Short Term Consultant (STC) for Development of National Guidelines on Triple Elimination of Mother to Child Transmission of HIV, Syphilis & HepatitisB

1. BACKGROUND

   Cambodia has achieved substantial progress in reducing HIV prevalence in adults (15-49 years old) from 1.7% (in 1998) to 0.54% in 2019.  From a peak of about 15,000 to 20,000 new infections a year in 1995-2000, this has fallen to less than 1000 a year from 2013 to the present.  AIDS related deaths have declined by 42% from 2,423 in 2015 to an estimated 1300 in 2019.   Cambodia is one of only seven countries globally to have achieved the 90-90-90 targets since 2017 and is committed towards achieving elimination by 2025. However, there is remaining gaps of around 8000 HIV infected people who did not know their status.  Mother to child transmission rate has declined to 6.2% at 6 weeks in 2015 from an estimated 37% in 2007. However, the MTCT rate at the end of breastfeeding period, projected via latest SPECTRUM for 2017, is 13%.  It is indicative of programmatic challenges identifying earlier HIV+ PW, initiating them on earlier HIV treatment, and providing prophylaxis, care, and testing to HIV-exposed infants (HEI).

   STI service is available at 35 Family Health Clinic and 22 NGOs clinics country wide.  STI Syndromic approach management are offered at health centre level.  Syphilis prevalence among Entertainment worker ( high risk population) dropped from 2.3% in 2005 to 0.79% (2017). Syphilis prevalence among antenatal care (ANC) clients, detected by RPR test and confirmed by treponemal assay has decreased substantially from 4.0% in 1996 to 1.3% in 2001. And it seemed it continue decreasing to 0.03% syphilis prevalence based on ANC report in 2015. There are challenging in providing standard Benzathine penicillin injection treatment for pregnant women and exposed infant due to capacity and stock shortage.

   Viral hepatitis represents a major cause of death in Cambodia. Disease burden modelling showed preliminary estimates of 450, 000 (3%) people living with chronic hepatitis B in 2017. While Cambodia has made significant progress in hepatitis B immunization, achieving 0.55% HBsAg positivity among children ages 5-7 years. Comprehensive viral hepatitis response in Cambodia is in its early stages and national strategy, guidelines and interventions to address viral hepatitis epidemic in the country is in progress of developing.

   With the good progress, Cambodia is committed to reach MTC HIV elimination by 2025 in which the National Road Map for the elimination of Mother-to-Child Transmission of HIV and Congenital Syphilis in Cambodia was launched in 2018. The National Strategic Plan for prevention of mother to child transmission of HIV, Syphilis and Hepatitis B 2016-2020 was launched in 2017.  There are exiting and updating Global and  WHO guidance including  the Triple Elimination of Mother-to-Child Transmission of HIV, Hepatitis B and Syphilis in Asia and the Pacific, 2018–2030, The global guidance on process and validation of EMTC HIV and Syphilis,  The global health sector strategy on viral hepatitis 2016-2021 toward ending viral hepatitis, The regional action plan for viral hepatitis in Western Pacific region 2016-2020 and The Triple Elimination of Mother-to-Child Transmission of HIV, Hepatitis B and Syphilis in Asia and the Pacific, 2018–2030.

   The WHO consultant should, therefore, supports National Maternal and Child Health Center, Ministry of Health Cambodia to develop practical National Guidelines on triple elimination  of Mother to Child Transmission of HIV, Syphilis and Hepatitis B to guide the national implementation and monitoring the progress towards its goal.

    

2. PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY

The purpose of the contract is to provide technical assistance to the National Program for Prevention of Mother to Child Transmission of the National Maternal and Child Health Center, Ministry of Health Cambodia in developing National Guideline on triple elimination  of Mother to Child Transmission of HIV, Syphilis and Hepatitis B.

3.  DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT

In collaboration with Ministry of Health and Health Development Partners and under the direct supervision of Health System Development Team Leader, WHO Cambodia, the consultant will undertake following tasks:

3.1  Conduct a desk review of relevant documents

3.2  Meeting with key stakeholders for getting more information on current and upcoming effort for triple elimination

3.3  Write national guideline for triple elimination of mother to child transmission for HIV, Syphilis and Hepatitis B which incorporate recommended interventions and good practice that can be implemented nationwide within MCH platform and health system strengthening context.

3.4  Facilitate consultative workshop to collect input from key stakeholders to finalize draft guideline 

3.5  Submit a technical report at the end of the consultancy with final draft of national guideline attached. 

4.  METHODS TO CARRY OUT THE ACTIVITY

Literature and document reviews; meetings and discussions with the MOH, development partners, and other technical programmes of WHO in country and regional office; facilitations of consultations and field visits to provinces as needed.

Output/s 

• Output 1:

  First draft of National Guideline for Triple Elimination   to Child Transmission of HIV, Syphilis and Hepatitis B is developed.

• Output 2:

  Consultative workshop to collect input for finalize draft national guideline organized.

• Output 3: Final report with final draft of national guideline attached.

5.  QUALIFICATIONS & EXPERIENCE

EDUCATION

Essential:  Post-graduate degree in public health, international development and/or related fields

EXPERIENCE

Essential:

• Minimum of 5 years of working experience in public health and related fields
• Experience or familiarity with health system, HIV/AIDS program and Maternal and Child Health program
• Work experience related to Prevention from Mother to Child Transmission (PMTCT)
• Experience in developing national policy/ guidelines especially  on HIV, STI, Hepatitis  and or MTCT

Desirable:

• Experience working in public health in a low- or middle-income country.
• Experience working in Cambodia

TECHNICAL SKILLS & KNOWLEDGE

• Knowledge on maternal, newborn, child and adolescent health and concept of health systems strengthening.
• Good writing, presentation and communication skills are essential.

LANGUAGES

Essential: Fluent in English (writing, reading and speaking)

COMPETENCIES

• Technical expertise
• Communicating in a credible and effective way.
• Producing results.

ADDITIONAL INFORMATION:

The consultant will work from long distance for most of the assignment (total of 30 working days) to conduct the desk review, draft the guideline and finalize based on the input and feedback from stakeholders including one mission to Phnom Penh, Cambodia (9 days) to facilitate a consultative workshop to collect input from key stakeholders to finalize the draft national guidelines.

Starting date:  21 October 2019

Duration of Contract:  21 Oct - 31 Nov 2019

APPLICATIONS

Qualified and interested specialists should submit their CV and Expression of Interest {cover letter} to the Supply Officer through WP RO UNGM at < wproungm@who.int > by 15 September 2019. 

The cover letter should outline how their experience and qualifications make them a suitable candidate for this position and should include their proposed daily consultancy fee and availability.

Please use Tender Notice No. WPRO/2019-09/CAM_HSD/TN96421/mom as subject to all submission.  Only successful candidates will be contacted.