UNITED NATIONS CHILDREN’S FUND
REQUIRES
Two International Consultants
To provide Technical Assistance to the Ministry of Health for development of national
evidence-based clinical guidelines in Perinatal Care
Requirements:
With this Terms of Reference, UNICEF requests two consultants. First consultant should have professional
background
in
Gynecology/Obstetrics.
Second
consultant
should
have
professional
in
Neonatology/Pediatrics. In addition to their professional background, both consultants should have the
following experience:
In addition to their professional background, both consultants should have the following experience:



Proven experience in providing similar consultancy services;
Previous experience in development of relevant Protocols/Guidelines in the region of South Eastern
Europe would be an asset;
Minimum 10 years of working experience in the relevant field.
If you are a dynamic person who would like to contribute to delivering of long-lasting, positive
changes for Montenegro’s children, please apply with a CV, P11 form, financial offer and
cover letter by email, mail or fax quoting the position “Technical Assistance to the
Ministry of Health” to the following address:
UNICEF, Vladike Danila 28, 81 000 Podgorica
Fax: +382 20 224 278
Email: podgorica@unicef.org
Closing date for applications is 20 December, 2013 by COB.
Only short listed candidates will be contacted for interview.
UNICEF IS A SMOKE FREE ENVIRONMENT
United Nations Children’s Fund
Vladike Danila 28
81 000 Podgorica, Montenegro
Telephone +382 20 224 277
Facsimile +382 20 224 278
www.unicef.org/montenegro
Terms of Reference
Technical Assistance to the Ministry of Health for development of national evidencebased clinical guidelines in Perinatal Care
1. Background
Montenegro is a country with low Infant Mortality Rate (5.7 per 1,000 live births in 2009 as per the Public Health
Institute Statistics Yearbook). Neonatal Mortality accounts for about 80% of all deaths (2008, UNICEF Situation
Analysis). Birth asphyxia is one of the principal causes of death. Montenegro has a good network of Primary
Health Care (PHC) and hospital facilities. The PHC network has been strengthened through a World Bank
supported project. The country spends around USD 1,100 (2007, UNICEF SitAn) per capita and a national
health insurance system is functional since 2004. Total Health Expenditures (THE) account for about 9% of
GDP, while Government expenditures represent 5% of GDP which is close to EU averages.
The country has implemented regionalization of perinatal care which is constituted by one tertiary National
Obstetrics and Gynecology Hospital in Podgorica and the Neonatal Intensive Care Unit (NICU), which is a
separate entity as part of the national pediatric hospital. There are about 7 other Level 1-2 maternity
hospitals/wards in the country with no explicit distinctions between these two levels.
The National Clinic of Obstetrics and Gynecology in Podgorica is not implementing all evidence-based
standards in perinatal care, including the Baby Friendly Hospital Initiative (BFHI) steps. There is no rooming-in
(all newborns are placed in a separate unit and are brought for breastfeeding to their mothers every 3 hours).
Early initiation of breastfeeding is inadequate (newborns are put on mothers breast just for few minutes after
delivery being separated afterwards for about two hours). There is no breastfeeding on demand and bottlefeeding is a wide-spread practice and even breastfeed babies are supplemented by bottle-feeding during the 3
hours intervals. There are no clear national Protocols on perinatal care, nor maternity hospital’s staff is
systematically provided with clinical guidelines on perinatal care.
The MoH (Ministry of Health) and the management of the hospitals are eager to change the situation and
decided to conduct a comprehensive Assessment of perinatal care system in Montenegro and identify priority
actions to improve quality of care for mothers and newborns.
Under the supervision of the MOH and UNICEF office a group of experts (local and international) has
conducted the Assessment of perinatal care system in Montenegro (December 2012) in a sample of maternity
units. The objectives of the assessment were to:
a) Identify critical issues concerning the quality of MNC care in selected maternity units
b) To suggest actions to improve MNC quality both at central and health facility level
The team of experts used WHO tool “Tool for assessment of quality of care for mothers and newborn babies in
hospitals” developed by WHO Regional office for Europe with technical support from WHO Collaborating
Centre in MCH in Trieste, Italy.
One of the areas that received the lower scores and that should be immediately improved is the area of case
management. This situation is mainly due to the lack of agreed national/local protocols/guidelines for main
obstetrical conditions and complications as well as for the management of normal deliveries. Continuity of care
and team approach has been identified as a burning issue.
United Nations Children’s Fund
Vladike Danila 28
81 000 Podgorica, Montenegro
Telephone +382 20 224 277
Facsimile +382 20 224 278
www.unicef.org/montenegro
2. Objectives and specific tasks
Objectives of the assignment:
Under the supervision of UNICEF responsible officer, the international expert/s will support the Ministry of
Health and the national group of experts in development of national evidence-based clinical guidelines in
perinatal health care, based on global best practice and WHO evidence-based medicine guidelines,
Specific tasks:
- Technical support to the national experts to prioritize evidence-based guidelines in perinatal care,
based on the quality of care assessment carried out in 2012;
- Technical support in development of national evidence-based guidelines and validation at the
level of maternity hospitals and among professional medical associations and the Ministry of Health;
3. Deliverables:

