To document the process and outcomes of program strategies and costing the community based HIV care and treatment for children, vulnerable adolescent and young people and pregnant/lactating women living with HIV in southern highland regions of Njombe and Mbeya.
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Tanzania is estimated to have 110,000 children aged 0-14 and 190,000 young people 15-24 years living with HIV in 2020. In the same year, 10,000 children 0-14 and 20,000 young people 15-24 were newly infected with HIV. This makes Tanzania a regional and global high priority country in prevention and treatment of HIV.
In 2020, early infant diagnosis rate was reported to be 55% while the vertical transmission rate including breastfeeding was still high at 11.12% against the global and national target of 5%. Awareness of HIV-positive status and treatment status among those aware of their HIV-positive status are indicators of access to services. Viral load suppression among those aware of their HIV status and on treatment not only provides an indication of access to and retention in care, but also when compared to viral load suppression among all HIV-positive individuals, provides a measure of program success.
National evidence on ART treatment outcome analysis suggest poor treatment access and outcomes for children and adults living with HIV. Evidence shows that only 54% (against national target of 90% by 2022) of children aged 0-14 years and 84% of adults aged 15 years and above were on ART and only 68% of them achieved to suppress their viral load. AIDS related death among children aged 0-14 years was 8,300 and 2,700 among young people 15-24 years in 2020. It is known that early initiation of ART is associated with many health benefits in terms of reduced morbidity and mortality in all age groups as well as preventing HIV transmission. These evidences require ART treatment programmes to recognize and better address the distinctly different needs of the children and young people living with HIV in both rural and urban areas in consideration of the current COVID-19 pandemic that has partially affected the service delivery to people living with HIV.
The national guideline for the management of HIV and AIDS make provision for a differentiated service delivery model (SDM) for all populations living with HIV. This is an important policy shift which expands the scope for ARV service provision from facility to community which aimed to increase the number of clients on ART. Service Delivery Models for differentiated care is a client-centered approach that simplifies and adapts HIV services across the treatment cascade. The aim is to reflect the preferences and expectations of various groups of people living with HIV whilst reducing unnecessary burdens on the health system. The SDM allows now for stable children and young people living with HIV to receive ART in their communities delivered by a trained health care provider. This approach is very important to ensure people living with HIV remain in care and treatment for a longer period. In MINS for example, access to services is sometimes challenging with nearest health facility being between 10 to 40 kilometers away coupled with less Programme on HIV prevention care and support and minimum support from school, community, and family.
In ensuring quality and effective service delivery to people living with HIV and to support government of Tanzania in reaching all people living with HIV with care and treatment services, UNICEF Tanzania supported financially and technically the implementation of different programmes to support comprehensive community based HIV care and treatment to support children, adolescents, young people, and their families in southern highland regions of Tanzania since 2018. The Programme has been implemented by Baylor College of Medicine Children Foundation (Baylor Tanzania) in different phases, before and during COVID-19 pandemic. The Programme aimed to strengthen community-based strategies for ALHIV in semi-rural areas in different contexts and document the lessons learned to inform public health authorities at subnational and national level on the implications for further strategic guidance. To operationalize the service delivery model, safe spaces were identified for adolescents to receive ART close to their home. Different groups of children and adolescents were formed to facilitate the provision of service to the targeted groups. Additional interventions being implemented in the same geographical zone include a collaborative work with NACOPHA and the Network of youth living with HIV to strengthening the network and facilitate psychosocial support among this group in Southern highlands regions. Further, UNICEF is supporting the Ministry of Health on catalytical intervention in collaboration with local government authorities to accelerate identification, linkages to care and treatment services for children living with HIV.
How can you make a difference?
It is important that documentation of the program implementation and experience in integrating COVID 19 prevention interventions is done together with establishing the estimated cost of implementing community based care and treatment for children, vulnerable adolescent and young people and pregnant/lactating women living with HIV. It is expected that the recommendations from this assignment will inform the scale up of community-based care and treatment for children, vulnerable adolescent and young people living with HIV in Tanzania.
Overall objectives of the consultancy:
The overall objective of this consultancy is to document implementation strategies, cost the community based HIV care and treatment interventions implemented in Southern Highland regions of Mbeya and Njombe and propose key recommendations for scale up of community-based care and treatment for children, vulnerable adolescent and young people living with HIV.
Specific objectives of the consultancy:
- To review national guidelines and tools for community HIV and health care for children, such as the Integrated Management of Childhood Illnesses
- To document the process of implementation of strategies under DSDM integrated with COVID 19 prevention interventions for children, adolescents and pregnant/lactating women living with HIV.
- Identify and document promising practices and lessons learned
- Provide strategic Programme recommendations for scale up of community-based care and treatment approach for children, adolescents and young people and pregnant/lactating women living with HIV.
- To review costs incurred during implementation of program activities and produce a package with standardized cost for implementing community-based care and treatment approach for children, adolescents and young people and pregnant/lactating women living with HIV.
