Statement of Work

For Public Health Consultant 

Enhanced Technical support for LF MDA Planning and Social Mobilization in 15 selected municipalities of Dhanusha, Mohattari, Sarlahi, Rautahat and Rasuwa districts.

Background:

Lymphatic Filariasis is a neglected tropical disease (NTD) endemic to Nepal. Based on the public health importance of Lymphatic Filariasis, the World Health Organization (WHO) made a global call for its elimination by the year 2030 to which the Government of Nepal has expressed its commitment. The elimination of LF in remaining endemic districts will be achieved through the mass administration of Ivermectin, Diethylcarbamazine citrate (DEC), and Albendazole.

The Nepal LF Elimination Program has made remarkable progress, having already covered all 64 endemic districts in the country. As a testament to its success, 49 of these districts have met the criteria to cease Mass Drug Administration (MDA) and have transitioned to conducting post-treatment surveillance.

One of the major challenges in this late stage of the LF program is that there is insufficient treatment coverage in certain communities within the districts that continue to require treatment. To confront these challenges from 2015 to 2023, the Ministry of Health and Population (MOHP)/Epidemiology and Disease Control Division (EDCD), in collaboration with ENVISION / Act to End NTDs | East, implemented a series of social mobilization tactics and advocacy campaigns. These initiatives were directed at engaging elected officials, private healthcare personnel, professional organizations, educational institutions, local clubs representing ethnic minorities, municipal employees, and the media. These efforts were launched at least two months in advance of the Mass Drug Administration (MDA) campaigns.

During the 2023 Mass Drug Administration (MDA), monitoring teams, comprising representatives from EDCD, WHO, and Act | East, identified an additional requirement for technical support to enhance the planning and execution of MDA in specific municipalities. The transition to a federalized system has given municipalities greater financial and technical authority over health programs. However, the technical competence of municipal health personnel has not yet fully aligned with this decentralization process. Municipal health officers are responsible for overseeing numerous health programs, juggling multiple priorities with limited human resources, occasionally leading to vacant positions. Consequently, this situation has resulted in deficiencies in both human resource capacity and technical expertise within the Lymphatic Filariasis program at the municipal level.

In response to this situation, Act | East has actively contributed to addressing the issue by offering short-term human resource assistance in specific districts to bolster Mass Drug Administration (MDA) planning and supervisory efforts. During the fiscal year 2022, Act | East deployed Public Health Consultants in two municipalities within the Bara District in the period leading up to and during the MDA, focusing on enhancing the planning and execution of the program. In the fiscal year 2023, EDCD identified an additional 35 supervisors whose role was to provide comprehensive planning and implementation support for LF MDA in the 11 districts. Act | East also served as a technical advisor to these supervisors when required. In both cases, the additional human resources and accountability ensured that:

• pre-MDA social mobilization activities down to community-level interactions were conducted and accurate information about LF MDA was shared.
• proper planning of LF MDA to reach all targeted populations took place.
• municipality and ward-level officials were aware of and engaged in LF MDA activities.
•  health workers and drug distribution teams benefitted from LF-specific technical support, ensuring house-to-house visits and DOT took place; and
•  recording and reporting LF MDA data were timely and accurate.

Ahead of the FY24 MDA, Act | East Nepal intends to recruit and train 15 public health consultants (1 in Rasuwa, 2 in Dhanusha, 3 in Sarlahi, 4 in Mahottari, and 5 in Rautahat) to be strategically positioned in municipalities with pockets of low coverage to provide support in the planning, implementation, and monitoring of LF MDA efforts. This year, particular emphasis will be placed on enhancing social mobilization initiatives.

These public health consultants will furnish supplementary assistance to these municipalities. With this temporary additional support, it is anticipated that municipalities grappling with human resource and technical limitations will have the opportunity to carry out a comprehensive MDA and offer tailored assistance to communities where MDA coverage rates are suboptimal.

Essential Duties of Public Health Consultants:

• Develop a detailed work schedule leading up to and including LF MDA in close coordination with the concerned municipality.
• Attend an in-person orientation and microplanning training.
• Support microplanning for LF MDA implementation with municipality officials.
• Support implementation and facilitation of orientation and awareness-raising activities before LF MDA in municipalities.
• Facilitate engagement with influential community members to ensure ward-level meetings are creative and engaging, and draw a crowd, which could include miking, film screenings, and street plays.
• Identify local community influencers in coordination with municipal officials to support health workers during LF MDA in booths and door-to-door drug delivery.
• Support drug distribution teams to identify clusters requiring additional human resource support (community influencers) for house-to-house visits during MDA.
• Support municipality staff in orienting a small group of community members to support drug distribution teams in selected communities.
• Support and implement the use of the SCT in coordination with municipalities and district health offices.
• Ensure that ward-level advocacy meetings are carried out in each ward and provide technical support with updated information on LF MDA.
• Support municipality officials in the timely recording and reporting of LF MDA data.
• Financial management of Act| East supported activities in respective municipalities as per RTI policy.
• Conduct weekly briefings/updates with Act| East staff during the period of performance.
• Document the process and feedback from participants, communities, and stakeholders and submit to Act| East.

Education & Experience:

• Bachelor’s degree in public health and 2 years of experience, Master’s degree in public health, or equivalent combination of education and experience.
• A candidate with prior experience working with the National Lymphatic Filariasis Elimination program will be an asset.

Skills and Capabilities:

• Excellent knowledge of MS Word, Outlook, PowerPoint, and Excel.
• Ability to manage multiple priorities.
• Ability to work well with others (Good coordination skills).
• Ability to listen and communicate well both verbally and in writing.
•  Ability to work independently.
• Information Gathering and Reporting
• Planning and Organizing
• Problem-Solving

Period of Performance and Deliverable Payments:

• The period of performance is approximately three months, tentatively from January to March 30, 2024. The consultant will be paid on three milestones upon submission of agreed deliverables.  Each milestone's deliverable will be communicated separately to selected candidates.

Deliverables:

• Monthly work schedule
• Monthly Report including several events supported and facilitated.
•  Supporting documents for activities expenditure.
• LF MDA implementation micro plan of the respective municipality.
• Final report including ward/health facilities level coverage data.
• Report of SCT conducted
• LF MDA reports