Terms of Reference for Institutional Consultancy
Technical assistance in development and introduction of a National concept on
Developmental Pediatrics and Early detection and intervention services in
Turkmenistan
Background and Justification
Developmental difficulties during early childhood are increasingly recognized as important
contributor to morbidity in children and adults and the major cause of inequity and deprivations
throughout the life course. While health care systems in high income countries provide
multiple opportunities for the prevention, early identification and management of
developmental difficulties in young children, interventions to improve the development of
young children are becoming increasingly available in low and middle-income countries as
well, and include low-cost strategies, such as addressing malnutrition and iron deficiency,
training caregivers, increasing psychosocial stimulation and providing community-based
rehabilitation1.
Turkmenistan, the country with an upper-middle income status as per WB classification since
2012, despite making considerable progress in reducing child mortality over the last years, is
still being listed among Countdown countries with high child morbidity and mortality rates.
The national inputs to the UNICEF CEE/CIS regional survey on early childhood development
and services for young children with developmental difficulties conducted in 2012, has
revealed serious gaps in the health system of Turkmenistan in terms of early identification of
developmental difficulties in children, provision of counseling and early intervention services
for their management in line with international standards2. Data on children with disabilities
and developmental delays in the country is very limited.
However, there are great opportunities for improving this situation in the country. In 2011,
President of Turkmenistan has approved the National Programme on Early Child Development
(ECD) and School Readiness for 2011-2015. In August 2012, the government of Turkmenistan
signed the Pledge on A Promise Renewed reassuring commitment to improvements in the area
of child survival and development. In 2013, the Ministry of Health and Medical Industry
(MOHMI) developed a National Strategy on Maternal, New born, Child and Adolescent Health,
which is currently under the government approval. In 2012, MOHMI initiated an assessment
of its home visitation system and in 2013 completed a road map for increasing effectiveness of
the PHC home visiting system with more focus on ECD, early identification of child
developmental difficulties and provision of early intervention services for children. UNICEF
CO has initiated assessment of social services in Turkmenistan, which is to be finalized by the
end of 2014 and planned to conduct a special survey on the situation of children with disabilities
in November 2014.
As a result of UNICEF CO’s systematic advocacy work with the government through technical
consultation meetings, advisory round tables, support to participation at international
conferences and workshops on developmental pediatrics and home visitation, as well as
familiarization with experience of Turkey, Lithuania, Belarus and UK, the government has
become dedicated to meet its global commitments and pursue national priorities through
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Developmental difficulties in early childhood. Prevention, early identification, assessment and intervention in
low and middle-income countries. A review. World, Health Organization, 2012
2
National inputs to UNICEF CEE/CIS survey on early childhood development t and services for young
children with developmental difficulties , October, 2012
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strengthening early detection services at the PHC home visitation system level and introduction
of a developmental pediatrics concept in Turkmenistan. The importance of keeping
child/family/community focused inter-sectoral, multi-disciplinary approach is being
emphasized by UNICEF with necessity of increasing the role of community based social
services and education sector along with strengthening health system in this area.
The Rolling Workplan for 2014-2015 signed by UNICEF Country Office with the Ministry
of Health and Medical Industry of Turkmenistan (MoHMI) reflects the abovementioned
technical assistance need.
Objective:
Technical assistance to Government of Turkmenistan in developing and introducing the
national concept of developmental pediatrics and early intervention services for management
of developmental difficulties in children in line with international standards.
Expected result: By the end of the assignment a draft of the evidence-based national concept
note is prepared in cooperation with partners and ready for submitting to government’s
consideration for approval.
Work Assignments, scope and deliverables:
Taking into account complexity of the country context and scope of the assignment, it is
expected that the assignment will be accomplished by the team of experts, consisting of
experienced developmental and behavioral specialist, health systems expert and expert
experienced in ECD Center management, representing one or more institutions of CEE/CIS
region. It is expected that overall management of the assignment will be provided by project
manager/health system specialist and the technical lead will be ensured by expert in
Developmental Pediatrics. It is planned that the expert team will be working with a team of
local experts in the area of mother and child health under the guidance of MOHMI. It is also
expected that the team will be in contact with the international expert team conducting
assessment of the existing social protection services in the country under the contract of Social
Protection section of UNICEF CO at the same time period and use results and
recommendations of that assessment.
It is anticipated that the above-mentioned objective will be achieved by the assigned expert
team in three phases.
The inception phase will include desk review of available materials and methodology design.
The task of the-in-country data collection phase will be to undertake data collection and,
based on the analysis of available service for young children, and through a participatory and
consultative process, agree on how development pediatrics could be incorporated in the
existing health care system of Turkmenistan taking into account the main strengths and
weaknesses of the health system building blocks and linkages required with other systems
(social services, education, child protection etc.). A debriefing meeting with UNICEF will
close this in-country work phase.
