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For every child, [Health]

UNICEF is inviting interested Consultants to apply to an open consultant position to conduct formative research and understand how healthcare providers, caregivers and communities value the life of a newborn.

Background and Rationale

Perinatal mortality rates have stagnated in Tanzania suggesting that a new approach is needed to spur the next phase of reductions ¹.  The UN Inter-Agency Group for Child Mortality Estimation (UN-IGME) estimates that 21 out of every 1,000 children die before they complete their first month of life in Tanzania. As the country improves its capacity to prevent deaths from malaria, pneumonia and diarrheal disease in older infants and children under age 5, the proportion of under-5 deaths during the neonatal period is climbing. Neonatal mortality is currently the leading cause of death in the under-5 age group accounting for 40% of deaths in this age group. One third of these deaths are directly related to birth asphyxia. The intrapartum stillbirth rate, a good indication of care quality during childbirth is also high in Tanzania. Almost a quarter of a million children die each year in Tanzania before being born. UNICEF Tanzania Country Office (TCO) is working with the Government of Tanzania (GoT) and the Revolutionary Government of Zanzibar (RGoZ) to design an innovative approach to reducing perinatal morbidity and mortality. The region of Mbeya on Tanzania Mainland and the Region of Kaskazini Pemba in Zanzibar are the programmatic target regions.

In order to best design an effective neonatal strategy, TCO must have a clear understanding of the perspectives of program participants regarding newborns. Anecdotal evidence from both target areas suggests that the life of a newborn carries less social value than that of an adult. For example, providers have reported that ambulances are not used to refer a sick neonate from one facility to another; however, if mother and child both need higher level care, then an ambulance may be mobilized. Delays in accessing care for sick newborns in the community may also be linked to how families (including men) value the life of a newborn^2-4. To date, no qualitative or quantitative research on the value of neonatal life in Tanzania has been identified. Evidence from other parts of the world, including rich ethnographic work ⁵, indicates that not only is life valued differently in different contexts, but that in settings with persistently poor outcomes for newborns, societies may limit social attachment to newborns until they have demonstrated the ability to survive.

If the providers and users of healthcare (the families and communities of newborns) in our target areas also place low value on neonatal life, this may determine or shape the response to newborns, especially those who are sick and/or small. In order for providers or users to mobilize resources in a timely fashion to save a newborn’s life, they must see the life as valuable. If our program participants place a low value on the life of a newborn, TCO and its partners may need to address this inequality and deeper social determinant as part of efforts to improve outcomes.

TCO is seeking to engage a Tanzanian researcher to conduct a qualitative study on this subject in Mbeya and Kaskazini Pemba. The research will be used by UNICEF to design future programming to reduce neonatal morbidity and mortality in target regions and may be used to inform country policy and programming more broadly

Assignment Objectives

The assignment has two primary objectives:

1. Understand the perspectives of and factors influencing healthcare providers in Mbeya and Kaskazini Pemba Regions on the value of neonatal life
2. Understand the perspectives of and factors influencing healthcare users (both active/recent users and community members) on the value of neonatal life in Mbeya and Kaskazini Pemba Regions.

Scope of the assignment

The successful bidder will be responsible for conducting a literature review on the subject of neonatal value of life among healthcare providers and healthcare users. He/she will write an IRB research protocol and related data collection tools and submit/get approval for the study from the National Institute of Medical Research (NIMR), Zanzibar Health Research Institute (ZAHRI) and  Zanzibar Medical Research Ethics Committee (ZAMREC). Pending approval, he/she will conduct in-depth-interviews and focus groups to collect data on the study research questions. The consultant will be responsible for having this data translated and transcribed for analysis. Translation and transcription may be independently outsourced by the consultant, but he/she will be responsible for the quality of the work. The bidder should use thematic content analysis to analyze the data.

Methodology and technical approach

This study will begin with a literature review of both qualitative and quantitative research on the subject in low-and middle-income countries. The literature review, as well as discussion and review by TCO health staff, will inform the development of semi-structured interview guides. A research protocol will be developed for submission to NIMR, ZAHRI and ZAMREC. The successful research consultant will then use qualitative interviewing techniques to gather information on the views and values placed on neonatal life among two primary target population types in two geographic areas. The first population type is healthcare providers including both doctors and nurses that care for newborns. The second population type is healthcare users. Healthcare users will include both recent (within 12 months) or active family members of newborns. Focus groups will then be conducted with community members (including religious leaders) who may or may not have used the health system recently. UNICEF staff and government counterparts will assist the researcher in identifying respondents. The data collection technique will be in-depth and focus group interviews in Swahili. Each Interview will be audio-recorded, then translated and transcribed. The researcher will communicate with the TCO contact person each week during data collection to review progress and make any necessary adjustments to the interview and focus group guide or the sampling strategy. Approximately 36 interviews and 6 community focus groups are expected to be necessary to achieve saturation of ideas. Sampling will be purposive and will follow the suggested approach in this matrix:

Tasks, deliverables and timeframe

Start date: May 1, 2020. Please note that all deliverables will be in English.

To qualify as an advocate for every child you will have…

• An advanced university degree (Master’s or higher) in health, social sciences or another relevant field;
• A minimum of [five years] of relevant professional experience in doing qualitative research
• Thorough knowledge and experience working with vulnerable and remote populations;
• Able to work independently as well as with UNICEF in an international, multicultural and interdisciplinary environment and establish harmonious and effective working relationships both within and outside the organization;
• Developing country work experience and/or familiarity with emergency is considered an asset.
• Fluency in English is required. Knowledge of another official UN language (Arabic, Chinese, French, Russian or Spanish) or a local language is an asset.
• An extensive proven track record of conducting similar research assignments
• Extensive experience in the implementation of qualitative research
• Tanzania national with work experience in Tanzania Mainland and in Zanzibar;
• Ability to travel to the target regions
• Have demonstrable procedures for quality assurance of research, procedures for confidentiality of information collected, etc.;

For every Child, you demonstrate…

UNICEF’s values of Care, Respect, Integrity, Trust, and Accountability (CRITA) and core competencies in Communication, Working with People and Drive for Results.

View our competency framework at

http://www.unicef.org/about/employ/files/UNICEF_Competencies.pdf

UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization.

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.

Remarks:

Mobility is a condition of international professional employment with UNICEF and an underlying premise of the international civil service.

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.

Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures, and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws.