1. Purpose of the Consultancy
The purpose of this consultancy is to support the process of institutionalization of MPDSR and implement relevant work plans in close collaboration with Department of Health, Government of Balochistan and focus facilities. The Consultancy will mainly support Provincial MPDSR Task Force as well as the MDR committees (Provincial, Districts and Facility) to ensure regular meetings, documentation, data management, reporting and trainings as required.
Maternal and perinatal l mortality remains a challenge worldwide affecting the developing countries the most. Pakistan contributes substantially to regional and global maternal and neonatal mortality figures with an estimated MMR of 276 per 100,000 live births; the lifetime risk of a maternal death stands at 1 in every 110 women. Equally high is the neonatal mortality rate in Pakistan, reported to be 55 per 1,000 births, with a stillbirth rate of 47 per 1000 live births. Moreover, Baluchistan’s MMR and NMR are significantly contributing to the national figures being highest in the country (785/100000 LBs and 63/1000 LBs respectively). A major proportion of these deaths could be prevented by timely intervention and good quality care during pregnancy and at the time of delivery.
The Government of Pakistan stands committed to globally recommended actions for eliminating preventable maternal and new-born mortality. This will require establishment of strong monitoring systems that are capable of tracking all maternal and neonatal deaths in real time, allowing for better understanding of the underlying factors contributing to the deaths, and guiding actions to avert similar deaths from occurring. Maternal and Neonatal Death Surveillance and Response (MNDSR) is a strategy that provides required information for guiding public health actions focused on reducing maternal and neonatal deaths. It is a form of continuous surveillance that links the health information system and quality improvement processes from local to national levels. MPDSR includes the routine identification, notification, quantification and determination of causes and to prevent all maternal and neonatal deaths, as well as the use of this information to respond with actions that will prevent future deaths.
In Pakistan, various partners like WHO, Population Council, GIZ and other MNCH stakeholders have been using different audit approaches. In 2015, UNFPA has institutionalized a system for reporting on maternal and neonatal deaths in all districts of Punjab province through lady health workers (LHWs). In December 2015, WHO hosted a national workshop attended by all provincial MNCH managers to advocate for maternal death audits and UNFPA also shared their experience in Punjab. Subsequently, a study tour was undertaken to Sheikhupura, Punjab in November 2016 to further learn from this experience.
In order to institutionalize MNDSR processes and create homogeneity in implementation across the country, the government of Pakistan with support from concerned partners aimed to standardize the MPDSR protocols. The WHO country office has provided technical assistance for developing national protocols on MPDSR for Pakistan, in consultation with national and provincial health authorities, partners, and other concerned stakeholders. This protocol is well aligned to WHO global standards (WHO publications “MDSR Technical Guidance”, 2012, and “Making Every Baby Count”, 2016). The protocols were translated into a comprehensive training package for building capacity of facility based health providers and district/provincial health officials in death audits and use of data for response. Moreover, the provincial task forces on MPDSR were notified by the provinces of Balochistan and Khyber Pakhtunkhwa in 2017 and have been operationalized to support this initiative. For institutionalization of MPDSR in Balochistan, two hospitals of Quetta district and one in Kech district were notified by the Department of Health, Government of Balochistan for jump start. In this regard all required committees in selected facilities were notified by the competent authorities. In addition, capacity building of the DoH and facility staff from the relevant districts was done in December 2017. However, the operationalization of MPDSR system has been very slow and it has not been scaled up to other facilities and districts. It is deemed necessary to engage a full-time technical staff for providing continued support to the Provincial MPDSR Task Force, MDR committees at various levels (provincial, district and facility) and the Department of Health, Government of Balochistan in ensuring regular meetings, documentation, data management and reporting on MPDSR implementation progress. Therefore, WHO country office is supporting a national consultant through STC for a period of 3 months to provide the required support.
3. Planned timelines
A total of 150 working days spread over the following timeframe:
Start date: 15/11/2019
End date: 30/6/2020
4. Work to be performed
The consultant would work very closely with the Provincial Department of Health including all the relevant programs (MNCH Program, LHW Program, DHIS Program as well as with the WHO Provincial Program Office (RMNCAH National Professional Officer) to provide technical assistance in organizing and facilitating the trainings on MPDSR in selected facilities across the province.
Over the given timeframe, the consultant is required to:
- Organize MPDSR trainings and refreshers for all selected facilities/districts of the province.
- In coordination with DOH Balochistan and the respective districts, draft a plan for the implementation in selected facilities, a plan for scale up to other facilities and districts and monitoring process.
- Support and facilitate the provincial DOH in coordinating facility, district and provincial review meetings through respective committees as per stipulated schedules and ToRs of the notified committees to measure the implementation rate of the system.
- Record minutes, perform analysis and generate technical reports of the reviews in coordination with the DOH focal person and secretaries of the committees
- Support the relevant committee members in use of MPDSR software tool.
- Facilitate the data recording at the implementing units at the selected hospitals.
- Support the scheduling and documentation of Provincial Task Force meetings.
- Present reports and lessons learned to all the stakeholders
- Relay data to national level and relevant stakeholders.
- Report to the WHO Provincial Office on progress level as per implementation plan for MPDSR and to the provincial DOH.
- Review/revise if needed the ToRs of various committees and assist in subsequent notifications if required for effective implementation.
- Assist provincial stakeholders in further refining MPDSR implementation plans.
Deliverables and time lines:
First Deliverable [10%]: Signing of contract
Second Deliverable [45%]: Submission of reports on MPDSR trainings/refreshers, provincial Task Force, District MDR committee and existing facility MDR committee meetings by 20th March 2020
Third Deliverable [45%]: Submission of consolidated report on MPDSR data reporting and scale-up of MPDSR in additional facilities and districts within Balochistan province by 20th June 2020
5. Technical Supervision
The selected Consultant will work under the supervision of:
Responsible Officer: National Professional Officer (MNCH), Quetta
Manager: Head of WHO-Sub Office, Quetta
6. Specific requirements
Skills / Technical skills and knowledge:
- Report writing skills
- Training skills
- Excellent networking and coordination skills
- Data management skills
Proficiency in reading, writing, and speaking English is required.
7. Medical clearance
The selected consultant will be expected to provide a medical certificate of fitness for work.
The consultant is expected to travel as needed.
All travel arrangements will be made by WHO – WHO will not be responsible for tickets purchased by the Consultant without the express, prior authorization of WHO. While on mission under the terms of this consultancy, the Consultant will receive subsistence allowance. Required Skills