Summary of expected outputs
- A summary report describing national Programme guidelines context, program implementation approaches for the integrated COVID 19 and community-based care and treatment interventions for children, adolescents and pregnant/lactating women living with HIV.
- An analytical report and description of promising practices and lessons learnt which can be used for policy advocacy
- Strategic Programme recommendations to inform scale up of the community-based HIV and health care for children, adolescents and pregnant women living with HIV
- A document with standardized cost for implementing community-based care and treatment approaches for children, adolescents and young people living with HIV.
The consultant is expected to work under the technical and regular supervision from UNICEF’s HIV Pediatric HIV Specialist, overall support from the NOD HIV Specialist and general leadership of the Chief of HIV/AIDS. The consultant will work in close collaboration with other UNICEF technical experts working on Community Health and Social Policy as well as UNICEF colleagues in the UNICEF Mbeya Field Office. In addition, s/he will work with the National AIDS Control Programme (NACP) and Tanzania Commission for AIDS (TACAIDS) at national and regional level for technical guidance. Furthermore, the consultant will work with regional government secretariats in Njombe and Mbeya and with community based care and treatment Programme implementing partners in the regions as well as health care workers at the Care and treatment centre (CTC) to solicit inputs for informed decision and documentation regarding the entire work. The overall process of this consultancy will involve field visits and an in-depth consultative approach with stakeholders at national, regional, and subnational levels.
The consultant will provide technical expertise to UNICEF, MoHCDGEC and PORALG on the actual costing of implementing the scalable community-based care and treatment HIV Programme, as part of the national community health Programme, which have COVID 19 prevention included. This may include a variety of areas such as policy and strategic guidance, advocacy, training, monitoring and evaluation and other aspects of HIV care and treatment.
Specific tasks, Methods and Expected Deliverables:
|Objective/ key task||Method||Deliverables|
Duration of the consultancy:
This consultancy covers a period of 40 days spread within 3-months with different timeline in report submission and payment.
Deliverables and Payment schedule:
|Deliverable 1: Inception report||Inception report detailing the overall consultancy framework including the methodologies for each objective, detailed workplan and timelines, data collection guides and tools.
|Deliverable 2: Field visit report
|A field visit report detailing the field experience and the Programme implementation experience.
|Deliverable 3: Draft report and Power point Presentation||
|Deliverable 4: Final report, costed implementation plan; Power point Presentation and policy brief
Payment of each phase will only be made after submission of the required approved (by HIV/AIDS Specialist, the supervisor) final reports for each deliverable
Assessment/ selection process and method:
Interested consultant will be assessed based on a technical and financial proposal. The financial proposal should include all related cost including travel cost with breakdown for each component of the proposed work deliverables based on an estimate of time taken which needs to be stated. The budget narrative must explain the assumptions behind all cost estimates.
The proposals will go through a technical and financial evaluation to determine their merits for this assignment. The technical proposal will have a weight of 75%, while the financial proposal will have a weight of 25%. Technical proposals should attain a minimum of 50 points to qualify and be considered for financial review. The below table shows the main criteria for the technical and financial review.
Communication and reporting:
The consultant will report to UNICEF Pediatric HIV Specialist with support from the Chief of CAIDS and other UNICEF colleagues. S/he will work closely with key government ministries, departments, and agencies and LGAs involved in this consultancy.
No member of the consultancy team may commit UNICEF or undertake any tasks or travel related to the consultancy before a contract has been duly signed between themselves and UNICEF. The consultant must abide by the terms and conditions of the contract signed with UNICEF. The consultant shall uphold professional standards of practice including observing human rights of children, adolescents, and women. UNICEF will require proof of medical insurance covering medivac by the consultant.
To qualify as an advocate for every child you will have…
- A minimum of [10 years] of relevant professional experience in public health, adolescent health, HIV care and treatment for children, adolescents, child health and community health programmes
- Experience of working in Tanzania especially with the government MDAs is highly needed.
- Proven experience in costing of Programme interventions
- Experience in community health system strengthening for essential services, preferably experience in the management of HIV programmes, research and designing of health related programmes with costed implementation plan.
- Excellent management and coordination skills and an ability to communicate effectively with diverse partners
- Excellent skills and proven experience to write and deliver timely and high-quality reports
- Developing country work experience and/or familiarity with emergency is considered an asset.
- Fluency in English is required. Knowledge of another official UN language or a local language is an asset.
For every Child, you demonstrate…
UNICEF’s values of Care, Respect, Integrity, Trust, and Accountability (CRITA).
The UNICEF competencies required for this post are…
Builds and maintains partnerships, demonstrates self-awareness and ethical awareness, innovates, and embraces change, drive to achieve results for impact, manages ambiguity and complexity, thinks, and acts strategically, work Collaboratively with others.
To view our competency framework, please click the link below.
UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization.
UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.
Only shortlisted candidates will be contacted and advance to the next stage of the selection process.
Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures, and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws.