafter spacing as well as focus on Adolescent Reproductive health.
Tamil Nadu has recently launched the Weekly Iron Folic Acid Supplementation (WIFS) programme to prevent and manage Adolescent Anaemia. There are programmes for Menstrual Hygiene Management and free sanitary napkin programme in coordination with Health and Social welfare in Tamil Nadu. Additionally Tamil Nadu has set up the Free Adolescent friendly Reproductive and Sexual health Clinics in 11 Government Hospitals directly under supervision of the medical Colleges.
In Tamil Nadu, 7 High priority districts have been identified by Government of India (GOI) Ministry of Health & Family Welfare (MOHFW). The 7 HPDs are Krishnagiri, Madurai, Vellore, Tiruchirappalli, Thirunelveli, Thiruvannamalai and Virudhunager. Recently at the state launch for RMNCHA held on 22nd November 2013 Ariyalur and Perambalur which are trifurcated from Trichy district have also been added to this list.
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 Mcloughin 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 Reproductive Child and Adolescent Health for the state of Tamil Nadu to monitor progress under RMNCHA strategy in the 7 high priority districts in Tamil Nadu.
2. Duty Station:
a) State Level Consultant – Reproductive Child and Adolescent Health.
b) To be recruited in the State RMNCHA Unit (SRU)/ UNICEF Chennai to be set up at NRHM/DPH Chennai, Tamil Nadu and jointly monitored by UNICEF and NRHM
c) 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. If needed travel for cross Learning to other states on RMNCHA.
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 key activities at the state level and High Priority Districts (HPDs) with focus on Reproductive Child and Adolescent Health strategies under RMNCHA;
• 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 with focus on Reproductive Child and Adolescent health.
• To support the state in dissemination of RMNCHA guidelines in high focus districts- Rashtriya Bal Swasthya Karyakram (RBSK), Adolescent Reproductive Sexual Health (ARSH) Clinics, Adolescent Anaemia Prevention, Prevention of Teenage pregnancies, Menstrual Hygiene Management, Prevention and Management of Sexually Transmitted and Reproductive tract Infections (STI/RTI) including HIV among adolescents, School Health programmes and focus on both In school and out of school and most vulnerable adolescents.
• To develop state and district level score cards and profiles and update them on a quarterly basis in coordination with all key stakeholders in Health, Nutrition, Water and Sanitation and HIV with focus on Reproductive Child and Adolescent programmes in the state.
• To develop need based district & block level capacity building on RMNCH+A with focus on Reproductive Child and Adolescent health.
• To conduct Facility & Community level gaps analysis in collaboration with Development Partners based on GOI RMNCHA guidelines with focus on Reproductive Child and Adolescent Health in HPDs.
• To coordinate with the District Level monitors/ consultants of UNICEF to monitor the district and block level gap analysis and block monitoring exercise based on RMNCHA guidelines of GOI- with focus on Reproductive Child and Adolescent health.
• Develop need based area/ district specific local action plans to address identified gaps under reproductive child health and to mobilize resources from the state Programme Implementation Plans (PIP) of Health, HIV, Nutrition and WASH programmes to address the gaps.
• Develop and ensure the Quarterly release of state and district score cards based on Health Management Information Systems (HMIS) data for both district and block level for all High Priority Districts (HPDs).
• To facilitate the implementation of Reproductive Maternal and Newborn Child Health + Adolescent Strategy (RMNCHA) at the state / district level in coordination with state and District Programme Managers of NRHM.
• To coordinate with UNICEF, NRHM/DPH and District Level monitors, development partners and key stakeholders and inter-sectoral departments of Health, HIV, Nutrition and WASH for implementation of state and district level actions under RMNCHA.
5. Major tasks to be accomplished- in Tamil Nadu in line with above:
Under Call to Action facilitate dissemination of RMNCH+A strategy at the state/ district level with focus on Reproductive Child Health programmes like RBSK, School health, WIFS, Menstrual Hygiene Management (MHM), Adolescent Reproductive and sexual Health (ARSH) clinics, STI/RTI prevention and management, Prevention and management of early teenage pregnancies and reaching out to both in and out of school and most vulnerable adolescents.
To conduct district level situation/gap analysis, strengthen supportive supervision and monitoring at district and state level to improve RMNCHA interventions in the HPDs with focus on Reproductive Child and Adolescent health.
To foster convergence and linkages for key RMNCHA interventions between Health, HIV Nutrition and WASH programmes across the continuum of care at the district level.
To conduct desk review and situation analysis of Teenage pregnancies provided maternal and new born care in Tamil Nadu.
To provide the situation analysis on implementation of Adolescent Friendly Sexual and Reproductive Health Clinics (ARSH) clinics in Tamil Nadu.
To provide situation analysis of RTI/STI prevention and prevention of early teenage pregnancies in the state of Tamil Nadu.
To provide the situation analysis of the RBSK yojana
To provide a situation analysis of School Health programme.
To document and map the most at risk out of school adolescents in the 7 HPDs.
To document the progress of the WIFS and Sabla programme in Tamil Nadu
To document the progress of new proposed vaccines like MMR and Human Papilloma Virus (HPV) Vaccine in Tamil Nadu.
To provide key reports to UNICEF / NRHM on progress of key tasks under RMNCHA with focus on Reproductive, Child & Adolescent Health programmes.
To coordinate with other development partners, stakeholders like Panchayati raj institutions, tribal welfare, Civil society organisations, international and local NGOs working Health, Nutrition, HIV and Water and Sanitation for state and district level monitoring of Reproductive Child and Adolescent Health programme.
To document the good practices and develop cross learning visits between the HPDs of other states on RCHA activities in the state.
To coordinate between state and district consultants under RMNCH+A, UNICEF Programme Specialists and DPH and NRHM programme managers at the state and district level for monitoring and assessment of reproductive child adolescent health programmes.
To develop standard operational protocols for strengthening quality of services under Adolescent Reproductive Sexual Health Clinics (ARSH) in 7 HPDs
6. Deliverables (End Product)/ Reports for Payment schedule:
*Additional Tasks under RMNCHA may be carried out if needed in consultation with UNICEF
7. Estimated duration of the contract: Duration 11 months
8. 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 identified by GOI and if needed for cross learning to Kerala and India Country Office.
9. Qualifications and Experience:
• 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 or Adolescent Health Programme management, research and evaluation will be an asset.
• A minimum of 5 years of experience at state level on programme management with focus on Reproductive, Child and Adolescent Health including HIV, STI/RTI prevention, School Health, Menstrual hygiene management, Anaemia Prevention and Adolescent friendly Adolescent Sexual and Reproductive Health (ARSH) clinics.
• Added 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.
• Knowledge of national guidelines on Rashtriya Bal Swasthya Karyakram (RBSK), Nutrition, HIV, Health and WASH programmes and RMNCHA guidelines
• Experience of working and coordination with various nodal departments of health, nutrition, HIV and WASH, tribal departments, district collector, and communities and civil society is an asset.
• Capable of developing evidence based district and state level strategies and innovative approaches for RCHA implementation.
• Knowledge and understanding of research methodologies, situation analysis in MCH Care and Immunisation 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 and desirable.
• Good knowledge of the RCH and Adolescent programmes in Tamil Nadu and India.
• 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 - Reproduction Child and Adolescent Health, 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.