Consultancy Services for the Review and Evaluation of Medical Services in UNMHA, Yemen

The United Nations Missions to Support the Hudaydah Agreement (UNMHA) is looking for a qualified consultant for the review and evaluation of the medical services in Yemen to ensure the efficient and effective use of resources and services which will be submitted in the next budget report. It is envisaged that the evaluation will include the following elements: a. (1) week desk review of relevant documentation and budgetary information, preferably in Amman. b. (2–3) week field visit to Sana’a and Hudaydah to review UN medical facilities in these two duties stations and meet with relevant stakeholders from UNMHA and the UN Country Team (UNCT). c. (2) weeks to prepare a report to UNMHA Senior Management with recommendations as per the below Terms of Reference. d. The report needs to be completed in time for the UNMHA 2024 budget submission (i.e., by February 2023). Terms of Reference: Clinic/SOP Review: 1. Conduct assessments/reviews of existing clinics/local facilities and make recommendations: a. Assess existing UN Clinic medical facilities in Aden, Sana’a, and Hudaydah and their ability to provide Level 1 medical services in accordance with the Medical Support Manual 2015 (MSM); b. Assess UNCT medical support options in Mocha where there is no UN clinic c. Assess existing UNMHA medical facilities in Hudaydah and their ability to provide Level 1 medical services in accordance with the MSM; d. Review UNMHA’s emergency preparedness plans and capability to respond to critical incidents (UNMHA Mass Casualty Response Plan, SOP for Medevac, etc.); e. Review existing local facilities in Hudaydah and their capacity to assist during medical emergencies and trauma cases, as well as mass casualty incidents; f. Make recommendations as to: • Whether we should continue with two medical clinics in Hudaydah or they should be merged into a single clinic for more efficient cost sharing and if so, how/with what staffing; • Staffing functions and numbers required to maintain a clinic(s) and based on previous patient visit statistics and existing/proposed UNMHA staffing levels for 2023; • Which SOP should be used for MEDEVAC? Health Risk Assessment (HRA): 2. Perform an HRA for UN staff in Yemen and recommend an appropriate level of care (UNOE or otherwise) and deliver a Health Support Plan with different options including the option to hire a CMO for the mission. Revision of the current MOU with the UNDP administered clinics vis-à-vis a possible restructuring of their medical services. Pharmaceuticals: 3. Advise as to: a. The risks facing UNMHA concerning the current utilization of pharmaceuticals procured by the UNMHA contractor and the UN Clinic, which have not been procured in accordance with WHO Quality Assurance WHO Quality Assurance Policy https://www.who.int/publications/i/item/9789240023789 and the WHO Model Quality Assurance System for Procurement Agencies: https://apps.who.int/iris/handle/10665/69721; b.The duty of care owed to staff and the general release form that they are asking them to sign, stating that they accept all risks associated with the provision of medical care. Is this acceptable when UNMHA is currently unaware of the quality of the pharmaceuticals being administered to staff and who are expecting as a minimum that UNMHA has conducted due diligence? c. Action that UNMHA will take to ensure that only Quality Assured pharmaceuticals will be dispensed to staff in the future, including the consideration of the use of UN systems contracts for drugs and consumables. Blood: 4. Advise as to what is required to render the proposed Damage Control Surgery (DCS) at the UNMHA Clinic fully operational. (In the absence of a WHO-approved blood bank, with a supply of blood that is adequate, reliable, and screened for infections prior to use including HIV, hepatitis B, hepatitis C, syphilis, and in accordance with WHO quality system requirements). Advise on possible access to global blood contracts through Medical Support Services. Mortuary: 5. Advise as to the establishment of a temporary mortuary facility in the UNMHA Compound, Hudaydah, and in the absence of a WHO-approved mortuary. Local facilities would have to be used until the deceased can be transported to Sana’a as appropriate and in the case of international personnel, transported out of Yemen. Other Issues: 6. Advise on the following issues: a. What are the costs and benefits of outsourcing medical support versus bringing it in-house? (costs, administrative burden, availability of personnel, risk management, etc.) b. What efficiencies could be gained through closer coordination with the UN Country Team in Yemen? c. Could we potentially move the helicopter to Aden airport, and support the Mission’s CASEVAC/MEDEVAC needs from there? d. What are the risks facing the Mission in order to support UN-standard medical functions in Yemen with continued denial of visas for medical officers? e. What support can be provided remotely by DHMOSH? Report: 7. The review and evaluation should be planned to include a desk review element and a visit to field operations in Yemen (Sana’a and Hudaydah) notwithstanding any potential visa issuance delays, as well as a briefing with the Chief of Mission Support and Senior Administrative Officer of UNMHA in Amman or Yemen. The consultant will be requested to submit a written report to the Mission on completion of the review and evaluation. 8. UNMHA will use its best endeavors to expedite the visa issuance process, noting that a report is required to be submitted on budget proposal in February 2023.