Universal Health Coverage - UHC: Malaria transmission risk assessment and health services need for mobile population including Nomads

1.       Area of expertise:

 Universal Health Coverage - UHC: Malaria transmission risk assessment and health services need for mobile population including Nomads.

2.       Purpose of consultancy

The purpose of this consultancy is to assess the risk of malaria transmission and the health services needs of mobile populations, including nomads, across the country for transmission reductions and the eco-climate stratification of Somalia. To provide strategic directions and recommendations to progress toward UHC.

3.       Background  

Somalia is committed to the achievement of Universal Health Coverage (UHC). The implementation of the Essential Package of Health Services (Somalia EPHS 2020) is expected to address the burden of disease responsible for the high morbidity, mortality and disability afflicting the Somali people, particularly the most vulnerable segments of the population, women, children, elderly, internally displaced persons (IDPs) and mobile populations. The EPHS 2020 is built upon analysis of the burden of disease and the most recent Disease Control Priorities (DCP3), and it is anchored on the UHC compendium of WHO. In Somalia the UHC index is among the lowest in the world, estimated at 27 out of 100. The EPHS is the country’s service delivery framework, based on a Primary Health Care approach, for progressing toward UHC and the achievement of the Sustainable Development Goals (SDGs).

The Somali population is prone to malaria outbreaks as well as natural disasters such as droughts and flooding, and consequent displacements. Malaria poses a major health risk, with a disproportionate distribution of the disease burden across different eco-climate zones of the country. The greatest impact is on arid and semi-arid lands with most variability and unpredictable rainfall that at times leads to flooding: these are associated with malaria upsurges and outbreaks.

The epidemiology of malaria transmission exposes the population to varying levels of risks of the disease. Malaria is endemic in the riverine areas while there are low levels of transmission in the remaining parts of the country. This poses different threats to different population groups: (i) in endemic areas, most at risk are children under 5, pregnant women, IDPs and mobile populations, especially those from areas of unstable transmission; and (ii) in areas of low levels of transmission, all groups are vulnerable due to low or no immunity which increases susceptibility to malaria outbreaks.

Overall, Somalia has a high burden of malaria, and between 2000 and 2019 an estimated 759,000 cases and 1,942 deaths from malaria have been reported. Various control and elimination efforts undertaken by the Government with the support of WHO and UNICEF, funded by the Global Fund, have resulted in the reduction of incidence from 2.6 cases per 1000 population per year in 2014 to 1.8 per 1000 population in 2020, showing a 25% reduction. Malaria remains a major public health problem in Somalia, with an estimated fever prevalence of less than 2% in 13 of the 18 regions according to the 2017 Somali Malaria Indicators Survey (MIS).  The plasmodium prevalence has been stable at 1.9%, as it was in 2014 MIS. A study of 158 mosquito breeding sites in Bossaso district documented that overall the birkits form the most productive habitats in this district (89%) and that 99.4% of the habitats were man-made. All breeding habitats are near human dwellings, hence predisposing the household occupants to mosquitoes and malaria transmission.

The updated National Malaria Strategic Plan 2021 – 2026 outlines four pillars to achieve the goal of zero deaths due to malaria and reducing malaria incidence from the mentioned 1.8/1000 in 2020 to less than 0.5/1000 population by 2025.

WHO have worked with the National Malaria Control and Elimination Program (NMCP) to adapt and optimize the use of programmed resources based on the shift in malaria transmission over recent years. It is critical to focus on the population most at risk of malaria and least served by essential health care to effectively reduce the burden of disease in the country.

4.       Deliverables

 Output1. To provide a complete dossier of background data, strategic directions and innovative approaches for Malaria Control in Somalia, tailored for national and subnational levels and specific to population groups and mobility patterns.

Deliverable 1.1: To conduct a comprehensive review of existing literature and data sources to identify the risk factors associated with malaria transmission in Somalia, including the prevalence of the disease, the geographic distribution of cases, and the risk factors associated with the mobile population based on available Malaria stratification data and the National Malaria Strategic Plan 2021 - 2026.

Deliverable 1.2: Update the IDPs and Nomads mapping

Deliverable 1.3:  Conduct comprehensive desk review and identify the health services needs of mobile populations, including previous mapping exercises, complemented by focused interviews with stakeholders, key informants identified across government institutions and development partners, from national to service delivery levels, as well as qualitative information gathered from specific population groups.

Deliverable 1.4: Analyze and compile the background information for the Malaria control and elimination dossier.

Deliverable 1.5: Develop strategic options to reduce malaria transmission among and by mobile groups,  improve access to essential services.

Deliverable 1.6: Provide recommendations about strategies to improve and maintain equitable coverage of EPHS interventions, with consolidated and innovative service delivery models for all at risk populations including nomads.

Deliverable 1.7: Recommend a set of key indicators to enable monitoring of consolidated path toward Malaria Control and elimination, innovative approaches to expand health service coverage to mobile population, and country’s monitoring frameworks.

Deliverable 1.8: Provide technical assistance to the health authorities and contribute to the dialogue about Malaria Control and elimination and equitable services in the context of the EPHS.

Deliverable 1.9: submit final consolidated comprehensive reportincluding findings of the assessment, strategic options, recommendations, information.

Essential:

Advanced university degree in medicine, public health, health policy, public health / global health with major in disease control / UHC strategies or other related fields from a recognized university.

Experience:  

•      7 to 10 years work experience in public health analysis, strategy development, healthcare provision to vulnerable populations, coordination of service delivery.

•      Experience with government institutions and international organizations.

•      Direct experience with Malaria control / elimination programmes, PHC / essential service package and community health strategies are desirable assets.

•      Knowledge of the Somali context is an asset.

Skills / Technical skills and knowledge:

•      Demonstrated ability to work in a multi-disciplinary environment.

•      Good IT skills including professional use of standard office package and statistic software.

•      Ability to work in a team and adapt to diverse educational and cultural backgrounds

•      Good communication and report writing skills, and excellent networking skills.

•      Proven experience in producing high-quality documents.

Languages and level required (Basic/Intermediate/Expert):

·         Expert knowledge in English language i (writing and speaking)

Location

·         Mogadishu Somalia: The Consultant is expected to travel to selected states within the country according to the assignment requirements, upon approval by the supervisor with agreed travel dates.

6.       Travel

The Consultant is expected to travel inside Somalia as and when needed for better implementation and coordination of the assigned tasks and functions, dates of travel will be agreed with supervisor.

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.

Visas requirements: it is the consultant’s responsibility to fulfil visa requirements and ask for visa support letter(s) if needed.

7.       Remuneration and budget (travel costs are excluded):

Remuneration: Level B (High end of range) – USD 9,980 (Monthly)

 a.       Expected duration of contract (Maximum contract duration is 11 months per calendar year): 4 months.

Additional Information (For HR use only):

• This vacancy notice may be used to identify candidates for other similar consultancies at the same level.
• Only candidates under serious consideration will be contacted.

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