Purpose of Activity/Assignment
Background
Between 2011 and 2015, the Philippines was repeatedly affected by several disasters (Typhoon Haiyan, Zamboanga Siege, Bohol Earthquake as examples) where draft management protocols were implemented to provide lifesaving care to affected children. Drawing from the experiences at LGU level during such emergencies, the DOH with technical support of UNICEF, led the development of the national guidelines. By Quarter 4 of 2015, two policy instruments on wasting were issued by the Department of Health (DOH) providing the policy and strategic framework to guide the local implementation of the National Guidelines for the Management of Acute Malnutrition (locally known as the Philippine Integrated Management of Acute Malnutrition or PIMAM) for children under 5 years and the Manual of Operations for SAM Management. WFP, on the other hand, provided technical support to DOH in developing the Manual of Operations for MAM Management.
Since 2014, UNICEF has been supporting the DOH who invested in and implemented a multi-year Scale-up Plan for the Management of Severe Acute Malnutrition (SAM) starting from an initial 17 priority provinces to nationwide implementation by 2022. Key components of the Scale-up Plan include development and dissemination of finalized policies and guidelines, procurement of essential supplies, development of training modules, drafting of a health insurance package for severe wasting, capacity building of trainers and implementers for delivery of PIMAM services in the identified priority provinces, and implementation of quality improvement methods to assess and monitor post-training implementation.
Program challenges remain including the sustained availability of essential commodities, increasing program coverage, and ensuring proper monitoring and delivery of quality services by trained personnel and volunteers at the local government unit (LGU) level where there are also issues on adequate planning and budgeting. From October 2018 to May 2019, UNICEF supported DOH in the conduct of the first ever Bottleneck Analysis (BNA) exercise for SAM management covering Phase 1 and Phase 2 Provinces of the Scale Up Plan. The BNA approach is a means not only to improve the access and effective coverage of SAM management services but very importantly to inform the SAM scale-up strategy and maximize the chance to achieve more responsive programming and better results for children of the Philippines. During the SAM BNA Validation and Action Planning Workshop last 9-12 April 2019, three main bottlenecks were identified that limit effective coverage of SAM management services in the study sites:
- ineffective supply chain for therapeutic and anthropometric supplies;
2) poor demand for SAM management services linked to poor community mobilization; and
3) limited supervision and lack of reporting/monitoring systems.
Because of the identified bottlenecks above, the DOH Philippines was also quick to issue Department
Memorandum 2019-0034 to guide local implementers on the distribution and utilization of RUTF and RUSF in exceptional circumstances effectively adopting 1) use of a single treatment product, 2) MUAC and edema only programming, and 3) optimized dosage using 1 sachet/day of RUTF to treat MAM cases and 2 sachets/day of RUTF to treat SAM cases.
At the onset of the COVID-19 pandemic in 2020, UNICEF and partners conducted a rapid assessment to understand the context and situation of each of the 19 local government units (LGUs) supported by UNICEF and to plan interventions accordingly. Examples of the adaptations include Family Mid-Upper Arm Circumference (MUAC) which empowers mothers and family members to screen for malnutrition and refer them to community workers for treatment. Furthermore, due to the COVID-19 pandemic, DOH also issued Department Memorandum 2020-0237 titled Interim Guidelines for the Delivery of Nutrition Services in the context of COVID-19 Pandemic reiterating the provisions of DM 2019-0034 and also allowing for the reduced frequency of follow-up visits by health care workers due to the movement restrictions and lockdowns imposed as part of the pandemic response. No formal studies have been conducted to demonstrate the effects and utility of the applied simplified approaches in the country.
Purpose
UNICEF continues to closely work with DOH to model simplified approaches and adaptations to the treatment protocols and programme design in the selected provinces in the Philippines. Several pieces of research are available on MUAC-only programming, use of single product, reduced treatment dosage, and community health worker-led treatment approaches and the body of evidence on their effectiveness, coverage and cost effectiveness has been growing globally.
However, due to mixed results and various contextual differences and limited data in Asian countries, there is a need to generate local evidence in the Philippines to support programmatic and policy changes for the management of wasting. Furthermore, it is important to closely monitor, and document use of simplified approaches to contribute to the evidence base of what works. Simplified approaches are now being implemented also in many Asian countries and it is likely that evidence from these countries will help contribute and soon fill the knowledge gap mentioned above.
Scope of Work
The consultant will be on-boarded through Action Against Hunger. Under the direct guidance and supervision of the UNICEF Health and Nutrition Specialist and Nutrition Officer of UNICEF Mindanao Field Office, the consultant will work closely with the Research Institution(s), the International Research Advisory Group, Nutrition Manager, UNICEF EAPRO and HQ Nutrition specialists, MOH officials, the PIMAM technical working group members, key NGAs and local government units, and UNICEF program specialists.
The consultant will provide expert technical assistance, coordination support, and facilitate the conduct of PIMAM technical trainings, supportive supervision and mentoring, quality assurance to PIMAM Programming, establishment/revitalization of OTC and ITC facilities, support the review of datasets and analysis of the Research Institution(s) tasked to implement the three Operations Research in Maguindanao Provinces.
The consultant is expected to work closely with the UNICEF MFO HN Specialist and Nutrition Officer in day-to-day activities, including support and coordination with implementing partners, service providers, and government counterparts to facilitate the delivery of UNICEFโs technical assistance through the operations research.
The consultant will directly support the provinces and health facilities and coordinate research activities with relevant local stakeholders.
Qualifications:
- A University Degree in public health, nutrition, family health, global/international health, health policy and/or management, or other health related sciences is required. An advanced degree in public health or related fields is desirable.
- Epidemiology, health systems, or M&E; educational background or post-grad training on Health
Systems Strengthening, Nutrition, Medicine, Public Health or medicine, Public Health, Child Health is an advantage - A minimum of 5 years of professional experience in public health/nutrition and research is required. Strong analytical and written and oral communication skills; people and leadership skills.
- Experience in planning, managing and monitoring research is desired. Familiarity with statistical packages and languages is an asset.
- Experience in nutrition program/project development in UN Systems agency or organization is an asset.
- Fluency in English and local dialect is an asset.