Annex 1-7
UNICEF UKRAINE
TERMS OF REFERENCE
For implementing agency for the updating of Monitoring and Evaluation system for Prevention of Mother to Child HIV Transmission (PMTCT) and Paediatric AIDS programmes in Ukraine
Duration: November – December 2016
1. Purpose of Contract:
Assistance to the Ministry of Health and Ukrainian Centre for Disease Control (UCDC) in the system of monitoring and evaluation of the programme ‘Prevention of Mother-to-Child Transmission of HIV’ in Ukraine (M&E of PMTCT) improvement.
Background and Rationale
The Global Plan Towards the Elimination of New HIV Infections among Children by 2015 became one of the priorities of public health systems of all countries. In Ukraine, the elimination targets are set in the National AIDS Programme (NAP) 2012 -2018 as less than 2% of HIV transmission.
Since introduction of the national PMTCT programme nationally, Ukraine achieved a significant progress in PMTCT. Implementation of the relevant programme interventions allowed to reduce MTCT of HIV rate from 27 % in 2000 to 3,9 in 2013. At the legislative level, the state guarantees provision of unrestricted access to prevention of mother-to-child transmission of HIV from HIV-positive mothers to their newborn babies. Starting from 2003, coverage with voluntary HIV testing among pregnant women constantly exceeds 97%. Coverage with preventive antiretroviral treatment among women who were diagnosed with HIV during their pregnancy increased from 9% in 1999 to 95% in 2015.
However, target MTCT value within the National Targeted Social AIDS Programme for 2014-2018 is 1%, which is far beyond the targets both national and global target of MTCT elimination. To achieve the target, a number of obstacles at all levels of healthcare system, community and personality are to be overcome. Among them is a lack of the effective public health program; issues related to government procedures to procure medicines and healthcare products; budget deficit on the background of humanitarian crisis and military conflict in eastern Ukraine; and insufficient coverage of women of reproductive age, including those living with HIV, with family planning services. The others are stigmatization from the side of healthcare workers towards women living with HIV and socially marginalized women as well as weak crosscutting integration of services in the areas of health care, education, social policy, justice and migration.
An important step in achievement of international and national targets in the area of prevention of mother-to-child transmission of HIV (PMTCT) was approval of medical and technological documents, namely ‘Adapted evidence-based clinical guidelines “Prevention of Mother-to-Child Transmission of HIV” and ‘Unified Clinical Protocol of Primary, Secondary (Specialized) and Tertiary (Highly Specialized) Medical Care “Prevention of Mother-to-Child Transmission of HIV”.
To monitor the progress in the PMTCT and maintenance of the measures, there is a need in update of the M&E system. Existing ‘handwork’ system of reporting on the PMTCT indicators from the local AIDS Centres and further analysis of the data obtained does not allowed to have a well-timed data on how the PMTCT measures are implementing and what should be done if the problems appears. The latest Ministry of Health Order on approval of forms for monitoring and reporting on PMTCT measures # 612 dated on 3 September 2012 and needs to be updated and reinforced with the software system to enable objective data and objective criterion are used for monitoring and planning of the respective measures to be taken to achieve PMTCT targets.
2. Objectives of the Contract with expected results / outcome / products /sub products/outputs:
The objective is:
· To improve the system of monitoring and evaluation of the programme ‘Prevention of Mother to Child Transmission of HIV’ in Ukraine (M&E of PMTCT) in order to ensure relevant changes in strategy and implementation.
Results expected:
i) The software is developed and tested;
ii) The national PMTCT M&E system is updated.
Outputs:
· Assistance to the Ministry of Health and the UCDC in revision and updating of the set of indicators that can be gathered at the local and national level to monitor PMTCT progress;
· Design and development of the programme and respective software for the M&E system;
· Development of the methodological recommendations on introduction of a data collection system on PMTCT at the local and national level;
· Probation of the newly developed M&E system at local and national level (UCDC);
· Organisation of round table/workshop to present a new M&E system;
· Documentation of project implementation and analysis of results obtained;
· Production of report;
3. Delivery dates based on the work plan (to be approved by UNICEF HIV/AIDS Officer):
· Workshop on revision of the indicators for PMTCT M&E system – 1- November 2016;
· Draft of the set of indicators for the software system – 10 November 2016;
· Methodological recommendations for the M&E system users – 30 November 2016;
· Report on probation of the software and M&E system – 5 December 2016;
· Presentation of the PMTCT M&E system at the working group on M&E – 10 December 2016;
· Submission of the final report on the project – 15 December 2016.
4. Details of how the work should be delivered:
The agency has to report in accordance with the delivery dates on activities and submit to UNICEF a final report upon completion of assignments.
5. Performance indicators for evaluation of results:
· Quantity of work (No. of information materials related to the project, No. of meetings with partners, No. of documents prepared during implementation etc.);
· Quality of work (Qualitative evaluation of the work of the agency by the MOH and UCDC and UNICEF supervisor)
· Responsibility (Timeliness of submission to UNICEF of the products according to the delivery dates, monthly reports and information requested)
6. Qualifications/specialized knowledge/experience required to complete the task:
· Implementing organisation should have an expertise and be experienced in development of the monitoring and evaluation systems and software;
· Knowledge and understanding of the national HIV programme;
· Experience of work with the partners (regional health care institutions and national health authorities);
· Team should include experts in PMTCT and monitoring of the both national AIDS programme and PMTCT;
· Team leader must have strong organisational and management skills, including financial management.
7. Definition of supervision arrangements:
The HIV/AIDS Officer, UNICEF Ukraine, supervises the implementation agency
8. Description of official travel involved:
Travels are not planned within the Contract. If otherwise, the travel costs are to be included into the budget, with the respective breakdown.
9. UNICEF recourse in the case of unsatisfactory performance:
In the event of unsatisfactory performance, UNICEF reserves the right to terminate the Agreement. In case of partially satisfactory performance, such as serious delays causing the negative impact on meeting the programme objectives, low quality or insufficient depth and/or scope of the assessment completion, UNICEF is entitled to decrease the payment by the range from 30 to 50%.
10. Support provided by UNICEF:
Technical assistance, consultations, funding.
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