Home-based: Individual Consultancy to Develop Strategy to Address Immunization Barriers in Roma and migrant Populations (129 working days; with travel as needed) – Europe and Central Asia Regional Office (ECARO)

UNICEF Regional Office for Europe and Central Asia (ECARO) is looking for a qualified Consultant to develop a comprehensive approach for addressing barriers to childhood routine immunization among children from Roma populations in Moldova and those affected by labour migration in Kyrgyzstan.

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. To save their lives. To defend their rights. To help them fulfill their potential.

Across 190 countries and territories, we work for every child, everywhere, every day, to build a better world for everyone.

And we never give up.

For every child, an advocate.

Purpose of Activity/Assignment

To support UNICEF ECARO to develop a comprehensive approach for addressing barriers to childhood immunization among Roma children in Moldova and children affected by labour migration in Kyrgyzstan.

Background

Providing vaccination for every child everywhere and ensuring that caregivers decide to timely vaccinate their children is a UNICEF’s fundamental goal and requires a thorough understanding of the barriers that may hinder reaching these goals in specific populations. In UNICEF Europe and Central Asia Region (ECAR), efforts have been made and to sustain vaccine supply, improve health workers’ (HWs) capacities and promote demand for getting all children vaccinated. Nevertheless, disproportionate differences exist among children in marginalised communities compared with those from the general population. Examples of such marginalised populations are minority ethnic communities (e.g. Roma communities in Moldova) and migrants (e.g. children affected by labour migration in Kyrgyzstan due to the parents’ seasonal and/or foreign employment).

In terms of the barriers to the uptake of CRI, research has been conducted in various countries in ECAR to understand the environmental (e.g. system-level characteristics, infrastructures and resources), social (e.g. norms and peer groups) and individual influences (e.g. fear of side effects and trust in vaccines). However, barriers identified in the general population may be markedly different for those children and caregivers who are from marginalised populations.

In Moldova, Roma communities have shown lower readiness to vaccinate their children, which is hypothesised to be related to sub-cultural specificities. Members of these communities do not normally engage with formalised systems, including due to discrimination, and their children are rarely sent to kindergartens and attend schools. All of these affects effective immunization service delivery. To gain meaningful insights about barriers that originate from within or outside these communities, investigators must gain trust of members of Roma communities not only by speaking their language but also by understanding their cultural nuances.

In Kyrgyzstan, it is estimated that 26% of households are affected by low-skilled labour migration, and these households often face challenges to gain access to social and medical care, including immunization, due to local system requirements.

To strengthen the appropriateness of nationwide strategies to promote demand for CRI, and improve national capacities to efficiently identify and tackle barriers across the social spectrum, it is imperative that the realities of specific sub-populations are also thoroughly understood. There is a need for a comprehensive approach that can guide countries to follow best-practice processes and evidence-informed approaches to engage with marginalised populations and relevant stakeholders, use suitable assessment tools for identifying barriers and develop evidence-based solutions to improve nationwide CRI. Through this consultancy, the Regional Office (RO) in UNICEF ECAR aims to bridge this gap in the region by supporting the development of a comprehensive user guide and toolkit that could provide a basis for countries to carry out a systematic analysis of their national situation regarding the uptake of CRI from the perspectives of relevant marginalised populations, and develop solutions to tackle the identified priority barriers.

Scope of Work

This consultancy aims to support UNICEF Country Offices (COs) in ECAR by developing a comprehensive user guide with best-practice and evidence-informed approaches to engage with marginalised populations, a toolkit for identifying barriers to the uptake of CRI among these populations, and example methodologies for developing and evaluating high impact solutions.

The consultant will develop tools, methodologies, while also providing overall guidance and working closely with contractors at country level who will be in charge of in-country data collection and analysis related to the usability and acceptability testing and pre-testing.

The aforementioned objectives will be achieved through completing this consultancy in two countries in ECAR (i.e. Moldova and Kyrgyzstan) with their respective sub-populations, as follows:

1. Moldova: children from Roma communities; and
2. Kyrgyzstan: children affected by labour migration (due to the parents’ seasonal and/or foreign employment).