The synthesis phase will be for drafting the concept, including, an executive summary with
analysis of gaps and bottlenecks and recommendations on introduction of development
pediatrics system in Turkmenistan.
The national concept and action plan for introduction of developmental pediatrics to the MCH
care system in Turkmenistan as a final product envision the following structure:
1 National Concept of the Development Pediatrics / Early Intervention services
1.1 Situation Analysis of the existing services for addressing developmental delays
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and difficulties in children
1.1.1 Health system context
(1) Service Delivery
(2) Human resources
(3) Policies and regulations
1.1.2 Needs for development pediatrics services/early intervention services
(1) Morbidity / epidemiological trends
(2) Description of current services and patient’s flows
(3) Gaps in the development pediatrics services
1.1.3 Summary of the situation analysis (SWAT)
1.2 Conceptual framework
1.2.1 Key principles and concepts
1.2.2 Description of development pediatrics/early intervention services
models
1.2.3 Determinants of policy (model) selection
1.2.4 Summary of conceptual framework
2 Action plan for introducing the Development Pediatrics/Early intervention
practices for management of developmental difficulties in children
2.1 Description of pathways (strategies), including inter-sectoral cooperation,
vertical and horizontal continuum of care
2.2 Key action blocks
2.3 Key actors
2.4 Risks and assumptions
Methodology
Combination of both qualitative and quantitative methods will be used for data collection to
triangulate data. The following techniques are expected to be employed:
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Secondary data collection and analysis of services;
Questionnaires and interviews with key informants;
Direct observations while visiting health care facilities;
Focus group discussions with selected target groups.
The data collection methodology to be further elaborated by the Technical Lead and Project
Manager/Health System Specialist. They should have an opportunity to discuss and propose
amendments to the methodology with members of the expert team on line and during the first
country visit. Data collection tools and research questions to be agreed in advance of the field
visit. Proposed changes to be discussed at the initial stage and reflected in the inception report.
Stakeholders from national and sub-national levels will be engaged throughout the whole
concept preparation process. The Ministry of Health and Medical Industry, the MCH centre
and the task force established for the development of a developmental pediatrics concept will
play an important role in commenting on the consultants’ assignments, facilitating data
collection and analysis, contributing to the concept’s design, and validating approaches and the
concept outline proposed by the consultant team.
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Specific Tasks
Team member
Technical lead – an
expert
in
Developmental
and
Behavioral Pediatrics
or related field (P5
level)
Project Manager Health Systems
specialist
(P5 level)
Tasks
-
Overall technical direction of the team work
Review of synthesis of available government
programmes,
regulations,
profile
of
existing
professionals, and research results in the area of ECI
produced by the rest of the team.
- Provides input to the Project Manager in the development
of the methodology and instruments for data collection.
- Hold consultations with government decision makers and
technical meetings with national experts to discuss and
agree on main benchmarks leading to introduction of
developmental
pediatrics/early
detection
and
intervention system for early identification and
management of developmental difficulties in children
- Responsible for the technical content of the final concept
note and action plan
- Facilitate round-table on presentation of newly
developed concept note and action plan.
Overall management of the expert team and main contact in
working with UNICEF Turkmenistan CO and the local expert
team of the MOHMI.
Phase I
- Desk review of available government programmes,
regulations and research results in the area of ECD and
related services
- Development of a methodology and instruments for data
collection required for conducting Phase II activities with
input from the technical specialists.
Phase II
- Review data collection methodology with technical
experts and local partners in country.
- Train international and local team in data collection
- Field visits to selected health facilities at primary,
secondary and tertiary levels supporting child care and
development and ECD centers under the MOE
- Assist in the synthesis of the collected data
- Apply health systems strengthening approach to analysis
of available and recommended ECI services
- Work with the Technical Lead and ECD/ECI services
management Specialist, as well as UNICEF consultants
conducting social protection services assessment in the
country, on recommendations for the government, taking
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into account the current health care system building
blocks and related social services
Phase III
- Contribute to concept note and action plan development
through the prism of HS building blocks
- Final lay out of the concept note
- Discuss the health system implications during the
national round-table on the newly developed concept
note and action plan.
ECD/ECI
services
management specialist
(P3 level)
Phase I
- Desk review of available government programmes,
regulations, profile of existing professionals, and
research results in the area of ECD and related services.
