Senior National Consultant for Updating Emergency Obstetric Care Guideline and develop Obstetric Care Protocol in Rwanda – UNICEF Rwanda

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Background and Purpose:

There have been dramatic improvements in Rwanda in the last decade as far as maternal and child health is concerned. The progress made can be attributed to a combination of factors that contributed to strengthen the Rwanda health system and improvements in services accessibility to the population. Despite the tremendous progress and reaching the MDG 4 and 5 targets in 2015, Rwanda still bears a heavy burden of maternal, high neonatal and child mortality. High impact interventions including implementation of Emergency Obstetric and Newborn Care (EmONC) helped Rwanda to be among one of nine countries which reached Millennium Development Goals (MDGs) related to the reduction of maternal and newborn deaths. The Maternal Mortality Ratio declined from 1,071 per 100,000 live births in 2000 to 210 per 100,000 live births in 2015 while Newborn Mortality declined from 37 per 1,000 live births to 20 per 1,000 live births during the same time frame.

According to the maternal death audit, 67 per cent  of audited facility-based maternal deaths registered in 2018 were due to direct causes where postpartum hemorrhage accounting for 39% of the total direct causes, followed by uterine rupture due obstructed labor (15%), abortion (12%) and pre-eclampsia/eclampsia (9%). As per the same source, the main causes of neonatal death are preterm birth complications (36%), intrapartum-related complications leading to birth asphyxia (34%), neonatal abnormalities (12%) and neonatal infections (11%). Barring maternal and neonatal deaths, perinatal mortality rate is still high with 29 deaths per 1,000 pregnancies as per DHS 2015. Hence, strengthening the basic and comprehensive emergency Obstetric and neonatal care could accelerate the reduction of maternal and newborn deaths as well as still births.

Through partnership with UNICEF and other partners, RBC/MCCH is developing emergency obstetric care protocol/guideline to improve the quality of care in health facilities. So that Partners implementing clinical mentorship program can improve the quality of care, it was found that there is a need to develop the protocol for obstetrical care to include new global updates and approaches to improve further the quality of maternal and newborn care in health facilities. This was discussed and agreed in the safe motherhood technical working group. Based on the recommendation of the safe motherhood technical working group, RBC/MCCH took a decision to develop, review and update the current emergency obstetric care protocol/guideline to improve quality of obstetric care within hospital and health centers across the country.

Therefore a short consultancy is necessary to develop, consolidate and finalize obstetric care protocol, norms and standard for obstetrics and neonatal care and as well finalize EmONC  guideline and  developing obstetric protocol training materials. The consultant will work under the guidance of RBC/MCCH, safe motherhood technical working group and UNICEF health section. 

Justification:

During implementation of the clinical mentorship program to improve quality of care for childbirth/intrapartum, it was found that there are gaps that need to be included/improved to the emergency obstetric protocol/guideline and also to update with the new global updates on emergency obstetric care. MoH/RBC of Rwanda has requested UNICEF to provide technical assistance to update the EmONC guideline, develop obstetric care protocol, obstetric protocol training materials and developing obstetric/neonate standards.

In order to facilitate the review and update of the emergency obstetric care protocol/guideline, UNICEF Rwanda CO will support the identification and deployment of a consultant with the required technical expertise to review and update the emergency obstetric care protocol/guideline in close coordination with the RBC/MCCH and safe motherhood Technical Working Group. 

Objectives

The main objective of this consultancy is to develop, review, update, consolidate and finalize EmONC guideline, obstetric care protocol, obstetric protocol training materials and developing obstetric/neonate standards. The consultant will also work on the final design and layout of the protocol, guideline and standard.  

Evaluation Criteria 

The following weighting will be applied during review and selection of the suitable candidate:

1. Technical Proposal           –              75%
2. Financial Proposal            –              25%

The average weight (technical and financial) will be used to determine the most suitable candidate.

Please note that the final remuneration will be negotiated by HR. 

Payment Schedule 

Payment is linked to agreed deliverables upon satisfactory completion and certification of deliverables by the supervisor.

