In February 2016, Tanzania was the first country to undergo the World Health Organization (WHO) Joint External Evaluation (JEE). The findings demonstrated that although there had been significant progress in establishing laws and policies for International Health Regulations (IHR) capacities, gaps still existed in the country’s core capacities to prevent, detect, and respond to public health emergencies. Tanzania’s mainland was rated as having “no capacity” (score 1) for antimicrobial stewardship (AMS) and “developed capacity” (score 3) for health care-associated infection (HCAI) prevention and control (IPC) programs. The challenge is raising the AMS scores and maintaining or improving upon the IPC scores to meet GHSA priorities.
MTaPS has worked with the Ministry of Health, Community Development, Gender, Elderly, and Children (MOHCDGEC) in developing the multisectoral “Policy Guidelines for Implementing Antimicrobial Stewardship” of June 2020. The AMS policy guidelines are aimed at controlling antimicrobial use in the human and animal health sectors to enable effective AMS implementation at all levels. MTaPS provided inputs into the strategies to operationalize the policy guidelines; provided technical support to formulate the Access, Watch, and Reserve (AWaRe) list of antibiotics and the national essential medicine list (NEML) as well as standard treatment guidelines (STGs). MTaPS disseminated the findings of the antimicrobial use and consumption surveys to the MCC and at 10 healthcare facilities (HFs). MTaPS now wants to continue facilitating AMS practices by assessing stewardship policies and activities, including the regulatory framework and SCM of antimicrobials, using a multisectoral approach. The implementation of this activity will address the one remaining action for WHO IHR benchmark 3.4 capacity level 2, thus contributing to 100% achievement for that level for Tanzania.
As part of the process of developing a national AMS plan, MTAPS is seeking a consultant to undertake a rapid situational analysis of antimicrobial stewardship policies, legislation, regulations, and guidelines in Tanzania using a multisectoral approach
Supervision and reporting responsibility: The consultant will be supervised by, and report to the Senior Technical Advisor–AMS at MTaPS Tanzania. The consultant will liaise with the Senior Technical Advisor, other country team members, relevant MTaPS headquarters, and regional technical staff, and will work in collaboration with the Pharmaceutical Services Unit (PSU) of the MOHCDGEC and the Ministry of Livestock and Fisheries.
Description of Services to be provided
The rapid situational analysis of stewardship policies, legislation, regulations, and guidelines will include assessment of national medicines policies and pharmaceutical legislation and regulation, as well as assessment of supply management restricted to relevant policies and guidelines on management of the antimicrobial supply chain.
The supply management in this activity will not include aspects of quantification, forecasting, storage, distribution, and logistics management as they are not relevant for the purpose of this assessment.
The situational analysis should involve both human health and animal health sectors. It will be guided by the MTaPS mini guide on rapid situational analysis of Antimicrobial Stewardship Policies in MTaPS program countries.
Specifically, the consultant will:
1) Gather appropriate, relevant reference documents and perform a desk review of current AMS policies, legislation, regulations, and guidelines
The relevant reference documents include medicines policies, pharmaceutical law, STG/NEMLIT, among others.
The desk review will cover selected aspects of market authorization, licensing and inspection; post marketing surveillance and pharmacovigilance; prescribing, dispensing and use as relevant to antimicrobials used in both human health and animal health sectors. The desk review should also cover policies and guidelines relevant for management of some aspects of the antimicrobial supply chain in both animal and human sectors, such as: antimicrobial acquisition/procurement policies at national level, antimicrobial historical consumption data, and method of private sector sourcing of antimicrobials from wholesalers, distributors, and pharmaceutical companies.
The consultant should itemize information gaps and areas that need further clarification that may be obtained through subsequent in-person stakeholder interviews and prepare a list of respondents.
The consultant will then prepare a draft situational analysis report based on the desk review. The source documents must be referenced in the report as numbered footnotes. The report should have the following structure:
- Background, objectives
- Market authorization, licensing, and inspection
- Post marketing surveillance and pharmacovigilance
- Supply management policies and guidelines relevant for antimicrobials
- Prescribing, dispensing and use as relevant for antimicrobials
- Recommendations for action
- Concluding remarks
2) Conduct key stakeholder informant interviews (that will be determined by the output of the process in No. 1 above) to gather more detail and clarify the previously assembled evidence of available policies, legislation, regulations, and/or guidelines. Gather additional policy documents as relevant. This information will be used to update the first draft situational analysis report and produce a second draft report.
3) Develop a summary of findings and use a multisectoral approach in engaging stakeholders to disseminate the findings. This will entail identifying different stakeholders involved in stewardship and disseminating the findings to those stakeholders in a workshop for consultative discussion.
4) Update second draft situational analysis report using the stakeholders’ recommendations and produce the final situational analysis report. Present findings to the AMS TWG and the AMR multisectoral coordination committee (MCC) and present recommendations that feed into the development of the national AMS action plan on AMR and AMS.
1. USAID MTaPS program. Mini guide: Tool to Support Conduct of Rapid Situational Analysis of Antimicrobial Stewardship Policies in MTaPS Program Countries.
Consultant qualification requirements:
- Should have a Degree in Pharmacy or Medicine and a Master’s degree in Public health, or a health science (a PhD will be an added advantage).
- Knowledge of Tanzania’s health system structure and health policies
- The consultant must also have experience working with the pharmaceutical sector in Tanzania particularly the Pharmaceutical Services Unit (PSU) of MOHCDGEC and the pharmaceutical regulatory bodies (The Pharmacy Council and the Tanzania Medicines and Medical Devices Authority (TMDA).
- Experience in review and development of pharmacy related policy and regulatory documents
- Demonstrated working experience in the areas of pharmaceutical supply chain and antimicrobial stewardship at policy as well as facility level.
- Preferably the consultant should also have experience working with the animal sector in antimicrobial stewardship or have participated or been involved in multisectoral coordination of antimicrobial resistance.
- Strong organizational skills; demonstrated ability to build relationships and work effectively with senior government officials and other stakeholders.
- Excellent written and verbal communication, ability to generate lucid reports, and presentation skills in English.
MSH is an equal opportunity employer and will not discriminate against any employee or applicant for employment on the basis of race, color, sex, sexual orientation, gender or gender identity, religion, creed, citizenship, national origin, age, veteran status, or disability unrelated to job requirements. MSH will take affirmative action to ensure that qualified applicants are employed and that employees are treated without regard to their race, age, color, religion, sex, sexual orientation, gender identity, national origin, veteran and disability status. In compliance with U.S. Department of Labor Executive Order 11246, Section 503 of the Rehabilitation Act, and Section 4212 of the Vietnam Era Readjustment Assistance Act, MSH has developed and maintains an affirmative action program and plan.