Individual Consultant:Technical Advisor for Integrated Community Health Health Systems Strengthening at Unicef Tanzania
- Organization: UNICEF – United Nations Children’s Fund
- Location: Dar es Salaam (Tanzania)
- Grade: Consultant – Contractors Agreement – Consultancy
- Occupational Groups:
- Children’s rights (health and protection)
- Women’s Empowerment and Gender Mainstreaming
- Public Health and Health Service
- Social Affairs
- Civil Society and Local governance
- Project and Programme Management
- Closing Date: 2020-02-10
To provide technical support for the coordination and strengthening of integrated community health systems in Tanzania, with a focus on operationalization of community primary health care structures aligned with strategic guidance from the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) and President’s Office of Regional Administration and Local Government (PORALG) in close collaboration with relevant partners and stakeholders.
UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. To save their lives. To defend their rights. To help them fulfill their potential.
Across 190 countries and territories, we work for every child, everywhere, every day, to build a better world for everyone.
And we never give up.
For every child, [Health]
Background, Problem Statements, and Justification
As a result, the focus shifted from the late seventies onwards to volunteers to support community health structures, often externally funded. Three decades of fragmented volunteer programs continued in vertical priority health issues such as HIV/AIDS, Nutrition, Family Planning etc. Each of these projects supported volunteers but activities varied in scale, training content and duration, and the extent of engagement with existing or potential health structures and the community itself. Limited coordination and lack of a comprehensive primary health care approach further isolated these approaches.
Today, the goals of integrated primary health care at community level have still not been realized, and for rural communities, access to care remains inequitable. Recent research shows that 66% of women in Tanzania faced at least one key barrier in accessing health care, primarily the costs of treatment (50%) and distance to the health facility (42%) (Afnan-Holmes et al, 2015). This is further demonstrated by the fact that in Tanzania, 86% of urban women give birth in a health facility compared to only 54% of rural women, 50% of urban children with diarrhoea are taken to a health provider while only 40% of rural children get treatment, and timely postnatal care for newborns is much more common in urban areas (61%) than in rural areas (35%) (MOHCDGEC, NBS, OCGS & ICF, 2016). These inequities are even more pronounced in certain regions, with 94% of births taking place in health facilities in urban Dar Es Salaam, compared to only 40% in Simiyu, which is 93% rural. (MOHCDGEC, NBS, OCGS & ICF, 2016).
Social protection, nutrition and environmental sanitation are three areas where progress has been limited in scale not the least due to the poor integration of these interventions into an overall community health structure supported by multi functional community and social welfare cadres.
Although Tanzania has made commendable progress in extending life expectancy, controlling communicable diseases and reducing the deaths of children under 5 in recent decades, the number of maternal and new-born deaths continues to be unacceptably high. Each year in Tanzania, more than 110,000 children under five and 8,000 mothers die, mostly of preventable causes, with pneumonia, malaria, and diarrhoea accounting for 55% of deaths in children aged 1-59 months (Afnan-Holmes et al, 2015). With the current national human resource gap estimated at 65%, a large percentage of this gap exists at the dispensary and village level in rural areas, and therefore, “task shifting”of primary care functions from professional health workers to community health workers (CHWs) is considered to be a means to improving the health of millions quickly and at reasonable cost (Hirschhorn at al, 2006).
CHWs with a broad health and social welfare mandate are relevant to function as the essential bridge with and between social and health structures. As part of this, the recent government health policy (2019) stipulates that strengthened community health structures (including CHWs) need to be put in place to address the multidimensional health needs in an integrated manner. To date, despite relevant policies and strategies being in final stages of approval, implementation of task shifting as well as integrating cadres of community-based social and health services providers into the formal health sector in Tanzania has yet to be fully developed.
How can you make a difference?
