UNICEF UZBEKISTAN OFFICE
Terms of reference for International Consultant on Comprehensive Assessment of Integration of
Newborn and Child Survival Packages into pre- and post-service Health Professional’s Education
Curricula
Title: International Consultant for Assessment of Integration of Newborn and Child Survival
Packages into pre- and post-service Health Professional’s and Nurses Education Curricula
1. Background:
In Uzbekistan, steady progress has been made on improving the health, nutrition and well being of
mothers and children since gaining the Independence in 1991. The under-five mortality rate fell
from 74 to 38 per 1000 live births between 1990 and 2008. This has been achieved as a result of
improved health care, progressive implementation of newborn and child survival interventions
including increased coverage of immunization.
The health system reform process initiated in Uzbekistan is focused on improving the
infrastructure and hard ware component with less allocation of resources towards the
improvement of skills of health care providers to practice modern medical care. The overall
sustainability of the system and making steps towards the modernization is not reflected in
sufficient improvements in the health system management making it more efficient and effective
governance. The key issues of sustainability remained unaddressed, leading to missed
opportunities to accelerate action towards the MDGs and overall wellbeing of children.
Challenges remain and further improvements have to be achieved with a more holistic approach,
embracing maternal and child health, nutrition and wellbeing as a whole in challenging context of
the climate change, economic crisis and reemergence of epidemic diseases. From the maternal
and child health point of view, the neonatal mortality rate (NMR) is 26 per 1000 live births. More
than 79 per cent of infant deaths occur during the first 30 days of life due to avoidable causes like
prematurity, birth asphyxia and neonatal infection. This is despite the fact that more than 95 per
cent of deliveries are occurring in government supported maternities. The poor quality of
maternal, perinatal and early neonatal care is contributing to a high rate of newborn and maternal
deaths (the Maternal Mortality Ratio stands at 24 per 100,000 live births).
In 2003, the Government of Uzbekistan initiated a sector reform programme to improve maternal
and child health services. The Programme, supported by World Bank, ADB, UNICEF, WHO, UNFPA
and others, addressed the gaps within the primary health care, supply and in-service training
systems.
With technical support from UNICEF, the Ministry of Health (MOH) piloted the innovative
Newborn Survival Programme in Ferghana region. The objective was to develop evidence-based
training materials on newborn care, neonatal resuscitation, perinatal healthcare surveillance and
the International Live Birth Definition and to introduce them through systematic training and
supervision. The evaluation showed that the package had an impact on reducing neonatal
morbidity and mortality and recommended scaling up the Ferghana model in transitional health
systems with established primary care and referral systems. The MOH and UNICEF worked
together to plan the expansion and scale-up in other 8 regions.
During the Project implementation period review of academic curricula for under and
postgraduate medical education took place and recommendations for improvement were given to
all medical universities. Additional components of child survival, health management and the
introduction of maternal child healthcare were recommended to be included in pre-service
training.
At present only few Medical universities have modified their curricula. There is no available
information about commitment and will to follow up to such recommendations. This means that
country is still producing the workforce of general practitioners who have not been trained in
evidence based treatment of children and mothers. In the short term, health system can only use
human resources that already exist. But in the medium and long term, investment in human
resources and skills development contribute to MCH service performance. The priorities therefore
should include development and deployment of the relevant human resources for the health
system. In context of changing practice of medical care it is essential to invest in maintaining their
competency, quality and productivity through continuous education and on job training support.
2. Overall purpose of assignment:
The overall purpose of the consultancy is to act as Team Leader in the process of review of medical
curriculum, including:
 to identify constraints and gaps in the introduction and implementation of Newborn and
Child Survival Packages into pre-and post-medical curriculum;
 to assist to the Ministry of Health of Uzbekistan in the adoption of WHO tool “Planning,
Implementing and Evaluating Pre-Service Training (IMCI)”, which shall be used as a model
for assessment of other modules of Newborn and Child Survival Packages;
 to build capacity of the National Experts Team to apply this tool;
 Lead at least two assessments guiding the National Experts Team during comprehensive
review of the Medical Curricula of Health Professional’s and Nurses;
 to guide the process of development of follow up actions and recommendations;
3. Duty Station:
Tashkent, Uzbekistan and desk work
4. Tasks to be accomplished:
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To conduct desk review of all existing documents (studies, reports, etc) on achievements
and constraints of Uzbekistan to integrate innovative packages of MNCH into curricula of
Medical Universities;
Based on the desk review, collect further information from key stakeholders, to
complement and validate the desk review findings develop/adopt a questionnaire to be
used for self-assessment of MNCH curricula in all existing Medical Universities (both pre
and post-service education) and selected nursing colleges;
To analyze the self-assessment results and prepare briefing paper and presentation to be
used during the orientation meeting and workshop on adaptation of WHO tool;
In close consultations with Team of national experts prepare agenda of Orientation
meeting and Adaptation Workshop, compile handout materials and review all
presentations;
Act as leading facilitator during the Orientation Meeting (Day 1) and co-facilitator during
the Adaptation of the Tool (Day 2);
Provide technical support to the team of national experts in adaptation of WHO tool on
“Planning, Implementing and Evaluating Pre-Service Training (IMCI)”;
- Provide advice and support to the Team of national experts in modifying the above
mentioned tool to be used as a model for assessment of other modules of Newborn and
Child Survival Packages;
- Lead and supervise the assessment of curricula in two Medical Universities located in
Tashkent;
- Lead and supervise the assessment of curricula in two nursing colleges located in
Tashkent;
- Conduct briefings and de-briefings with the Management of these two Universities and
two nursing colleges prior and after assessment;
- Conduct working session with Team of National Experts and give them final
recommendations for further assessments;
- Prepare mission report based on the first field visit;
- Upon submission of results of assessments conducted by team of National evaluators
prepare first draft of the report and preliminary recommendations in consultation with
international co-evaluators, UNICEF and WHO technical specialists;
- To prepare agenda for the Round table aimed to discuss first draft of the Report and
facilitate the process of discussion, elaboration of Recommendations and Plan of Actions;
- Conduct series of briefing meetings with relevant authorities and donors;
- Prepare and submit the final report with recommendations.
