National Consultant to review and update Village Health Worker (VHWs)/Community Health Worker (CHW) Training Manual and Handbook and develop Supportive Supervision Tools for CHWs.

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For every child, a future.

Purpose of Activity/Assignment:

To update the Village Health Worker/Community Health Worker Training Manual, Handbook and Supportive Supervision Tools. The recent developments on health, nutrition, social and behavior change, impact of climate change on health, re-emerging diseases, environment and occupational health, nutrition, etc. need to be incorporated into the updated training manual and the handbook. These documents will enable CHWs to enhance the knowledge and create awareness in the communities for promotion of health and nutrition, and prevention of diseases.

Scope of Work:

Background

Bhutan embarked upon modern health care system in early 1960s with commencement of the First Five-Year plan. The country has made significant progress in reducing maternal, new-born, infant and child mortality, stillbirths, stunting and underweight over the last decades. Community participation in promotion of health and nutrition practices at community level for prevention of diseases is important to benefit individuals and families at the community level. It is the first level of care in health systems for individuals, the family, and communities by bringing health care as close as possible to where people live and work.

The Astana declaration on October 27, 2018, emphasizes the critical role of primary health care and aims to refocus efforts on primary health care to ensure that everyone everywhere can enjoy the highest possible attainable standard of health. Community Health Workers (CHW) are the backbone of community health system for Primary Health Care (PHC) services for delivering a range of preventive, promotive and basic curative services related to reproductive, maternal, newborn and child health, communicable and non-communicable diseases, mental health, environmental health and nutrition for children, adolescent and women.

Section 5.3 of the National Health Policy 2011, states that “primary health care shall also reach out to the communities through Outreach Clinics, Village Health Workers and other available modes of communication”, section 6.9 states that “Village Health Workers shall be trained in order to sustain achievement of universal health coverage and to encourage community participation in the health care delivery system”, and section 13.1 of the National Health Policy 2011 states that “active community participation and empowerment in the healthcare delivery system shall be encouraged to facilitate achieving universal health coverage especially to unreached rural population”.

During recent years, many developments have occurred in the areas of health and nutrition, including emerging health issues such as impact of climate change on health, emerging and re-emerging diseases, environment, and occupational health, non-communicable disease, triple burden of malnutrition, food system which are not well included in the current training manual and handbook developed in 2017. These need to be incorporated into the CHW training manual and handbook to be able to impart the comprehensive knowledge to the CHWs for serving the communities better.

The training manual is a guide for trainers in training CHWs to demonstrate, using simple terms and explanations to align with the minimum level of knowledge and understanding required by community health workers including VHWs on disease prevention, antenatal care, institutional delivery, postnatal care, immunization, safe water, sanitation and hygiene, promotion of better health and nutrition, waste management, menstrual health and hygiene, impact of climate change on health, disease outbreak in the community, provision of simple first aid treatment for emergencies, minor ailments and referral of patients to the nearest health center.

The handbook, on the other hand is a quick reference document to be used by the CHWs. It lists simple drugs and dosages and provides practical tips and key points to remember and apply while serving the communities. It is also intended to be used as a companion to the CHWs Trainer’s manual and includes important illustrations that the trainers can use for explaining better.

Methodology:

The assignment involves thorough review and analysis of the current VHW training manual and handbook, and other training manuals on community health and nutrition, inter-personal communication manuals, consultations with the stakeholders representing both the central and community levels. Focus group discussions and key informant interviews with relevant participants will be conducted. Other methodological approaches such as, review of current guidelines and handbook, desk review and field visits, etc., will be considered as appropriate.

The selected consultant will work under the direct supervision of Health and Nutrition Officer, UNICEF Bhutan with technical guidance from the Chief Programme Officer, Health Promotion and Risk Communication Division (HPRCD), Ministry of Health and in close collaboration with other programme officers, Department of Public Health, Ministry of Health and UNICEF Child survival and Social Behavior Change (SBC) Sections. In addition, the consultant in consultation with the HPRCD will coordinate the meetings/workshops for the purpose of bringing stakeholders together to discuss the inputs into the revision of the CHWs training manual and handbook. This consultancy will also involve travel to the selected districts and communities as per the implementation plan to carry out the assignment. Feedback sessions will be organized with various stakeholders and debriefing to the senior management of Ministry of Health and UNICEF Bhutan. In addition to the training manual and handbook, the consultant will develop Supportive Supervision Tools to be used by supervisors of CHWs.

The methodology will consist of the following:

• Submit an inception report with methodology, tools and workplan for the consultancy assignments.
• Desk review of relevant documents including the draft report of situation analysis of community health and nutrition for PHC, draft updated the community/village health workers strategy and action plan, assessment and evaluation reports on community health and nutrition in Bhutan, policies, strategies, action plans, training manuals, guidelines, handbooks, and any other relevant documents in health, nutrition, and WASH, social and behaviour change and community engagement in the provision of community health components of RMNCAH, environmental health, mental health, NCDs, nutrition, ECCD.
• The consultant needs to ensure the inclusion of health and nutrition promotion, disease prevention, service delivery strategies and models, including the package of services provided by VHWs/ CHWs.
• Develop data collection tools including focus group discussions (FGD)s, key informant interviews (KIIs) among others.
• Conduct meetings with relevant programmes of UNICEF and MoH to finalise data collection plan and tools.
• Conduct focus group discussions (FGDs) and key informant interviews (KII) with relevant stakeholders including relevant programmes at MoH and UNICEF, WHO and selected NGOs/CSOs.
• Conduct focus group discussions, and key informant interviews with VHWs/CHWs, supervisors, trainers, community leaders and members, including pregnant mothers and young people to understand VHWs’ role in supporting community participation in health care delivery and empowering them to contribute to the improvement of health and nutrition outcomes for children through health promotion and health seeking behaviours for the achievement of universal health coverage.
• Draft CHW/VHW/CHWs training manual and CHW/VHW handbook and share the draft with MoH and UNICEF.
• Design supportive supervision tools: Develop practical tools (e.g. checklists, job aids, performance monitoring forms, etc.) to facilitate regular and effective supervision of VHWs.
• Conduct a pilot session/ pre-testing with a group of selected CHW/VHW trainers, CHW/VHWs and their supervisors to gather feedback on the draft training manual, handbook, and supportive supervision tools.
• Facilitate stakeholder’s meetings to present the draft training manual, handbook and supervision tool.
• Finalize and share the final CHW/VHW training manual and CHW/VHW handbook in editable version (e.g. Ms. Word, PDF, Canva etc) and with MoH and UNICEF.
• Design and edit graphic design of CHW/VHW training manual and CHW/VHW handbook including the cover and share with MoH and UNICEF.