The Government of Tanzania (GoT) through MOHCDGEC and PORALG has recently updated the national Community Based Health Programmes (CBHP) policy guideline and the national CBHP implementation design to facilitate coordinated implementation of CHW programmes in the country. The overseeing role for the implementation of the two policy documents is vested in the CBHP unit of the Health Promotion Section – MOHCDGEC. The CBHP unit, although seriously understaffed, is supported by a very active Technical Advisory Group (TAG) where other key ministries, departments and government agencies (MDAs including PORALG, MOF, POPSM, etc); technical experts and academicians; community health implementing partners and donors meet regularly under the chairmanship of the assistant director of MOHCDGEC HPS to provide technical and financial support to guide the ministry in its coordinating, monitoring and governance role.
Recognizing the technical gap in the CBHP unit of the MOHCDGEC HPS, UNICEF Health section is proposing to recruit an experienced consultant to provide technical support to the key ministry/ies and partners for the coordination and strengthening of integrated community health systems in Tanzania, with a focus on operationalization of community health systems and structures aligned with the new national CBHP policy guideline and implamentation design.
UNICEF, in coordination with members of TAG, could play a pivotal role in moving the policy and implementation strategic guidance forward with technical and financial support to MOHCDGEC HPS, while other donors have pledged support for implementation of CHW activities at community level through LGAs. Improved community health systems and structures with effective community health and social welfare workers serve towards achieving sustainable development goals (SDG) 3 – to achieve health and well-being for all; SDG 5 – to achieve gender equality; SDG 9 – innovation for all; SDG 10 – growing equality; and SDG 17 – to promote private-public partnerships.
2. Tasks, Deliverables and Timeline
The consultant is expected to work in close collaboration with UNICEF Tanzania in the following tasks:
- To support the Assistant Director of the HPS and the CBHP unit of the MoHCDGEC in guiding the process of implementing the new national CBHP policy guideline and implementation design, including to establish a learning agenda to inform implementation research, to monitor progress and to reflect on results achieved.
- To support the Assistant Director of the HPS and the CBHP unit of the MoHCDGEC to shift the focus of the Technical Advisory Group (TAG) from CHW agenda only to integrated community health systems; to advocate for the active involvement of PORALG in this process; and to ensure harmonization and coordination with relevant community and primary health care structures across programmes and cadres.
- To ensure that UNICEF Health section and the Children and AIDS section (CAIDS) are kept informed on the CHW agenda and community health systems policies to ensure strategic decision making and follow up of lessons learned to guide priority setting and work plans within the respective sections.
- To advise UNICEF Health, Nutrition and CAIDS sections and collaborating regions (Kigoma, Mbeya and Songwe) on technical aspects of the implementation of the newly updated national CBHP policy guideline and implementation design such as financial mechanisms, integration of support from various programs (including integrated community case management of childhood illnesses – malaria, pneumonia, diarrhea) and links with official and unofficial community structures, e.g. adolescent peer educators.
- To promote coordination of programmes related to community systems and structures within UNICEF Tanzania Country Office (TCO) through supporting the CHW Task force and its transitioning to a community systems task force to enable coordination and integration of activities within TCO
- Provide expert guidance to the implementation of UNICEF supported CBHPs in Kigoma, Mbeya, Njombe and Dar es salaam regions, including strengthening community based strategies to support adolescent living with HIV and their families
The consultant will provide technical expertise to UNICEF and MOHCDGEC on supporting the roll out of the Community Health programme. This may include a variety of areas such as policy and strategic guidance, advocacy, training, job tasks and other aspects of Community PHC implementation, logistics and costing of programming etc. The consultant will review all policies and materials related to Community Health and support the government in coordination of all agencies and internally in the MOHCDGEC, as well as assisting the CBHP unit in their role of monitoring the programme.
The Technical Advisory Group, donors, implementing partners, academics and others are crucial to the success of the CHW programme, and the consultant will act as a liaison among agencies, facilitate quarterly meetings, prepare meeting notes and ensure smooth functioning of the TAG. The consultant will also coordinate among government ministries in relation to community health and CHWs, such as with the PORALG and other relevant departments, as well as ensuring that CBHP and CHW roles and programming are reflected in a variety of MOHCDGEC strategic documents and materials.
