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In Malawi the community health program aims at bringing cost-effective integrated, quality health care services closer to the people. Community health system comprises community health structure with a composition of Community Health Teams (CHTs). Members of CHTs are Community Health Volunteers (CHVs), Health Surveillance Assistants (HSAs), Senior Health Surveillance Assistants (SHSAs), Community Midwife Assistants (CMAs), Community Health Nurses (CHNs) and Assistant Environmental Health Officers (AEHOs). CHTs are responsible for service delivery to their respective catchment populations. The CHTs are linked to the Health Centre Management Committees (HCMCs) that are in turn linked with the health centers. The community health structure is also linked with local government structure at community level in the senses that the Area Development Committee (ADC) oversees Health Centre Management Committees (HCMCs) within the jurisdiction of the ADC at TA level.
The ADC is linked to the Council through the Counsellors and Member of Parliament as well as the Traditional Authority, all of whom are members of the Council in some respect. At the GVH level, the Village Development Committee (VDC) oversees and coordinates community level DIP interventions through the VHC and CHAGs. These community level structures are supported by technicians who are linked to both the HCMC thereby ensuring linkage across the technical and political decision-making arms of the District Council and hence relevant mechanisms at the national level.
By 2030, the NCHF aims to contribute to the achievement of health outcome targets aligned with the HSSP III in these strategic objectives:
• Health Service Delivery: By 2030, 90% of CHW delivering most of the community components of the HBP.
• Human Resource: By 2030, 75% of CHN’s (4000), CMA’s (8000) and HSAs (9100) recruited.
• ICT: By 2030, 100% of CHTs using mHealth for integrated service delivery, data collection and supervision.
• Supply chain and infrastructure: By 2030, 802 health posts operating and supporting community integrated health service delivery; 98% of CHWs provided with equipment for their work and 70% of CHWs have durable transport facility.
• Community engagement: By 2030, 80% of community structures (VHCs, CHAGs, HCMCs and HMCs ) are functional.
• Leadership and coordination: By 2030, 95% of all agreed-upon coordination activities and milestones completed.
• Community health financing: By 2030, 75% ($560,407,173) of community health finances mobilized.
Within this system, community health refers to a package of basic preventive, promotive, curative, rehabilitative, and surveillance health services delivered at the community level with the participation and ownership of rural and urban communities. This package consists of the community components of Health Benefits Package (HBP), as defined by HSSP III. CHWs continued to deliver these services through an integrated approach. Integration take place at the point of care, which helps to improve health system efficiencies, reduce fragmentation, and increase access to care. UNICEF as a part of universal public Health System strengthening agenda, committed to provide technical support to the government to improve community health system to improve maternal and newborn health including immunization coverage in districts.
The consultant is therefore essential in providing technical and strategic support for the revision/adaptation of community health programme to improve maternal, child and adolescent health and nutrition in Malawi. The consultant will be responsible for providing technical support to Ministry of Health in strengthening the community health programme through capacity building of the community health workers. This will require a professional experience in community health, health and nutrition, routine immunization including coordination and negotiation skills, as this involved working various divisions and departments within Ministry of Health.
SCOPE OF WORK/OBJECTIVES
The consultant will be responsible for providing technical assistance and supporting the implementation of community engagement component of community health programme and new vaccine advocacy:
1. Advocacy and demand generation for new vaccine
- Develop new vaccine advocacy package for stakeholders (faith leaders, health professionals community leaders and media) defining key asks from each stakeholders in English and Chichewa.
- Develop HPV advocacy plan focusing schools and health institutions to improve coverage of HPV among adolescent girls.
- Support EPI and Health Promotion Division to develop communication messages and materials including dissemination plan to address issues from social listening.
2. Evidence Generation on community health and nutrition landscape
- Develop community health structure mapping, stakeholder analysis including understanding gap data collection tools.
- Conduct community mapping, stakeholder analysis and capacity assessment of community health workers.
- Develop various capacity building package (online and offline) for HSAs and community health volunteers to address vaccine hesitancy and identification of zero dose care givers and referrals.
- Prepare the list of communication and skills building plan and content for community health workers.
3. Community Engagement toolkits and materials
- Develop tools/materials for community health workers.
- Develop communication materials co-creation guidelines for HPV.
- Conduct co-creation workshop with adolescent boys and girls to understand the barriers of vaccine uptake and draft communication materials together with the adolescent groups.
- Collaborate with Designer and finalize communication materials for adolescent girls, parents and and messages to promote HPV uptake.
- Develop integrated community health programme with strong social accountability mechanism for pilot implementation in two districts.
4. Community Monitoring and evaluation (follow up and feedback mechanisms)
- Collaborate with district and community-based network to identify the low performing health and nutrition indicators for behaviour tracking.
- Design two-way social accountability mechanism for improving community health system in two districts together with the communities (adapting community behaviour tracking being implemented in 14 districts for nutrition programme).
- Develop capacity building plan for community behaviour tracking for health and nutrition in collaboration University of Malawi and Department of Nutrition.
- Capacity building of community health workers and local leaders, faith leaders on community behaviour tracking, rumors tracking and closing the feedback loop.
- Establish social accountability mechanism in the selected TAs of Chikawawa and Mangochi) under the leadership of District Health Management Team.
5. Collaborate with Partners and Stakeholders:
- Ensure an effective collaboration by working closely with the Ministry of Health, UNICEF staff, WHO, and other partners to ensure that all vaccine hesitancy interventions are aligned with national immunization goals and public health strategies.
- Coordinate with implementing partners to ensure the efficient delivery of communication materials and community-level interventions.
How can you make a difference?
The consultant will lead evidence generation on the community health and nutrition landscape through community mapping, stakeholder analysis and capacity assessment, from the two pilot districts Mangochi and Chikwawa. By leveraging community health systems, the consultant will work closely with health facility staff, community health workers and local leaders, to improve community outreach with preventive, promotive and curative services. The consultant role will also be critical in supporting ministry of health, EPI and HPD in increasing the uptake of underutilized vaccines such as the Human Papillomavirus Virus (HPV) and Oral Cholera Vaccines (OCV), mitigating the negative impact of vaccine hesitancy on public health outcome and Non-Communicable Disease (NCD) screening program.
To qualify as an advocate for every child you will have…
Academic qualification:
- Advanced university degree in Health Communication, Behavioural Science, Sociology, Anthropology, Psychology or another relevant technical field is required.
- A first level university degree in combination with additional 2 years qualifying experience may be accepted in lieu of the advanced university degree is required.
Work experience:
- At least 5 years of professional work experience at national and international levels in health communication, community health and other relevant programme is required.
- Work experience related to the demand generation for routine immunization and strengthening community health programme or capacity building of community health workers is required.
- Work experience managing large-scale projects, working with governments, working in resource-limited settings, monitoring and evaluating supply chains, and risk management, mitigation will be an asset.
- Experience in generating social data and evidence will be an asset.
Technical skills, knowledge, and strength areas:
- Skills for implementation of the Community level Primary Health Care is required.
- Strong analytical, negotiation, oral and written communication skills is required.
- Effective presenter including ability to adapt the message and visual aids for multiple audiences to deliver concise, impactful presentations of primary health care interventions is required.
- Effective facilitator with proven ability to engage and train a group of individuals at national level and for front line health workers as well is required.
- Ability to work in a multi-cultural environment will be an asset.
Languages:
- Sound written and spoken fluency in English and Chichewa is required.
Please refer to the attached full 
TOR for Community Health and New Vaccine Advocacy – Consultant.pdf for more details on the consultancy and requirements.
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