Work Assignments Overview

1. Produce an inception report and workplan

• Inception report/workplan for the assignment – 3 days

2. Review CHWs training manuals and handbook, desk review of relevant national, international, and other countries documents, and conduct technical consultation meetings and FGD/KII.

• Report on Desk review of relevant national, international, and other countries training documents – training manual, handbook, policies, situation analysis, assessments, strategies, manuals, guidelines, handbooks etc. – 7 days
• Report on Technical consultation meetings, FGD and KII with relevant stakeholders including CHWs – 15 days

3. Draft, pre-test and update the CHW training manual and handbook, and supportive supervision tools

• Draft CHW training manual – 6 days
• Draft CHW handbook – 6 days
• Draft support supervision tools – 2 days
• Pre-test CHW training manual, handbook, and supervision tools with VHW trainers, VHWs and VHW supervisors and trainers. – 5 days
• PPT and presentation of the draft CHW training manual and handbook for inputs from the technical people – 2 days
• Final draft training manual and handbook following technical consultation meeting for review and update CHW training manual and handbook – 5 days

4. Finalize CHW training manual, handbook, and supportive supervision tools

• Final training manual, handbook, and supervision tools. – 4 days
• Presentation of final training manual, handbook, and supervision tools – 2 days
• Summary report on the assignment, the final manual and handbook both designed and editable versions, and presentations. – 3 days

Deliverables, Timelines and Payment Schedule 

1. Inception report, desk review report and report on technical consultation meetings, FGD and KII – 30% payment

2. Draft CHW training manual, handbook, and supportive supervision tools – 40% payment

3. Final training manual, handbook, and supervision tools, PPT presentations and summary report on the assignment. – 30%

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

Minimum Qualifications:

• Masters in Public Health and Nutrition, or Health Policy System, Social Sciences, or other relevant fields.
• At least five years professional work experience at the national and international levels in development of strategies, planning and programming for health and nutrition sector.
• Working experience in health, child survival, health, nutrition, development and care, and adolescent health programme interventions.
• Experience of working with UN, especially UNICEF, WHO and NGOs on similar assignments will be an asset.

Knowledge/Expertise/Skills required:

• Demonstrated communication, analytical and facilitation skills, and able to manage diverse viewpoints and work in demanding situations.
• Excellent writing skills and ability to synthesize complex information and issues. Strong analytical and conceptual thinking, ability to work in teams.
• Experience in developing training manual/guidelines, handbook, modules on public health and nutrition programmes.
• Experience on teaching/training facilitation on primary health and nutrition care (PHC) will be an asset.
• Ability to organize and plan complex work following the established timeframes.
• Experience in liaising with public officials and capable of responding rapidly to ad hoc requests for meetings under tight deadlines; facilitating discussions among diverse stakeholders.
• Demonstrated technical knowledge on Primary Health Care and Community Health and Nutrition programmes.

For every Child, you demonstrate… 

UNICEF’s values of Care, Respect, Integrity, Trust, Accountability, and Sustainability (CRITAS). 

To view our competency framework, please visit here. 

UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious or ethnic background, and persons with disabilities, to apply to become a part of the organization. To create a more inclusive workplace, UNICEF offers paid parental leave, breastfeeding breaks, and reasonable accommodation for persons with disabilities. UNICEF strongly encourages the use of flexible working arrangements. Click here to learn more about flexible work arrangements, well-being, and benefits.

According to the UN Convention on the Rights of Persons with Disabilities (UNCRPD), persons with disabilities include those who have long-term physical, mental, intellectual, or sensory impairments which, in interaction with various barriers, may hinder their full and effective participation in society on an equal basis with others. In its Disability Inclusion Policy and Strategy 2022-2030, UNICEF has committed to increase the number of employees with disabilities by 2030. At UNICEF, we provide reasonable accommodation for work-related support requirements of candidates and employees with disabilities. Also, UNICEF has launched a Global Accessibility Helpdesk to strengthen physical and digital accessibility. If you are an applicant with a disability who needs digital accessibility support in completing the online application, please submit your request through the accessibility email button on the UNICEF Careers webpage Accessibility jobs-near-me.org UNICEF.

UNICEF does not hire candidates who are married to children (persons under 18). 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 based on gender, nationality, age, race, sexual orientation, religious or ethnic background or disabilities. UNICEF is committed to promote the protection and safeguarding of all children. All selected candidates will, therefore, undergo rigorous reference and background checks, and will be expected to adhere to these standards and principles. 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, and selected candidates with disabilities may be requested to submit supporting documentation in relation to their disability confidentially.

Remarks: 

1. The candidates are required to submit both technical proposal and financial proposals. 

2. 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. 

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