Transform: Primary Health Care is a USAID funded project to improve healthcare outcomes to End Preventable Child and Maternal Deaths (EPCMD) in Ethiopia, which in turn supports Government of Ethiopia’s efforts within the Health Sector Transformation Plan (HSTP). Transform: Primary Health Care Project will operate in the four most populous regions of Ethiopia (Amhara, Oromia, Tigray and Southern Nations, Nationalities and People’s Region). This will be accomplished in part by: mitigating the drivers of child and maternal mortality in these regions through the facilitation and implementation of quality health service delivery; improved management and performance of health systems; and implementation of innovative and evidence-based social behavioral change and communication interventions. The Project will strengthen the capacity of the health system to effectively use management tools and implement best practices at all levels of the health system and health care delivery with a major focus at the primary care level that includes primary hospitals and PHCUs.
Background
In service training on Basic Emergency Obstetric and Newborn care has been instrumental to timely respond to the country wide need in improving the skill of front line health providers to deliver basic lifesaving emergency obstetric care as identified by the 2008 National EmONC assessment. With the collaborative effort of MOH and partners, it was possible to reach over 6,000 health providers with the training.
To assure uniform high quality maternal and newborn health service provision in the country and with recognition of the need for a standardized Basic Emergency Obstetric and Newborn Care (BEmONC) training, BEmONC Training package was developed and has been in use for several years. The training package has served as a standard guide and resource both for pre-service and in-service trainings of health professionals.
Rationale
In the past few years of in-service BEmONC training implementation, there have been changes in global and national recommendations, guidelines as well as focus areas in management of MNH emergencies throughout the continuum of care. More over the cost effectiveness of the ongoing conventional training approach is questioned as it is found to be resource intensive in terms of finance as well as trainee (health worker) time spent away from service provision.
Based on analysis of existing data on MNH, gaps in ANC quality related to late initiation of first visit as well as very low coverage and quality of PNC due to early discharge of mothers delivering at facilities has warranted attention and hence become priorities of the MOH MCH program. Accordingly early initiation of ANC as well as 24-48 hours postnatal stay in facilities is being advocated for and implemented. Respectful maternity care as part of the transformation agenda on CRC is also a new development gaining increasing consideration.
The first ever national MDSR data report (2014-15) has revealed that post-partum hemorrhage is the leading cause of death followed by hypertensive disease in pregnancy as the second most important direct cause of death. In line with this the MOH MCH directorate is in the process of preparing a National Plan of Action To Eliminate preventable Obstetric Hemorrhage Deaths which highlights the need to give more emphasis to these mortality drivers in capacity building efforts like the in-service BEmONC training. There is also increasing experience with use of some teaching methods like emergency drills to maximize transfer of learned skills to practice which is worth considering.
In light of the resource intensive nature of the conventional BEmONC training, few partners have conducted some comparative studies to evaluate the effectiveness and efficiency of other alternative training approaches like blended training. The blended approach gives more time to skill learning with reduced overall duration of training. It is assisted by technology and uses self- learning and more interactive approaches in comparison with the conventional training approach. Results of these studies have shown that the blended approach is equally effective as the conventional approach with low cost and time.
In addition to the above local circumstances that deserve consideration in the BEmONC training material there are current global technical updates in the area of MNH care in terms of new WHO guidelines on ANC, PNC, PMTCT, and management of emergencies such as postpartum hemorrhage. Hence revision of the BEmONC training package based on but not limited to the above justifications and considerations as well as grounded in the objective realities of the country is planned.
Objective
This TOR is meant to recruit national consultant to fully revise and update the BEmONC training package (training manual, participants and facilitator guide) by incorporating all relevant topics; national and global technical updates and focusing on the key intervention areas to address maternal and newborn mortality drivers. Revision of teaching learning methods and training approach shall be considered in consultation with the MOH.
Scope of work
The consultant is expected to conduct the following activities:
Duration &Time frame of the consultancy
The total consultancy period will be 2 & 1/2 months and the consultant is expected to start assignment on the 15th of August 2017 and ends by the 31st of October 2017.
Background qualification in clinical medicine with specialty in Obstetrics and Gynecology
Minimum of 10 years’ experience working in the Ethiopian health system
Experience in capacity building of reproductive, maternal, new-born and child health programs at pre and in-service levels
Excellent report writing and communication skill
Postgraduate degree in public health will have an additional value
Excellent command of English language both oral and written.
Renewed license for a consultancy service with VAT and TIN Registration certificate