Out of country work (estimated at 5 days of individual consultancy work):
o Desk review of background documents;
o On-line consultation with national experts on priority guidelines to be developed;
o Provide access to international evidence-based guidelines from relevant sources;
o Provide guidance on national adaptation of international evidence-based guidelines;

In country work (estimated at 5 days of individual consultancy work):
o Support national experts in finalization of guidelines;
o Adaptation at the level of maternity hospitals, including technical and human resource
mapping to ensure implementation; and
o Validation among professional medical associations and the Ministry of Health
4. Qualification or Specialized Knowledge/Experience Required
With this Terms of Reference, UNICEF requests two consultants. First consultant should have professional
background
in
Gynecology/Obstetrics.
Second
consultant
should
have
professional
in
Neonatology/Pediatrics. In addition to their professional background, both consultants should have the
following experience:
 Proven experience in providing similar consultancy services;
 Previous experience in development of relevant Protocols/Guidelines in the region of South Eastern
Europe would be an asset;
 Minimum 10 years of working experience in the relevant field.
5. Technical Proposal
Applicants should submit:
 Detailed work plan within the timeframe suggested in the TOR;
 Evidence of relevant capacity, qualification or specialized knowledge/experience;
 CV of recommended experts for implementation of the planned activities
6. Price Proposal
The request for services under this contract will require the prospective consultant to indicate their fees for the
services to be provided as well as the lump sum for travel costs. As part of the selection process, the office will
select the individual who quoted the lowest fee from the list of individuals who are deemed suitable for
achieving all tasks in time, and as per the criteria and deliverables stipulated in the Terms of Reference.
United
Nations
Children’s
Telephone
20 224
Note: Prior to each trip, Consultant will be paid advance travel
costs
depending
onFund
the duration
and+382
mode
of 277
Vladike
Danila
28
Facsimile
+382
20
224
278
travel for each specific trip.
81 000 Podgorica, Montenegro
www.unicef.org/montenegro
7. Payment schedule:
Payment will be processed as per satisfactory and timely completion of above listed deliverables, as per the
following schedule:
• 60% upon timely and satisfactory completion of the in-country mission and submission of the draft report and
proposal for improving of quality of maternal and newborn care;
• 40% upon timely and satisfactory completion of the final project proposal;
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.
8. Supporting documents to be provided to the expert
o Health Care Law,
o Law on patient rights,
o Law on Infertility Treatment with Assisted Reproductive Technologies,
o Law on the conditions and procedures for termination of pregnancy,
o The strategy for the preservation and promotion of reproductive and sexual health 2013-2010,
o Analysis of perinatal care; Rating safety and quality of hospital care for mothers and
newborns; Action Plan to improve the quality of perinatal care
United Nations Children’s Fund
Vladike Danila 28
81 000 Podgorica, Montenegro
Telephone +382 20 224 277
Facsimile +382 20 224 278
www.unicef.org/montenegro