- Documentation, minutes and action plans based on interactions and quarterly meetings on implementation and coordination with the TAG – MOHCDGEC HPS/CBHP and PORALG
- Learning agenda for CHWs and community health systems agreed by TAG members, MOHCDGEC HPS/CBHP and PORALG
- Update reports/presentations for UNICEF TCO health and Children and AIDS sections as well as other stakeholders and donors on progress of implementation of new national CBHP policy guideline and implementation design
- Policy/advocacy briefs for UNICEF senior management from lessons learned implementing new national CBHP policy guideline and implementation design
- Policy/advocacy briefs for MOHCDGEC and PORALG senior management from lessons learned implementing new national CBHP policy guideline and implementation design
- Advocacy for the integrated community case management/basic curative services (iCCM) for childhood illnesses (malaria, pneumonia and diarrhea) including conducting and facilitating a symposium/consultative meeting engaging key stakeholders to push iCCM agenda forward
- Conduct field visits for technical support to the implementation of CHW programmes in Kigoma, Mbeya and Songwe regions, and share reports and lessons learned to UNICEF, the Government (MOHCDGEC, PORALG), LGAs and implementing partners
To qualify as an advocate for every child you will have…
- Minimum of Masters in public health or social science, specializing in international health, accountability and public service delivery
- Minimum 10 years of experience in international development sector, health systems and basic service provision issues in resource constrained countries.
- Solid experience in liaising and networking with high level senior government officials, stakeholders and donors in the health and development areas. Experience working in Tanzania especially with the government MDAs.
- Experience in community health system strengthening for essential services, preferably experience in the management, research and design of programmes.
- Excellent management and coordination skills and an ability to communicate effectively with diverse partners and donors at international, regional and country levels
- Excellent skills and experience to deliver timely and high quality products.
- Ability to function effectively in English Knowledge of another official UN language (Arabic, Chinese, French, Russian or Spanish) or a local language is an asset.
- Transport will be provided to the consultant during field travel.
- No contract may commence unless the contract is signed by both UNICEF and the consultant
- No travel should take place without an email travel authorization from the section prior to the commencement of the journey.
- Additional details of UNICEF rules, regulations and conditions will be attached to the contract.
Terms of payment
|Deliverables||Timeline||% of total contract|
|Documentation, minutes and action plans based on interactions and quarterly meetings on implementation and coordination with the TAG – MOHCDGEC HPS/CBHP and PORALG||10 days||17.0%|
|Update reports/presentations for UNICEF TCO health and Children and AIDS sections as well as other stakeholders and donors on progress of implementation of new national CBHP policy guideline and implementation design||8 days||13.0%|
|Policy/advocacy briefs for UNICEF senior management from lessons learned implementing new national CBHP policy guideline and implementation design||6 days||10.0%|
|Policy/advocacy briefs for MOHCDGEC and PORALG senior management from lessons learned implementing new national CBHP policy guideline and implementation design||6 days||10.0%|
|Advocacy for the integrated community case management/basic curative services (iCCM) for childhood illnesses (malaria, pneumonia and diarrhea) including conducting and facilitating a symposium/consultative meeting engaging key stakeholders to push iCCM agenda forward||10 days|
|Learning agenda for CHWs and community health systems agreed by TAG members, MOHCDGEC HPS/CBHP and PORALG||15 days||25.0%|
|Conduct field visits for technical support to the implementation of CHW programmes in Kigoma, Mbeya and Songwe regions; assess implementation progress and identify adjustments required in line with any policy; and share reports and lessons learned to UNICEF, the Government (MOHCDGEC, PORALG), LGAs and implementing partners||15 days||25.0%|
For every Child, you demonstrate…
UNICEF’s values of Care, Respect, Integrity, Trust, and Accountability (CRITA) and core competencies in Communication, Working with People and Drive for Results.
The functional competencies required for this post are…
View our competency framework at
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.
Mobility is a condition of international professional employment with UNICEF and an underlying premise of the international civil service.
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Applications from non-qualifying applicants will most likely be discarded by the recruiting manager.