UNICEF UKRAINE
TERMS OF REFERENCE
National consultant for the analysis of the Mother-to-Child Transmission of HIV rate
(MTCT) in 2009-2013 among vulnerable to HIV drug addicted pregnant in selected cities
of Ukraine
Duration: 1 December 2014 – 10 January 2015, 15 full working days
1. Purpose of Contract:
To conduct the comparative analysis of the MTCT among vulnerable to HIV drug addicted pregnant
in selected cities of Ukraine where pilot project ‘Prevention of Mother-to-Child Transmission and
Improving Neonatal Outcomes among Drug-Dependent Pregnant Women and Children Born to
Them in Ukraine’ was implemented.
Background
HIV prevention programmes in Ukraine for most-at-risk populations are lacking gender
specificity. Despite the impressive progress of Ukraine’s PMTCT programme, challenges remain
when it comes to adequate access and timely entry into antenatal care among pregnant women
using drugs. In 2011, injecting drug use was identified as the risk factor of mother-to-child
transmission of HIV in 19.1% of HIV-positive reproductive-aged women. 3.5% of pregnant HIV+
women reported active drug use during latest pregnancy (probably an underestimate due to the
stigma of admitting drug use, especially in pregnancy) 1. Only 29 of 395 (7.3%) of pregnant HIV+
pregnant women who used drugs got substitution maintenance therapy and most opioid dependent
pregnant women continued using drugs during pregnancy.
Low uptake of health services, including antiretroviral treatment (ART) among female HIV-positive
women who inject drugs is a well-recognised problem. Because drug-using pregnant women often
receive prenatal care only towards the end of their pregnancy or attend a clinic for the first time for
the delivery, they miss out on the possibility of taking the both preventative course of ART and
standard ART. Maintaining access to ART for women with treatment indications remains a priority
in Ukraine.
The pilot project ‘Prevention of Mother-to-Child Transmission and Improving Neonatal
Outcomes among Drug-Dependent Pregnant Women and Children Born to Them in Ukraine’ was
initiated by UNICEF in 2011 in order to remove barriers to the provision and utilization of
services by drug-using pregnant women.
The project aimed on the setting up functional linkages between MCH, HIV services, addiction
services and integration with social services. The project focuses on introducing integrated
services for drug addicted pregnant women by establishing Centres for Integrated HIV
Prevention, Care and Support Services in Dnipropetrovsk, Kyiv, Poltava and Krivui Rig. Centres
provide a range of medical and psychosocial services to drug addicted women and their children:
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Martsynovskaya, 2012.
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offering antenatal care, HIV testing and counselling, ARV treatment to prevent HIV transmission
from mother-to-child, assisting in delivery, postnatal care, and treatment of neonatal withdrawal
syndrome, drug dependency treatment, psychosocial counselling and social support to families.
The expected impact and result of the project is the reduction of vulnerability among pregnant drug
addicted women in selected pilot cities, increased coverage and uptake of PMTCT services by them
and reduction of the MTCT rate among target group of pregnant drug- dependent women.
In order to assess the progress towards expected results of the project, there is a need in the national
consultant with understanding and knowledge of PMTCT programme, trends and dynamic in
national MTCT rate and skills to analyze the data to provide comparative MTCT data analysis in
the respective pilot cities.
It is expected that the findings of the analysis will be used for interpretation of the results and
evaluation of the effectiveness of the pilot project ‘Prevention of Mother-to-Child Transmission and
Improving Neonatal Outcomes among Drug-Dependent Pregnant Women and Children Born to
Them in Ukraine’ and formulation of the future PMTCT interventions related to the pregnant
women, including most at risk and vulnerable to HIV.
2. Objectives of the Contract with expected results / outcome / products /sub
products/outputs:
The objectives are:
 To conduct the comparative analysis of the MTCT rate in 2009 - 2014 as an impact indicator
of the effectiveness of interventions among vulnerable to HIV drug addicted pregnant in
Dnipropetrovsk, Poltava, Kyiv City and Krivui Rig;
 To ensure the data obtained are presented the Ministry of Health for programming and
implementation of the future interventions in the area PMTCT.
Results expected:
 The coverage and uptake of PMTCT services by pregnant women using drugs within the
period from 2009 – 2014 in selected cities is analysed;
 The results of the analysis is presented to the Ministry of Health for further programming
and formulation of future interventions in the area of PMTCT.
Outputs:
1. Demographic data analysis in the respective pilot cities among pregnant (age group, HIV–
status of drug dependent pregnant women, drug use story, partners’ HIV and drug using
history etc.)
2. Analysis of maternal health indicators and eligibility to the ART preventive treatment in
selected cities;
3. Analysis of PMTCT service uptake and coverage of all pregnant HIV-positive women and
cohort of drug-dependent among them (time of diagnosed pregnant IDU as HIV-positive,
time of admission to the maternity hospital; coverage and length and type of ART course of
treatment, mode of delivery etc.);
4. Comparative analysis of the data obtained with the national ones. Power point presentation
with the data analysis.
5. Presentation of the data at the forum of specialists.
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3. Delivery dates based on the work plan (to be approved by UNICEF HIV/AIDS
Officer):
 Analysis of demographic data, maternal health indicators and services uptake – 15 December,
2014;
 Comparative analysis of the data obtained to UNICEF – 22 December, 2014;
 Power point presentation with the data analysis – 25 December, 2014.
 Power Point presentation at the Working Group on PMTCT – 10 January, 2015;
 Final report with the final version of the data analysis – by 12 January, 2015.
4. Details of how the work should be delivered:
The consultants have to develop and submit to UNICEF final report by 12 January, 2015.
5. Performance indicators for evaluation of results:
The evaluation of results will be based on the following indicators:
 Technical and professional competence (will be measured by the quality of product provided to
UNICEF and feedback from UNICEF)
 Quality of work (timely submission of the products to UNICEF as it is defined in the part 3)
 Quantity of work (completing the assignments indicated in parts 2, 3, and 4 above)
 In addition such indicators as work relations, responsibility and communication will be taken
into account during the evaluation of the consultant’s work.
6. Qualifications/specialized knowledge/experience required to complete the task:
a. An advanced university degree in Medicine/Public Health, an academic degree in medical
sciences is an asset;
b. At least five years of practical/scientific experience in HIV/AIDS area, particularly in PMTCT;
c. Recorded experience of analysis of data related to HIV and PMTCT in particular;
d. Knowledge of international standards in PMTCT and understanding of a national health
system structure and functions;
e. Strong analytical and writing skills;
f. Good organisational, communication and managerial skills;
g. Basic knowledge of English and fluent in Ukrainian, as the data analysis has to be developed
and presented to the Ministry of Health Ukrainian.
7. Definition of supervision arrangements:
Consultant will be supervised by the HIV/AIDS Officer, UNICEF Ukraine.
8. Description of official travel involved:
Travels are not envisaged.
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9. UNICEF recourse in the case of unsatisfactory performance:
In the event of unsatisfactory performance, UNICEF reserves the right to terminate the
Agreement. In case of partially satisfactory performance, such as serious delays causing the
negative impact on meeting the programme objectives, low quality or insufficient depth and/or
scope of the assessment completion, UNICEF is entitled to decrease the payment by the range
from 30 to 50%.
10. Support provided by UNICEF:
Technical assistance, consultations, funding.
The deadline for submission of applications is 30 November 2014.
Only short-listed candidates will be contacted.
Applicants that fulfil the above requirements are requested to complete the United
Nations Personal History Form (P. 11) available at www.unicef.org/employ and
submit it together with a CV and a cover letter describing your professional interests
in working for UNICEF.
Applications should be sent to:
UNICEF Office, 1, Klovskiy Uzviz, Kyiv, Ukraine
Fax No. 380-44-230-2506
E-mail: recruitment_kiev@unicef.org (Please indicate ‘National consultant for the analysis of
the Mother-to-Child Transmission of HIV’ in the subject of your application)
UNICEF does not charge any fees or request money from candidates at any stage of the selection process,
nor does it concern itself with bank account details of applicants. Requests of this nature allegedly made on
behalf of UNICEF are fraudulent and should be disregarded.
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