TERMS OF REFERENCE
Technical Assistance to the Ministry of Health/Republican Centre for Immunoprophylaxis to
Review the Cold Chain System in Tajikistan
Background and Rationale:
The National Immunization Programme 2011-2015 is one of the main preventive healthcare services in
Tajikistan. It is performed by primary health care level facilities (polyclinics and rural health centers) in
both urban and rural areas as well as maternity houses for newborns. The Republican Centre for
Immunoprophylaxis (RCIP) and the Department of MCH services are the main agencies for managing
immunization services. Responsibilities of RCIP include programme planning and monitoring, forecast,
procurement and management of vaccine supply and other EPI related items, including cold chain items
and distribution of immunization reporting forms. The RCIP is also responsible for reporting and
registration, EPI data collection and analysis, technical guidance/assistance and vaccine-preventable
disease surveillance. The RCIP supervises six regional centres located in Dushanbe, Khujand, KurganTyube, Kulob, Khorog and Rasht.
In past UNICEF-Government of Tajikistan Country Programme cycles, UNICEF provided regular
technical assistance to the MoH/RCIP to support the strengthening of its cold chain infrastructure. The
technical support was provided at the request of the MoH/RCIP to re-assess the capacity of the cold chain
system in the country as part of cold chain infrastructure preparedness for major immunization-related
events, such as mass vaccination campaigns and introduction of new vaccines. The most recent Cold
Chain Assessment was conducted in 2009 with support from UNICEF. Additionally, in 2009 the WHO
CO conducted the Effective Vaccine Store Assessment. Both assessments revealed major gaps in cold
chain management. Since that time major work has been done, including provision of cold chain
equipment and capacity building activities across Tajikistan.
The recent 2010 Polio outbreak in Tajikistan revealed weaknesses of the routine immunization
programme, including cold chain planning and management at sub-national and local levels. There is a
need to constantly build capacity of local and provincial cold chain managers to ensure safe vaccine
handling. It becomes much more critical in mass campaign settings such as one on Diphtheria, which is
planned to take place in May-June 2012 based on the results and recommendations of WHO-supported
sero-survey.
Objective:
At the UNICEF-MoH Annual Review and Planning meeting held in December 2011, the MoH/RCIP
requested UNICEF’s assistance to provide technical assistance in reviewing the cold chain system
capacity and prepare an investment plan with proposed replacement plan for cold chain equipment and
spare parts in anticipation of the following:
-
A mass diphtheria campaign to be held in May 2012, and
-
Introduction of new Rotavirus vaccine in 2013.
The proposed international consultancy aims to provide the technical assistance to review the existing
cold chain infrastructure to facilitate smooth implementation of the National Immunization Programme.
More specifically, it will include a re-assessment of the current cold chain system capacity and will assist
in a detailed update of the existing cold chain inventory. It will also provide recommendations for
improvement to ensure safe vaccine storage during the introduction of new vaccines and implementation
of mass immunization campaigns.
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Expected Results (Deliverables):
The consultant will produce the following results:

Detailed cold chain inventory list by region, districts and health facilities;

Detailed recommendations on the improvement of overall vaccine management and cold chain
system;

Revised Standard Operating Procedures for vaccine and cold chain management at the national,
regional and district levels;

National cold chain investment plan, including replacement plan for cold chain equipment;

Cold chain forecast and its costing for 2012-2015 within the country multi-year plan (cMYP);

Interim report, including trip reports upon completion of field trips;

Final report with recommendations.
The assignment will be undertaken in close collaboration with responsible MoH/RCIP officials at all
levels. The assignment seeks to provide deliverables in the following phases:
Phase
Phase I
Assignments

Assessment of vaccine and cold chain management
capacity and performance at National, Oblast and
Rayon levels with regards to vaccines in use and in
the light of forthcoming major events (diphtheria
campaign and introduction of Rotavirus vaccine);
 Thorough analysis of the cold
chain system and further
recommendations:

Cold
chain
equipment
regions/districts and analysis;

Establish adequacy of the storage capacity for
routine vaccine storage and additional storage
needs for vaccination campaign against diphtheria
as well as inclusion of Rotavirus vaccine in the
programme.
- on enhancement of cold chain
management at the three
administrative
levels
(national,
regional
and
district);
Inventory of
cold chain
equipment
12 working
days
Phase II
Deliverables
inventory
by

Find gaps if any and recommend actions/
replacement plan/procurement of spare parts;

Revise and update cold chain equipment
replacement plan and provide recommendations for
the expansion/ rationalization of cold chain
capacity demonstrating effect on vaccine storage
with diphtheria campaign for the short term;

Assess vaccine storage, distribution precautions
and practices in the health facilities at all levels,
following WHO guidelines and recommend actions
for correction.

