Maternal Newborn and Child Health
Unicef
Nigeria
5d ago

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Background :

The maternal and newborn mortality and morbidity in Nigeria is one of the highest in the world with an estimated 574 maternal deaths for every 100,000 live births (NDHS 2013).

Nigeria contributes about 10% of global burden of maternal deaths. The main causes of high maternal morbidity and mortality among women include anaemia in pregnancy due to malaria, intra-

partum and post-partum hemorrhage, sepsis, obstructed labour, and hypertensive conditions in pregnancy.

The morbidity and mortality among children in Nigeria is also very high. The under-five mortality rate staggers at 158 per 1,000 live births and the infant mortality (IMR) at 39 per 1,000 live births (MICS, 2016), but still higher than many other countries in Sub-

Saharan Africa with similar GDP. Pneumonia, malaria, and diarrhoea continue to take lives of many children in Nigeria. Under nutrition and malnutrition are major causes of childhood morbidity.

It is estimated that 24% of children under five (U5) years of age are underweight and 36% of children are estimated to be stunted (MICS 2016).

Health indices are particularly very poor in the northern part of Nigeria. Maternal and infant mortality rates are 3-4 times the national average.

In Adamawa State, 15% of adult women were underweight / thin while 11.6% were overweight / obese while in Kebbi 16.6% were underweight / thin and 23.

8% overweight / obese. Both conditions are associated with negative nutritional outcomes in childhood. Low birth weight, among other causes, is indicative of the poor nutritional status of the mother.

 The poor health indices in Nigeria may be attributable to four main problems identified with Nigeria’s health system which include :

  • Governance and stewardship : Autonomy of the 3 tiers of government (Federal, State, and Local Government Administration (LGAs) has led to duplication of efforts, weak governance and lack of accountability;
  • Human and Financial Resources : Inappropriate allocation of human and financial resources with greater support to tertiary and specialized care, instead of primary health care;
  • Coverage : Low coverage of core maternal, newborn and child health interventions, and
  • Limited access to health services due to financial and socio-cultural barriers.
  • Federal Ministry of Health, Ministry of Budget and National Planning, European Union and UNICEF launched the new EU-MNCH project which seeks to contribute to addressing the sub-

    optimal status of health for women and children in Adamawa and Kebbi States characterized by high maternal and childhood deaths.

    The goal of the project is to assist the Governments of Bauchi, Kebbi and Adamawa in line with their State Strategic Health Development Plans (SSHDP) to reduce maternal, newborn and child deaths by significantly improving the health and nutrition status of women and children under 5 years by ensuring an equitable and strengthened primary health care delivery system.

    In order to support human resources and deliver appropriately, UNICEF intends to recruit consultants that will manage programme implementation in Adamawa, Kebbi and Kebbi States.

    Rationale

    This position is to support the State ministry of health, state primary health care development agency and other partners in the implementation of evidence-

    based interventions that will result in the scale-up of and improved access to maternal and newborn health services with a particular focus on systems strengthening, local capacity building, focused mentoring in local facilities and communities in Adamawa, Kebbi and Bauchi States.

    The officer will support the SMOH, SPHCDA and other partners in the implementation of various strategies and interventions that will strengthen partnership for policy reforms, sector governance and stewardship at LGA level, increased transparency and accountability, capacity building, provision of sustainable and scaled-

    up integrated MNCH service delivery with equity and community participation.

    The Goal is to significantly contribute to the reduction of maternal, new-born and child mortality and morbidity in 3 States in Nigeria towards the achievement of SDGs as well to establish an integrated primary health care model which can be easily scaled up.

    The Overall Objective is to improve the nutrition and health status of women and children through a sustainable primary health care delivery system and improved community resilience.

    Specific objectives include :

  • Increase the proportion of poor, marginalized, rural women and under-five years old children with increased access to, and effective utilization of, high impact health and nutrition interventions.
  • Improve the functionality of health service provision for health facility, outreach and community based services in 774 wards in three States.
  • Strengthen coordination, policy and institutional framework to scale up, sustain and replicate MNCHN interventions.
  • Major Tasks to be accomplished : (estimated time required to complete tasks. Attach additional sheets, if necessary, to describe assignments) :

    State and LGA

  • Work with the SMOH, SPHCDA and other partners to support dissemination of national policy, strategy, guidelines and quality of care model for MNCH at state and LGA level.
  • Support SMOH and SPHCDA by providing technical assistance to the development of good quality state and LGA annual operational plans and their review using the Primary Health Care Mechanism.
  • Support dissemination and use of approved training modules and guidelines on selected high impact Integrated Maternal New-
  • born Child Health continuum of care interventions such as- Focused AnteNatal Care (FANC); Skilled Birth Attendance (SBA);
  • Emergency Obstetric and New-born Care (EmONC); Helping Babies Breath (HBB); Post Natal Care (PNC); Community Based New-born Care and Integrated Community Case Management (iCCM) for diarrhoea, malaria and pneumonia.

  • Support state and LGA level supportive supervision, monitoring and evaluation of MNCH programmes.
  • Health Facilities :

    Priority areas of work to be supported at this level and strategy based on TSS model (Training, Supplies, Supportive Supervision) include but not limited to the following

  • Set up and implement a quality of care model for MNCH services in health facilities based on few selected high impact interventions.
  • Train health workers using approved training modules and guidelines on selected high impact Integrated Maternal New-born Child Health continuum of care interventions with assistance of state and LGA based TOTs.
  • Support end user monitoring of equipment and supplies provided to health facilities.
  • Participate in On the Job Training, Supportive Supervision and mentoring of health workers.
  • Communities, Villages, Households

  • Support setting up of structures for implementation of Community Health Strategy †WDCs, VDCs, training of VHWs, CHEWs and CHWs.
  • End user monitoring of supplies and demand for MNCH services in communities and households.
  • Use updated Mama / CHEW / CBNC kits as entry point for promotion of desired health seeking behaviour and link with immunization / polio related activities.
  • Promote uptake of selected high impact family care practices jointly with other sections namely -C4D, Nutrition, Child Protection, Media, advocacy and communications and WASH.
  • Promote uptake of integrated Community Case Management for diarrhoea, pneumonia and malaria.
  • End Product :

  • Annual State work and operational plansQuarterly DHIS and PHC review reportsMonthly progress reports containing iCCM and outreach services data, stock update, etc.
  • Reports of Workshop / Meetings with actionable recommendations.Quarterly reports of milestones achieved to advance project implementation.

    11.5 Months term is required for this assignment

    UNICEF’s core values of Commitment, Diversity and Integrity and core competencies in Communication, Working with People and Drive for Results.

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

    Opening Date Tue May 15 2018 05 : 00 : 00 GMT-0400 (EDT) W. Central Africa Standard Time

    Closing Date Mon May 28 2018 18 : 55 : 00 GMT-0400 (EDT)

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