Purpose of Consultancy/Institutional Agreement: To provide technical support and mentoring to the Paediatric Hospital in Port Moresby in Papua New Guinea.and two other provincial hospitals in initiating the SAM management using the recommended WHO revised guidelines (2013). Requesting Section: Young Child Survival and Development *************************************************************************** 1. Nature of Consultancy: Malnutrition continues to be a huge problem in PNG children, as indicated in the Key Results Areas 4 of the National Health Plan. The 2012 Annual Statistics from the Pediatric Hospital Reporting records that 12.6% of all admissions had severe malnutrition. Severe malnutrition was associated with 36% of all deaths with a case fatality rate (CFR) of 23.3% (2010: 21% and 2011: 18%). As comorbidity, malnutrition contributes up to 40-50% of all admissions. As for now nationwide, the management of these cases is haphazard and poor – nutrition units being a thing of the past. From the above rapid diagnosis of the situation of SAM management from the Paediatric Hospital at the General Hospital in Port Moresby, PNG, the MoH has requested UNICEF support to guide the revitalization of the SAM management in the country, starting from the General Hospital which will later serves as training centre, and progressively expand to all provincial hospital and in major district hospitals and health centres in the country. Although the Young Child Survival and Development Program has a position of P3 Nutrition Specialist in his structure, this post has not yet been filled due to lack of funds. Therefore, given the emergency of the situation, UNICEF PNG is willing to recruit a SSA P3 Nutrition Specialist to immediately handle the SAM component, starting at the Paediatric Hospital in Port Moresby General Hospital and later scale up in other provincial hospitals in the country. Background: Since 2012, UNICEF office in PNG has launched an advocacy work to bring the malnutrition issue into the government priorities list. The National Nutrition Policy has been revised with a strong focus on the multiple sectors response. During the development of this policy, UNICEF has successfully brought forward the problem of malnutrition in the country through multiple stakeholders meeting, field consultations and visits and finally has succeeded in raising a particular issue on severe acute malnutrition management, one of the lifesaving nutrition interventions. A close review of the SAM management at the General Hospital in Port Moresby and in other major provincial hospitals in the country has shown that although the recommended WHO guidelines are available to health workers, there are no therapeutic milk (F75, F100) and plumpynut to properly apply these guidelines and better handle the cases. The death rate remains high and health workers have progressively lost the skills in using the appropriate therapeutic milk to the benefit of a “marketed” milk. UNICEF first step in supporting the government on SAM management has been to supply a quantity of therapeutic milk (F75, F100), plumpynut and Resomal enough to cover 2,000 cases of SAM. These supplies are already in the country waiting to be used. 2. Purpose of Consultancy/Institutional Agreement: To provide technical support and mentoring to the Paediatric Hospital in Port Moresby and two other provincial hospitals in initiating the SAM management using the recommended WHO revised guidelines (2013). 3. Programme Area and Specific Project Involved: Young Child Survival and Development 4. Work Assignments: The consultant will perform the below tasks under the supervision of the UNICEF Chief of Young Child Survival and Development (Pierre Signe). - Provide technical assistance to the Paediatric Hospital / General Hospital Port Moresby and two other provincial hospitals (to be selected by the MoH) including: a. Assessment of the SAM management activities in selected hospitals b. Review of the SAM treatment protocol (drafted by the Paediatric Hospital medical staff) to ensure both stabilization/inpatient care and outpatient care are adequately addressed as per the latest WHO guidelines c. Facilitation of a working meeting with the Paediatrician Society to finalize and endorse the SAM protocol d. Performing on-site training of health workers e. Mentoring SAM activities in selected hospitals (at least 1 month per hospital) to ensure efficiency and effectiveness of the intervention f. Assisting the MoH to forecast the 2015 and upward therapeutic foods needs and include them into the regular procurement plan together with other essential health supplies. g. provide inputs to the development of plans to progressively expand management of SAM beyond the three hospitals. 5. Work Schedule: The contract shall commence by 1 April to 30 September 2014 (6 months). The consultant will submit reports according to the end products and work schedule described in paragraph 6 below. 6. End Product(s): Not all key tasks carry specific dates or timelines, therefore the tasks/end-products provided below are based on a broad schedule. The consultant will produce the following end-products. 1)Work Assignment a: Review the situation of SAM management at the Paediatric Hospital in Port Moresby and in 2 other provincial hospitals, providing better insight and clear baseline to support the intervention 1.1 Rapid assessment of SAM management in 3 selected hospitals 1.2 In each hospital, help to plan the follow up activities with a comprehensive schedule 1.3 Agree on the baseline data and targets to achieve by each hospital in the area of SAM management Rapid Assessment Report submitted Individual hospital SAM management plan with baseline, targets and time table submitted 4 weeks (2 weeks in Port Moresby and 2 weeks out of POM) Inception report and work plan – 7 days after signing the contract. Other deliverables to be submitted at the end of the first month after signing the contract. 2)Work Assignment b & c: Review the draft SAM protocol available and facilitate a working session with the National Paediatrician Society to finalize and endorse the protocol 2.1 Sessions work with the Paediatric hospital medical staff to review and adapt the SAM protocol 2.2 Working meeting with the Paediatrician Society to finalize and endorse the SAM protocol -Revised SAM protocol based on the WHO guidelines and adapted to PNG context -Meeting report submitted -New SAM protocol finalized and endorsed by the Paediatrician Society submitted Starting from the first day of the consultancy till the end of the second month of the consultancy By the end of the first month of the consultancy 3)Work Assignment d & e: Performing on-site training of health workers and mentoring SAM work -Training and mentoring reports submitted 3 months (1 month per selected hospital) Monthly report expected 4)Work Assignment f & g: Providing technical assistance to the central MoH to forecast therapeutic food supplies and insert them into the regular annual procurement plan for 2015 and upward; and to provide inputs for the scale up plan Therapeutic foods needs for 2015 forecasted and submitted -scale-up plan drafted 7. Estimated Duration of Contract: Period of contract is 1 April to 30 September 2014 (6 months). 8. Official Travel Involved: Yes. In selected provinces. _______________________________________________________________________ 9. Estimated cost of the consultancy: A total of $135,000 is considered ($46,000 fees and $89,000 for DSA and other travel costs). 10. Payment Schedule Consultancy fees will be paid in three installments: • DSA to be paid on monthly basis • 20% of fees to be paid at submission of work plan and inception report • 50% of fees at submission on deliverables for task a, b, c, d and e • 30% upon submission of deliverables for task f and g and the final consultancy report. 11. Supervisor of the contract The consultant will work under the direct supervision of the Chief of Young Child survival and Development Section at UNICEF. The consultant will work in collaboration with NDoH and selected hospitals for skills transfer and capacity building. 12. Qualifications or Specialized Knowledge/Experience Required: • Advanced university degree in the Nutrition • At least three years of relevant work experience in the area of SAM management, planning and management of nutrition rehabilitation for severe malnourished children, both inpatient/stabilization care and outpatient management • Fluency in English. • Demonstrated ability to effectively work and communicate in a multicultural environment • Computer literacy • Excellent knowledge of the WHO SAM management guidelines. 13. Consultants work Place The consultancy will sit at UNICEF 10% of the time and for the remaining 90% of the time s/he will be at the selected hospitals either in POM or in the provinces. 14. Nature of Penalty Clause to be Stipulated in the contract If any deliverable/output is not satisfactory in technical quality, UNICEF reserves the right to delay the consultant’s fee until s/he submits satisfactory deliverable /output and/or UNICEF reserves the right to reduce the fee prorated according to the deliverables that are not satisfactory. Please apply by sending CV and application letter to spierre@unicef.org