- Contribute to development of the concept’s design and a
methodology and instruments for data collection required
for the concept’s formulation
Phase II
- Conduct of mapping of facilities and services related to
child development and developmental pediatrics/early
interventions through:
- Field visits to selected health facilities at primary,
secondary and tertiary levels supporting child care and
development, including care for preterm and low birth
weight newborns, and children with congenital disorders
and developmental delays
- Field visits to model ECD centers under the MOE
- Familiarize with results of the assessment of existing
social protection services conducted by international
consultants under the Social Protection section of
UNICEF CO for incorporation into the concept
- Data collection in Ashgabat and selected velayats
through meetings, interviews or focus groups with:
o Administration of health care facilities
o Health care providers at different levels
o Medical university and college teachers
o Parents with children of 0-8 years old, including
families with developmentally challenged young
children
Phase III
- Contribute to concept note and action plan development
- Assist MOHMI in developing the regulations/statute of
the ECI center
- Participate at the round-table on presentation of newly
developed concept note and action plan.
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Timeline: October 2014 – March 2015.
Location and Duration: assignment workday breakdown (projections)
Out-of-country
Technical Lead
level ) – 24 days
(P5 Phase I – 5 days
Phase III – 10 days
In-country
Phase II – 6 days
Phase III – 3 days
Project manager - Phase I – 5 days
Health
Systems Phase III – 15 days
specialist (P5 level) 29 days
Phase II – 6 days
ECD/ECI
services Phase I – 5 days
Management Specialist Phase III – 10 days
(P3 level) - 24 days
Phase II – 6 days
Phase III – 3 days
Phase III – 3 days
Deliverables:
Stage I. Background work, including desk review, development of the concept’s design and
a methodology and instruments for data collection is completed.
The main deliverable of this stage will be an inception report based on desk review (out-ofcountry).
Stage II. Data collection and the analysis of available services for young children is
conducted and agreement on proposed development pediatrics model is achieved.
The deliverable of the second stage will be a presentation with initial findings and
recommendations presented and discussed with concerned partners and UNICEF (incountry).
Stage III. National concept and action plan for introducing the Developmental pediatrics
principles to health care system in Turkmenistan is drafted in consultation with national
experts (out-of-country) and presented to government officials and key specialists in mother
and child health area at the round-table (in-country).
Final deliverable will be the Report with national concept and action plan for introduction
of developmental pediatrics/early intervention services to the MCH care system in
Turkmenistan.
Qualifications and Experience requirements:
1. Technical Lead (P5 level)
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
Advanced university degree in Medicine/Public Health in area of early childhood
development and certified specialist in Developmental and Behavioral Pediatrics or
equivalent speciality.
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Internationally recognized expertise in the development and management of familycentered early identification, assessment and early intervention services for children
with disabilities and developmental difficulties.
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At least 8 years professional work experience at the national and international levels in
planning and programming in public health, child survival, child care and development
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Relevant consultancy experience with international organizations/UNICEF/WHO in
the field of public health planning and program development

Previous experience of work with UNICEF in CEE/CIS countries would be an asset
Competencies and Skills:
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Strong analytical and communication skills
Conceptual thinking and strategizing ability
Strong facilitation and training skills
Excellent writing skills
Ability to work in a multi-cultural environment
Prior experience of work with UNICEF in CEE/CIS countries would be an advantage
The consultant should be fluent in spoken and written English. Working knowledge in
Russian would be an asset.
2. Project Manager/Health Systems Specialist (P5 level)
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Proven experience in policy advice and development in the area health systems
strengthening , public health and MCH care;
Minimum 10 years of working experience in the field of public health policy
Proven experience in research, analysis, policy and strategy formulation in PHC and
MCH in CEE/CIS region;
Previous experience in implementation of relevant or similar consultancy work in the
region of CEE/CIS;
Knowledge of global policies, development frameworks of WHO and UNICEF in ECD
area.
Competencies and Skills:
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Excellent analytical thinking, report writing , training and communication skills
Conceptual thinking and strategizing ability
Prior experience of work with UNICEF in CEE/CIS countries; familiarity with
Turkmenistan health system would be an advantage
The consultant should be fluent in spoken and written English. Working knowledge in
Russian would be an asset.
3. ECD/ECI services management specialist (P3 level)

Advanced university degree in Medicine/Public Health in area of early childhood
development and developmental pediatrics
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Proven extensive work experience in establishing and management of developmental
pediatrics/early interventions services for children with developmental difficulties at
the national and international levels
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At least 5 years professional work experience at the national and international levels in
planning and programming in public health, child survival, child care and development

Relevant consultancy experience with international organizations/UNICEF/WHO in
the field of public health planning and program development

Previous experience of work with UNICEF in CEE/CIS countries would be an asset.
Competencies and Skills:





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Strong analytical and communication skills
Conceptual thinking and strategizing ability
Strong facilitation and training skills
Excellent writing skills
Ability to work in a multi-cultural environment
The consultant should be fluent in spoken and written English. Working knowledge in
Russian would be an asset.
Evaluation process: Given that the assignment is a part of Regional Key Leadership Area 7
on A Child's Right to Comprehensive Well-being, the evaluation of proposals will be
conducted by relevant staff representing CO and RO, based on technical and financial review
of submitted proposals.
Performance evaluation will be done based on the following attributes:
Quality of work
Technical skills
Value for money
Meeting time schedule
Work supervision and reporting: The team will work under supervision of UNICEF
Turkmenistan Deputy Representative and Health and Nutrition Specialist, in collaboration with
the Ministry of Health and Medical Industry of Turkmenistan.
Funding source: WBS 4360/ AO/04/008/001/001.Country Programme Output: By 2015,
health system delivers quality service in mother and child health, in line with international
standards. Activity under RWP 2014-2015: Development of the national concept /vision on
Early Intervention services/Developmental Pediatrics
Logistics/trip arrangements: UNICEF will provide logistical support in the organization of
the consultants’ visit to Turkmenistan, in-country travels, if required, and facilitate meetings
with partners.
Payment Schedule:
The consultancy fee will be paid through bank transfer, in 2 tranches: the 1st – 30% upon
provision of combined deliverables of the first 2 stages;
Final payment – after completion of the 3rd stage and submission of the final report.
Terms of payment:
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The contract fee will be paid by bank transfer based on the payment schedule upon completion
of the assignment stages and submission of the deliverables. UNICEF reserves the right to
withhold all or a portion of payment if performance is unsatisfactory, work/outputs are
incomplete, not delivered or for failure to meet deadlines.
Expression of interest:
UNICEF accepts applications from institutions. For the purpose of selection it is requested to
submit a Technical Proposal, which will include the following documents and information:
- A completed Expression of Interest form (see Appendix A);
- A narrative proposal including a work-plan, outlining inputs and outputs;
- A proposed timeframe;
- Consultants’ curriculum vitae, P11;
- A summary of experience of consultants in similar assignments, samples of works
- A financial proposal with a description of unit costs (in US Dollars), including travel costs
calculated based on the economy class travel, regardless the length of travel. Costs for
accommodation meals and incidentals shall not exceed applicable daily subsistence
allowance (DSA) rates, as promulgated by the International Civil Service Commission
(ICSC).Travels and other incidental expenses that were not known ex ante or any additional
costs with regards to the travel expenses submitted in the proposal should be justified and
accepted by UNICEF before they are incurred. Such expenses may be paid as reimbursable
against actual cost incurred and in these cases necessary documentation shall be submitted
with the invoice for reimbursement (e.g. proof of airline ticket purchased). Consultants are
responsible for their health/life insurance coverage.
The proposal will be a key basis for the selection. TOR can be partly modified based on the
selected most suitable proposal.
The application package should be transmitted via email to:
Dilara Ayazova, H&N Assistant, dayazova@unicef.org with a copy to
Shafag Rahimova, Health and Nutrition Specialist, srahimova@unicef.org
Email Subject: Expression of Interest – UNICEF National concept for introduction of
Developmental Pediatrics in Turkmenistan.
Closing date for all applications is COB September 26, 2014.
Submitted by:
Shafag Rahimova
Health and Nutrition Specialist,
OIC Deputy Representative
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Approved by:
Oyunsaihan Dendevnorov
Representative,
UNICEF Turkmenistan CO
2 September 2014
Appendix A: Expression of Interest Form
Technical assistance in development of a National concept for introduction of
Developmental Pediatrics in Turkmenistan
Please fill-in page 1 of the form in its entirety and submit it to us electronically or via fax.
First Name:
Last Name:
User Salutation:
Mr.
Ms.
Mrs.
Dr.
Job Title:
Mobile:
code
(please include country & city)
Fax:
code)
(please include country & city)
Email address:
Address:
City:
State:
Postal Code:
Country:
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Alternate contact
Please respond to the questions below in a narrative not exceeding 2 pages.
1. Provide information which will enable us to determine whether you have relevant
experience. Information should include:
 A description of your technical competencies, and the number of years of
relevant experience in developmental pediatrics/early identification and
management of developmental difficulties.
 A description of public health programming experience in relevant field
 Reports commissioned by UN agencies or comparable organizations that you
conducted, or participated in as a member of a team. Please submit samples of
your previous work/reports
2. Provide any additional experience that may be critical to the success of the proposed
technical assistance, including:
 affiliation to universities or professional bodies in one or more sample
countries
 any other information that you deem relevant that would give you an
advantage over other competing for the same consultancy
3. Please provide your professional fee rate, per person day.
4. Confirm that:
 you have no on-going litigation with the UN;
 are not currently removed/invalidated or suspended by the United Nations or
UN system organizations.
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