Establish vaccine storage requirements for the
campaign and ensure proper storage at all levels.

Plan vaccine distribution and transportation needs
confirming transportation at recommended
temperatures using proper equipment.

Complete trainings at the Regional level and
Preparations
for diphtheria
campaign
10 working
days
2
- on improvement of the cold
chain system;
 Revised
plan
for
the
replacement of cold chain
equipment;
 Revised
plan
for
the
replacement of cold chain
equipment specifically for
mass diphtheria campaign;
 Identified malpractices in
vaccine management and
proposed
corrective
measures;
 Prepared plans with vaccine
storage requirements along
with distribution plan to all
levels of EPI service delivery;
 Completed trainings on cold
chain management at regional
level and priority districts;
Phase III
Preparation to
introduction of
Rotavirus
vaccine and
overall
rationalization
of cold chain
system at all
level of
provision of
vaccination
services for
routine EPI
Programme;
20 working
days
develop training plan (with realistic timelines to go
on cascade scenario);
 Developed trainings plan for
cascade trainings at district
level.

Provision of recommendations to RCIP/MoH and
UNICEF for the improvement of cold chain system
management and performance;

Review Standard Operating Procedures (SOPs) in
the light of introduction of rotavirus vaccine;

Assess training needs for EPI managers/focal
points on vaccine and cold chain management at
all levels of health facilities, demonstrating effect
on vaccine storage with introduction of rotavaccine
for long term.
 Full set of recommendations
on improvement of cold chain
system management and
performance and presentation
to the UNICEF Health team
and MoH and other partners
on
further
steps
on
improvement of cold chain
system;

Provide on-job training and coaching to the
national cold chain manager and cold chain
technician at RCIP on care and maintenance of
cold chain equipment;

Provide on-job training and coaching to
responsible RCIP staff on appropriate cold chain
vaccine forecasting and cost calculation;

Propose options to introduce a backup system for
cold chain functioning in the cases of energy
crises;

Complete trainings for the regional and district
level cold chain managers at regional centres with
particular focus on implementation of SOP;

Prepare cold chain equipment forecast for next for
2012-2015 considering various scenarios and
population growth (target group);
 Revised SOPs;
 Identified training needs on
cold chain management;
 70 trained regional and
district
EPI/cold
chain
managers;
 Trained national cold chain
manager and cold chain
technician at RCIP on care
and maintenance of cold
chain equipment;
 Provided on-job training and
coaching to responsible RCIP
staff on appropriate vaccine
forecasting/calculation of EPI
related needs (vaccines in
use, syringes, safety boxes
and cold chain equipment
needs) for routine EPI
programme;
 Forecast for cold chain
equipment needs for 20122015, including planned
budget
and
potential
efficiency gains.
Required Qualifications and Expertise:

University degree in Public Health or related field with focus on EPI and/or Cold Chain
Management;

Five or more years of working experience in the field of vaccine and cold chain management,
with international/UN organization. Experience in CEE/CIS countries is preferable.

Technical knowledge and experience in cold chain management (assessment of vaccine stores
management as per WHO guidelines, vaccine storage equipment and their characteristics for
vaccine storage.

Experience in undertaking/ analyzing inventories of cold chain equipment and suggesting long
term plans.
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
Strong facilitation skills, with teaching experience in vaccine stores management aspects.

Fluency in English. Knowledge of Tajik and/or Russian is an asset.
Duration of the Assignment:
Two months (April-May 2012). Total number of working days: 42 days.
Consultancy fee:
The Consultant will be paid at the rate of P3 level on a monthly basis upon satisfactory completion of all
assignments.
Travel and daily subsistence allowance:
Travel from the country of origin of the consultant will be undertaken by most economical carrier in
economy class. The consultant will receive UN-approved DSA while in Tajikistan.
Duty station:
The consultant will be stationed in Dushanbe, Tajikistan with frequent travel in all regions of the country.
Performance indicators:
Consultant will report to UNICEF Tajikistan Health Specialist with overall supervision of the Chief of
H&N. Consultant’s performance will be evaluated against the following criteria: timeliness,
responsibility, initiative, communication, and quality of the products delivered.
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 process in order to
identify an alternative candidate.
Health Statement & Certificate:
Health Statement and certificate of Good Health must be received prior to signing the contract.
Supervision:
Health Specialist, UNICEF Tajikistan
Chief Health & Nutrition, UNICEF Tajikistan
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