The ‘comprehensive’ nature of the user guide and toolkit refers to three main requirements, as follows:

1. The user guide will cover the entire process and provide guidance on how to: engage with the countries, do field observations relevant to specific audiences, engage with the audiences and relevant stakeholders who interact with these communities (e.g. Roma leaders, non-governmental organisations etc.). The user guide will include details on development, acceptability and usability testing, and pre-testing of approaches and assessment tools with guidance for future use and adaptation. It will also provide details on how to develop appropriate solutions to address the identified barriers and include well-defined methodological recommendations for the evaluation of these solutions. The proposed approaches and tools will be developed based on the specifics of these populations and their preferences, most effective ways of engagement with them, and evidence generation.
2. All tools in the toolkit need to be designed so that each can be used individually and has the capacity on its own to identify individual, social and environmental barriers to the target behaviour in the sub-populations in case resource constraints do not allow for the implementation of the entire toolkit.
3. Barriers need to be identified from the perspectives of the target sub-populations, HWs who provide the relevant health/immunization services as well as the health/immunization services (service design and delivery barriers).

The consultancy will conclude with solution development to address identified priority barriers and a well-defined methodological proposal for future evaluation.

This project will entail the following phases and deliverables:

1. Inception phase:

• Establishing working arrangements between the RO, the COs, and stakeholders. The consultant is expected to gather information needed for the inception report.
• The consultant will refer to relevant documents shared by the RO, COs, national stakeholders and will conduct a desk review of the literature.
• The consultant will engage with relevant members of the COs and national stakeholders through semi-structured interviews to gather relevant information (max. 5-8 interviews per country).
• The consultant will submit the inception report that must include:
• the documentation of current realities of the identified sub-populations in each country in the context of CRI. The description should answer the following key questions: what is the estimated size of each sub-population; what is the demographic composition; where are they located geographically in the country; what are the key issues that may need to be considered in the context of CRI (e.g. unregistered, zero dose, no vaccination card/history, delayed vaccination etc.), and who are the relevant stakeholders who interact with them;
• a summary of the evidence, if any, regarding barriers to CRI identified specifically in these populations;
• a summary of the evidence, if any, regarding validated tools that have been previously developed to identify barriers in these populations;
• a summary of the evidence, if any, regarding effective solutions that have been previously developed to address barriers in these populations;
• appropriate citations for the sources of information reported;
• the proposed framework that will be used to identify barriers (i.e. inform the toolkit development and analysis) and develop solutions to address those barriers;
• the proposed approaches and methods to ensure the usability, acceptability, validity and reliability of the toolkit in the given contexts; and
• a detailed project timeline with key steps and deliverables highlighted.

2. User guide and toolkit development phase:

• This will involve three main line of activities, as follows:

2/a: developing a preliminary user guide with a toolkit that encompasses research tools to identify barriers to the uptake of CRI among the two target populations. The consultant will identify previously validated research tools, if they exist, and adapt them to the contexts of this consultancy. The consultant is expected to take into account both qualitative and quantitative research tools insofar they are suitable for assessment with the target populations. Highly participatory qualitative approaches are likely be more suitable, for example, when working with Roma communities.

2/b: conducting an interative ‘usability and acceptability testing’ and ‘refining’ of the preliminary toolkit through participatory approaches with members of these populations. It is expected that by the end of this interative co-creation process, the assessment tools and approaches will be suitably developed for pre-testing.

2/c: developing necessary study protocols and supporting obtaining ethical approvals (where appropriate) for pre-testing the developed tools in Moldova and Kyrgyzstan with members of the respective populations.

• During this phase the consultant will submit:
• a preliminary user guide and tools for identifying barriers in these populations;
• documentations of insights gathered through usability and acceptability testing, and any refinements needed to the tools and approaches;
• study protocols and analysis plan for pre-testing in Moldova and Kyrgyzstan; and
• any further information needed to obtain relevant ethical approvals for pre-testing.
• The consultant will draw on the framework(s) proposed in the inception report to ensure that all relevant barriers are considered, and that the framework(s) will be made explicit in the description of the tools.
• Depending on the type of tools in the toolkit, a detailed user guide is needed that describes the variables and operationalises any potentially lesser known or composite measures together with a suggested coding system. Guidance for future adaptation will be included in the user guide (e.g. highlighting the core questions, and any composite measures that should not be modified without validity and reliability checks to ensure proper psychometric properties, if relevant).