Payment schedule:

Deliverable	Payment proportion
Deliverable 1: First draft of the EmONC guideline, Obstetric care protocol, Obstetric protocol training materials and obstetric/neonatal standards to be shared and presented to the Safe motherhood and RMNCH technical working group (TWG).	60%
Deliverable 2: Submission of validated, final well-designed print ready EmONC guideline, Obstetric care protocol, Obstetric protocol training materials and obstetric/neonatal standards.	40%

General Conditions: Procedures & Logistics

UNICEF will issue the contract and pay the consultant, based on the payment schedule mentioned above and after the validation of the deliverables by safe motherhood/MCH TWG, RBC/MOH and UNICEF. UNICEF Health Specialist – in collaboration with RBC/MoH technical expert- will manage the contract and be the focal point for all contractual matters. For all contractual issues, the consultant will report to UNICEF. For technical issues, the consultant will work directly with the technical team, led by UNICEF and RBC/MOH and safe motherhood technical working group. All deliverables must be validated by safe motherhood/MCH TWG RBC/MoH and UNICEF to be considered final.

During the consultancy period the consultancy will cover his/her transport cost in Kigali and at the request of the supervisor, UNICEF shall provide the Consultant with transport for field visits.

For field visit the consultant will be reimbursed out of pocket expenses for accommodation, meals and incidentals but not exceed applicable daily subsistence allowance (DSA) rates for any location, as promulgated by the International Civil Service Commission (ICSC).

. Other expenses such as local travels, banking/cash services, or office space and equipment (including computers and photocopiers) shall be under the responsibility of the consultant. The consultant is expected to use his or her own equipment, including computers. UNICEF premises will be available for the meetings and collecting inputs from other partners.

The consultant shall not make use of any unpublished or confidential information, made known in the course of performing duties under the terms of this agreement, without written authorization from MoH/UNICEF. The products of this assignment are not the property of the consultant and cannot be shared without the permission of MoH/UNICEF. The consultant shall respect the habits and customs of the local population and abstain from interfering in the country’s political affairs. Law no 31/2007 on intellectual property right will be applicable where necessary.

The consultant shall abide by and be governed by UNICEF Procedure on Ethical Standards in his duties and will be required to complete mandatory trainings before s/he is hired. 

Payment will only be made for work satisfactorily completed and accepted by UNICEF. UNICEF reserves the right to withhold all or a portion of payment if performance is unsatisfactory, if work/deliverables is incomplete, not delivered or for failure to meet deadlines.

All materials developed by the consultant will remain the copyright of MoH/UNICEF, who will be free to adapt and modify the materials for future use.

There are two Outputs associated with the assignment divided into two phases, phase 1 and phase 2 grouped into 2 deliverables:

• Deliverable 1: First draft of the EmONC guideline, Obstetric care protocol, Obstetric protocol training materials and obstetric/neonatal standards to be shared and presented to the Safe motherhood and RMNCH technical working group (TWG).
• Deliverable 2: Submission of validated, final well-designed print ready EmONC guideline, Obstetric care protocol, Obstetric protocol training materials and obstetric/neonatal standards.
• All deliverables need to be developed in consultation with and validated by RBC/MOH and UNICEF. 
• The write up of all outputs above should be in a clear language so that they can be easily understood, avoiding long sentences, jargon, abbreviations and technical terms to the extent possible, and should as necessary define the terms used.

To qualify as an advocate for every child you will have…

• Desired competencies, technical background and experience  
  • Medical background with specialization in obstetrics or midwifery, masters public health or related field
  • Miminum of 8 years of relevant experience in guidelines/protocols development
  • Experience in clinical and standard public health and primary health care services
  • Fluency in written and spoken English is required.
  • Knowledge of Rwanda health system is an asset.
  • Strong analytical and conceptual skills.
  • Computer skills (excel, word, PowerPoint)

For every Child, you demonstrate…

UNICEF’s core values of Commitment, Diversity and Integrity and core competencies in Communication, Working with People and Drive for Results.

How to Apply

UNICEF is committed to gender equality in its mandate and its staff. Well qualified candidates, particularly females are strongly encouraged to apply.

Interested candidates should send their complete Personal History (P11) form, which can be downloaded form (http://www.unicef.org/about/employ/files/P11.doc). or a CV/resume, as well as a cover letter explaining what makes them suitable for this consultancy.

Qualified and experienced candidates are requested to submit a letter of interest including a Technical Proposal outlining a road map for review and implementation timeline (must to submit technical proposal and possible to team up with another expert who has experience in the field). In their letter of interest, candidates should highlight their previous work experience relevant to the assignment, the attributes that make them suitable, their proposed approach to the assignment.

The Selected candidates will be requested to submit a Financial Proposal by email , outlining the total costs for this consultancy with payment linked to the main deliverables outlined above.

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, therefore, undergo rigorous reference and background checks, and will be expected to adhere to these standards and principles.

Remarks:

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.