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5. Supervisor:
The consultant will be supervised and report to Health Officer of UNICEF Uzbekistan Country
Office with debriefing and consultation with UNICEF Uzbekistan Representative and Deputy
Representative.
The consultant will work in close co-operation with involved consultants on Mother and Newborn
Health, Nutrition, national co-facilitators and WHO.
6. Programme Area and specific Project involved:
Programme 1: Access to Quality Basic Services for Women and Children
Project 1.1:
Maternal Child Health and Nutrition
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7. Key deliverables:
Assessment aimed to provide information in format of Report that the Government will use during
the preparation of Comprehensive Strategy of Mother, Newborn and Child health care
improvement, policy dialogues, and funding negotiations with donors and international agencies.
 Developed/adopted WHO Self-assessment questionnaire for Medical Universities and
nursing colleges (2 days)
 Brief report based on desk-review made and self-assessment results (5 days);
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Concept and Agenda of the Orientation meeting and Adaption workshop for WHO Tool for
Medical Curricula review (2 days);
 Facilitation of the Orientation meeting and facilitation of adaptation workshop for national
team (2 days);
 Master Assessments of two Medical Universities and two nursing colleges located in
Tashkent city (5 days);
 National team of pre- and post service evaluators established and capable to perform
Medical Curricula review;
 Mission Report upon completion of first field visit (3 days);
 First draft of the report on assessment (10 days);
 Facilitation of Round Table to discuss first draft of the report and elaboration of follow-up
actions and recommendations (2 days);
 Briefing with national authorities and donor community (2 days);
 Final report on comprehensive assessment in English (4)
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8. Timeframe and Estimated duration of the contract:
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37 working days, including two visits to Tashkent. Suggested duration of each visit 56 days.
 Contract will be signed for the period of April 14 – July 16 (37 working days)
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9. Team composition
Team of National Experts will include leading national experts on Nutrition, Nursing Education,
IMCI, Newborn Health, EPC, HIV/AIDS and Immunization.
10. Travel of consultant
Two visits to Tashkent: in the beginning and in the end of assignment. Travel arrangements will be
provided by UNICEF Uzbekistan country office and consultant is entitled to Tashkent standard UN
DSA rate.
11. Medical clearance
Consultants expected to work in any office of the Organization shall be required to submit a
statement of good health prior to commencement of work and to take full responsibility for the
accuracy of that statement, including confirmation that they have been fully informed regarding
inoculations required for the country or countries to which travel is authorized.
12. Insurance
Consultants are fully responsible for arranging, at their own expense, such life, health and other
forms of insurance covering the period of their services on behalf of UNICEF as they consider
appropriate. Consultants are not eligible to participate in the life or health insurance schemes
available to United Nations staff members.
13. Qualification or specialized knowledge/experience required:
 Advanced degree from Medical University on Pediatrics or Public Health;
 Relevant degree and experience in MCH care;
 Familiarity and practical experience in the implementation of WHO recommended
strategies “Integrated Management of Childhood Illnesses”, promotion of integration of
innovative packages into curricula of medical universities in CIS countries;
 Proven track record of similar type of expertise;
 at least 10 years of professional experience in maternal and child health related program
implementation;
 Solid knowledge of Medical Educational System in CIS countries;
 Experience of working in countries in transition on collecting, analyzing, and preparing
recommendations to child and maternal health, health policy formulation;
 Good analytical, communication, networking and facilitation skills;
 Ability to prepare analytical reports independently, prioritize and organize work
assignments;
 Knowledge of English and Russian languages is a must.
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14. SUBMISSIONS FROM INDIVIDUAL CONSULTANTS
The application should be submitted by e-mail with CV and filled Personal History (P11) to the
following e-mail address: tshirvanova@unicef.org
15. Reservations:
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.
All materials developed will remain the copyright of UNICEF and that UNICEF will be free to adapt
and modify them in the future.