3. Pre-testing phase:

• The consultant will conduct pre-testing of the tools with appropriate sample sizes from these populations in Moldova and Kyrgyzstan and identify barriers to CRI. Samples for pre-testing are not expected to be representative to the entire sub-populations.
• The consultant will document key steps in the user guide, and make necessary refinements in the guide and/or assessment tools based on the results and experiences gained from pre-testing.
• When analysing and interpreting the findings from pre-testing, the consultant will identify priority barriers based on their likely impact and centrality to improving CRI uptake in the populations.
• The consultant will submit regular progress reports to RO for review.

4. Solutions development phase:

• This will involve the use of participatory approaches for the solution development (e.g. human centered design) with the populations to adequately and effectively address identified priority barriers.
• By the end of the co-creation process with members of the target population and relevant stakeholders, the consultant will develop two well-defined, implementable and sustainable solutions for each country to address potentially high-impact priority barriers.
• The framework and approaches used for solutions development will need to be documented in the user guide so that it is replicable in other contexts.
• Detailed implementation instructions will be needed for each solution proposed.

5. Final report write-up phase:

• The consultant will develop and submit a final report that must include:
• a summary of key insights gathered in the inception phase;
• a summary of key methodologies and approaches used for various phases;
• the final version of the comprehensive user guide and the toolkit;
• insights gathered from Moldova and Kyrgyzstan;
• approaches and frameworks for solutions development;
• well-defined solutions (max. 2 per each country) developed to address the priority barriers identified and their implementation plans;
• methodological recommendations for the evaluation of the proposed solutions.

6. Webinar planning and delivery phase:

• The consultant will prepare power points, plan and deliver a regional webinar to present the user guide, findings and the developed solutions. The consultant will:
• Develop the webinar concept note and proposed agenda.
• Engage with relevant COs/stakeholders to organize the meeting and agree on speakers.
• Prepare a power point presentation detailing: phases of toolkit development as well as theoretical models used for its development, findings from pre-testing in Moldova and Kyrgyzstan, solutions developed for these countries, recommendations for adapting and further utilizing the toolkit in other countries.

Work Assignment Overview

Estimated Duration of the Contract

129 working days between September 2024 and September 2025.

Consultant’s Work Place and Official Travel

The Consultant will be remote/home-based.

As part of this assignment, some international travels are foreseen. The consultant will arrange her/his travel as and when they take place, and related costs will be reimbursed per UNICEF travel policy.

Travel Clause

• All UNICEF rules and regulations related to travel of Consultants apply.
• All travels shall be undertaken only upon the prior written approval by UNICEF.
• The consultant must be fit to travel, be in a possession of the valid UN BSAFE certificate, obligatory inoculation(s) and have a valid own travel/medical insurance and an immunization/vaccination card.

Estimated Cost of the Consultancy & Payment Schedule

Payment will be made on submission of an invoice and satisfactory completion of the above-mentioned deliverables. UNICEF reserves the right to withhold all or a portion of payment if performance is unsatisfactory, if work/outputs are incomplete, not delivered or for failure to meet deadlines. All materials developed will remain the copyright of UNICEF and UNICEF will be free to adapt and modify them in the future.

Please submit a professional fee (in USD) based on 129 working days to undertake this assignment, without travel fees as these will be reimbursed as and when they take place.

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

Required:

• PhD in social sciences, preferably on social and behaviour change, behaviour sciences and social psychology, is required.
• At least seven (7) years of experience in planning, designing and assessing SBC interventions and strategies, preferably for public health and immunization.
• Experience in using participatory approaches (e.g. human centered design) with populations in the context of social and behavioural change;
• Experience in designing a variety of tools for qualitative and quantitative data collection, including qualitative semi-structured interview guides, field observation guides and quantitative surveys;
• Experience in using behavioural science frameworks and methods for identifying and understanding factors that influence given target behaviours in context; and
• Experience in developing evidence-based solutions to influence behaviour change.
• Strong written and spoken English ability.

Desirable:

• Proven familiarity and experience working with the UN (ideally with UNICEF).
• Previous experience working with Roma communities and/or migrants;
• Fluency in Kyrgyz, Russian, Romanian and/or Romanes/Romani languages.

For every Child, you demonstrate…

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

To view our competency framework, please visit here.

UNICEF is here to serve the world’s most marginalized children and our global workforce must reflect the diversity of those children. The UNICEF family 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:

Please include a full CV and a Cover Letter in your application. Additionally, indicate your availability and professional fee (in USD) to undertake the terms of reference above. Applications submitted without a professional fee will not be considered. 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.

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts.

UNICEF offers reasonable accommodation for consultants with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment.