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UNICEF GEORGIA
VACANCY ANNOUNCEMENT FOR THREE EXPERTS TO CONDUCT A
PRE-NATAL CARE ASSESSMENT AND FOLLOW UP MCH TRAININGS IN ABKHAZIA
Background:
As a result of continuous isolation and the sensitive political context caused by armed conflict in the region of Abkhazia
42,000 children receive basic services of lower quality than those available to their parents a few decades ago. Maternal
and child healthcare remains poor, which was confirmed through the Mother and Child Health (MCH) assessment conducted
by a team of an obstetrician, a neonatologist and a midwife in November 2012, followed by trainings on Effective Perinatal
Care and breastfeeding in 2013.
There is no current and reliable data on child and maternal mortality rates within Abkhazia or on critical child health indicators
such as nutrition and micro-nutrient deficiencies, stunting etc. Locally available/unconfirmed data show quite high rates of
perinatal mortality (up to 15.0 per 1,000 live births in the recent years). There are also limited data for MCH for the region,
while those available through the local health care services (though quite unreliable) and estimations of international actors
on the ground show that most of the indicators are far above international standards and 2-3 times higher than e.g. in
neighboring Russia. In 2012 the official early neonatal mortality was 6.6 and perinatal mortality was 13.8 per 1,000 live
births. These figures are definitely underestimates, since many cases of stillbirths and early neonatal deaths occur in
Georgia proper and Russia, to which ca 15-20% of the mothers from Abkhazia come for antenatal care and delivery. Usually,
these mothers have complicated pregnancies and higher chances of unfavorable pregnancy outcomes. The UN Review of
Socio-Economic Needs in Abkhazia, as well as more recent assessments conducted by UNICEF, also concluded that the
quality of health care in the region is low and the level of services is insufficient to meet even the most basic needs of the
population. Health care services in Abkhazia require significant improvements and increased delivery capacities. This is
mainly due to the fact that much infrastructure is still in need of repair and rehabilitation, there is lack of equipment, materials
and supplies throughout the system and low capacity of the local staff that has little opportunity to maintain or upgrade their
qualifications and skills. Health statistics and data management also require considerable improvements in order to become
comprehensive and reliable.
UNICEF’s assessments carried out recently indicate that besides mother and child healthcare the following areas are also
in severe need of attention: HIV/AIDS (especially research into and testing of high-risk groups, prevention and treatment);
primary health care, especially in the rural areas; promotion of preventative care, healthy lifestyle and health education; and
addressing micronutrient deficiencies. Reproductive health and promotion of effective pre-natal and post-natal care is of
particular concern, with a lack of services, programmes and information for young women and mothers.
At the same time, a more receptive environment for improvements of the healthcare system needs to be prepared and
created. This can be undertaken by assisting senior health care providers and managers at Sukhumi and district levels to
analyse the current system’s gaps and widening their views and exposing them to alternative systems and methods of
healthcare. Social mobilisation is required to improve health seeking and preventative behaviour at the community and
family level.
UNICEF in Abkhazia
UNICEF has been continuously providing assistance in Abkhazia since 1994, focusing primarily on supporting the provision
of basic services to conflict affected children and youth, especially in the areas of maternal and child healthcare, education
and child protection. UNICEF remains committed to continue the provision of assistance in Abkhazia to ensure improved
health, education and social outcomes for the most vulnerable. This assistance is carried out within the framework of the
2011-2015 UNICEF Country Programme Document and the United Nations Development Action Framework (UNDAF).
UNICEF is also coordinating it’s intervention in Abkhazia through the Strategic Partnership for Humanitarian Action in
Abkhazia, which brings together other international organizations active in the region, including sister UN agencies and
international NGOs.
Consultancy – MCH trainings
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In order to address the situation in Abkhazia and in line with UNICEF’s strategic approach to address issues in the health
sector (and especially MCH), as well as to further strengthen the ongoing capacity building for improving MCH in Abkhazia,
UNICEF is seeking consultancy and technical support in order to provide a prenatal care assessment, a follow up EPC
evaluation, as well as trainings to medical professionals on MCH topics, such as effective perinatal care (EPC), pre-natal
care, breastfeeding, antenatal care, etc.. The constancy activities will focus especially on MCH facilities and their practices
and standards. The consultancy will also be an integral part of other UNICEF activities in Abkhazia, such as the
strengthening of immunization practices, health promotion and communication, as well as capacity building for the local
health care workers.
The consultancy is a follow up to the MCH assessments and trainings conducted 2012-2013, which anticipated to have
several stages, roughly divided into the following three segments:
- Initial assessment of MCH facilities and existing practices and protocols
- Capacity development, including training of key medical professionals in the MCH area, using the
methodology of UNICEF / WHO Effective Perinatal Care and Integrated Management of Children Illness
(IMCI) training packages
- Development of a strategic approach to improvements of MCH services provision in Abkhazia, including
programme assistance to UNICEF and policy development at the level of relevant local stakeholders
These terms of reference are defining the immediate tasks and deliverables for the second and third stages of the whole
process linked with the previous stages (MCH assessments and initial trainings). At the same time, they set the ground for
key activities to be conducted at a later stage with regard to capacity development and the development of a strategic
approach to MCH.
Scope of work of the consultants:
Under the direct supervision of the Sukhumi-based UNICEF Health & Nutrition Officer and in the close collaboration with
the Tbilisi-based UNICEF Health Officer, the team of consultants, consisting of each one obstetrician, neonatologist and
midwife, will:
- Provide technical assistance to medical professionals and health care providers in Abkhazia on strengthening the
MCH services infrastructure, organization and quality, including related mother and child healthcare promotion
initiatives
- Provide a prenatal care assessment, a follow up EPC evaluation, as well as trainings on prenatal care and
effective perinatal care for key MCH professionals in Abkhazia
- Provide situation analysis and recommendations in the area of EPC and prenatal care in Abkhazia and further
UNICEF engagement in the sector in 2014-15
- Provide situation analysis, recommendations and strategy development in the area of neonatal care in Abkhazia
and further UNICEF engagement in the sector in 2014-15
The aim of the pre-natal care assessment, follow up EPC evaluation, and trainings is to improve the capacity of local MCH
health care workers and to introduce further evidence-based WHO recommended practices in the routine health care for
children and mothers.
The prenatal care assessment, follow up EPC evaluation and trainings on prenatal care, neonatal care and EPC are an
integral part of the medium-term technical assistance of UNICEF aiming at strengthening the capacity of key medical
personnel within the MCH sector in Abkhazia through training and consultations. The capacity building / training of medical
professionals is anticipated to be further strengthened through a number of monitoring and supervision activities later in
2014-15, and is closely connected to some further procurement of equipment for and rehabilitation of MCH facilities in
Abkhazia by UNICEF and other international organizations.
Tools and methodology
The prenatal care assessment, follow up EPC evaluation and trainings will be carried out using WHO, UNICEF and USAID
developed standard questionnaires and training modules. The standard assessment will be based on WHO/UNICEF tools,
while the training package will be based on the follow up effective perinatal care training package (EPC), developed by
WHO EURO together with John Snow Inc. and USAID. The prenatal care assessment, follow up evaluation and trainings,
will be conducted by an obstetrician, a midwife and a neonatologist, who would have experience in conducting similar
assessments and delivering similar trainings in other regions and countries. The consultancy is supposed to last two full
weeks (one week only for the neonatologist). One week will be devoted to the prenatal care assessment (3 days) and
followed by a pre-natal care training (3 days), while the second week will include a 2-day evaluation of EPC practices in the
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maternities in Abkhazia followed by a 3-day refresher training on EPC. Number of training days could slightly increase,
depending on the assessment and EPC evaluation results, but it will not affect the total number of days of the consultancy.
The obstetrician and midwife are supposed to take part in the whole duration of the mission, while the neonatologist will
take part during one week only (EPC follow up evaluation in the maternities and 3-day training for local neonatologists).
Consultants in communication with the UNICEF Office in Sukhumi and UNICEF Health Officer based in Tbilisi will agree on
the order of EPC follow up evaluation and trainings and prenatal care evaluation and training.
The mission will imply the following key objectives:
1. Identification of key institutions to be targeted by the assessment, evaluation and trainings
2. Planning visits to the health care institutions during the assessment and evaluation mission
3. Identification of the training venue, necessary equipment and facilities, outlining the requirements for the
participants
4. Adaptation of the training materials to the local situation in Abkhazia, taking into account the results of the recent
UNICEF MCH assessments and trainings
5. Provision of the trainings for the total duration of at least 3 days for prenatal care and at least 3 days for refresher
EPC training
6. To promote the concept of peer review and quality improvement among hospital managers and health care
providers
7. Submission of a training report, recommending further steps to continue MCH capacity building activities in
Abkhazia
8. Development of a strategy for neonatal care development and UNICEF engagement in Abkhazia in this sphere in
2014-2015
Consultancy period:
The duration of the consultancy will be 15 working days for the obstetrician and midwife and 9 working days for the
neonatologist, out of which 2 days before coming to Abkhazia will be devoted to preparations for the mission, adaptation of
the training materials and 2 days for mission report writing and compilation of recommendations after the mission, while 11
days for obstetrician and midwife and 5 days for the neonatologist are to be allocated for the assessment, evaluation and
training(s). The consultancy period is planned for July 7th-18th (July 7th-11th or July 14th-18th for neonatologist), 2014 (field
visit) followed by report writing and submission.
Consecutive 3-4 visits for MCH capacity building activities (follow up, monitoring, trainings, etc.) are planned for 2014-15,
with the exact dates depending on the availability of the consultants. The duration of each consultancy team visit in the
forthcoming period is anticipated to be between 5-10 working days in the field, with 1-2 days preparatory activities and 1-2
days for report writing. The overall amount of days for the consultancy visits is anticipated to be up to 50 working days for
each consultancy team member in 2014-2015. The consecutive visits are to be agreed in consultations between the team
of consultants and UNICEF pending on the results of the initial assessment and the situation in Abkhazia.
Supervision:
Overall supervision will be the responsibility of the UNICEF Health and Nutrition Officer (based in Sukhumi) and the UNICEF
Chief of Field Office (based in Sukhumi) with the support from the UNICEF Medical Officer (based in Tbilisi), and in close
coordination with the Deputy Representative and Representative (both based in Tbilisi) as appropriate.
Deliverables:
The team of consultants is requested to submit the final consultancy report within 20 working days upon completion of the
mission, outlining key results of the assessment, evaluation and trainings, as well as recommendations for necessary follow
up actions.
The key deliverables of the final consultancy report are specifically:
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1.
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6.
Prenatal care assessment results (before prenatal care training)
Main prenatal care training results (by the end of the field mission)
Follow up EPC evaluation results (before EPC training)
Main refresher EPC training results (by the end of the field mission)
Main gaps revealed and potential for improvement for the next MCH trainings
Recommendations for follow up activities, including actions, change of practices, monitoring, supervision and further
capacity building
7. Preparation and completion of the prenatal care assessment, follow up EPC evaluation and training report
8. Further refinement of the recommendations for development and implementation of the short and medium-term
strategy for UNICEF’s engagement in MCH activities in Abkhazia in 2014-15
9. Strategy and recommendations for neonatal care development and related UNICEF activities in Abkhazia in 20142015
Performance indicators
The consultants’ performance will be evaluated against the following criteria: timeliness, responsibility, initiative,
communication, and quality of the products delivered.
Eligibility Criteria
5-10 years of experience in research, analytical work;
Similar working experience;
Strong analytical skills;
Strong training/facilitation skills
Excellent writing, presentation and training skills in Russian
Good writing skills in English
Unsatisfactory performance
In case of unsatisfactory performance the contract will be terminated by notification letter sent 5 days prior to the termination
date. In the meantime, UNICEF will initiate another selection in order to identify appropriate candidate(s).
Health Statement & Certificate
The Health Statement and certificate of Good Health must be received prior to signing the contract.
Remuneration
The consultants will be paid based on UN rates.
*Note: 80% of DSA advance will be paid upon arrival to Georgia, while remaining 20% and consultancy fee will be
paid upon service provision.
How to apply
Interested candidates are kindly requested to submit their Curriculum Vitae and Completed UN Personal History Form
P11 to the following e-mail address: hrtbilisi@unicef.org with Ref. subject: Pre-natal care assessment and follow up MCH
trainings in Abkhazia, Georgia
Incomplete applications will not be considered.
Application deadline is COB 20 June, 2014. Only short-listed applicants will be contacted.
* Kindly note that all correspondences will be included into the Programme Consultants’ Roster at UNICEF Georgia office
for further consultancy references.
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