Consultant to Support Health Programmes in Belize CO

UN Children's Fund, Belize
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Job Summary

Job Description

In Belize, about 20% of the population falls into the 10 to 19 age group, with many underserved by our social services and programmes that could improve their quality of life. Recent data from Belize Health Information System shows that mental health is a growing concern among adolescents. Between 2008 and 2017, the number of adolescents aged 10-19 who attempted suicide represented over one third (36%) of attempted suicides among all age groups. Unintentional injuries are also growing concerns for adolescents. Reckless driving, lack of supervision, inadequate laws and enforcement result in high road traffic accidents as well as drowning. The 2017 mortality report identifies homicides and suicides as leading causes of death among adolescents in Belize. Adolescents are also likely to contract sexually transmitted diseases. In 2017, 96% of those diagnosed with an STI in Belize were between 15-19 years old. Adolescents continue to face barriers when trying to get information on health and reproductive services; in particular, there is a lack of education programmes and youth friendly services.

In response, Belize has committed to implementation of the “Every Woman, Every Child, Every Adolescent Strategy” (EWECEA) and is among the first countries to adopt the Accelerated Action for Health for Adolescents (AA-HA!) with a special emphasis on adolescents as a neglected population. In conjunction with WHO/PAHO, UNFPA and partners, UNICEF globally has supported the development of the (AA-HA!) framework, encouraging holistic health policies for adolescents to achieve good sexual and reproductive health outcomes, prevent injuries and violence, non-communicable diseases (NCDs), mental health disorders, as well as substance abuse, often a co-factor of mental health problems, while promoting physical activities and healthy lifestyles.

UNICEF and the Ministry of Health have been working closely together in defining norms and standards for adolescent health services and exploring options to improve health service, including mental health services, delivery for adolescents. Challenges include 1) limited data on mental health including risk factors in adolescence; 2) Limited specialized human resources and capacity of healthcare providers especially at the community level to provide care for mental health needs of adolescents, as staff in most clinics work for all age groups; 3) Limited scale of existing programmes providing relevant support, and 4) Weak coordination between sectors to ensure effective support towards prevention and response to adolescent health. This document describes the approach suggested by UNICEF to fill crucial data gap by creating a data collection instrument for measuring adolescent mental health at the population level, capacity building for implementing adolescent health norms and standards, developing intervention package for improving adolescent mental health through multi-sectoral approach. Improved data on the prevalence of mental health conditions among adolescents, as well as on exposure to risk factors and access to interventions, is an essential step towards planning more effective and supportive programming and identifying vulnerable populations at higher risk.

Belize has been proposed as a pioneer country in this endeavor given the government commitment led by the Ministry of Health, and in collaboration with partners, in adolescent health programmes, focusing on prevention, early detection and treatment of health conditions of affected adolescents.

In Belize, MICS 2016 data indicated that about 93% of mothers received antenatal care (ANC) four or more times, 3% of mothers have less than three ANC visits and 2% did not attend ANC at all. Only 65% of women had their first ANC visit during the first trimester of their last pregnancy. Service delivery, including medical laboratory services, as well as low awareness of health services in pregnant women in the remote areas are challenges. The approach suggested by UNICEF is to study the demand for health services in pregnant women and local communities and capacity building of community health workers on referral system and utilization of available healthcare services in Belize.

Purpose of the assignment:

In this context, UNICEF is looking for a Health Consultant, who under the supervision of the M&E Officer and in coordination with Belize government partners and UNICEF HQ and Regional Office, will be responsible for technical support towards health programmes in Belize.

Scope of work (Work assignment):

The consultant will be responsible for day-to-day tasks and activity planning. It will be the Consultant’s responsibility to coordinate the activities related to the recruitment of all personnel needed for the field work including focus groups coordinators, note takers, and support for all other processes including data collectors. Identify school areas for recruitment and liaise with national counterparts as needed. The consultant will also be in charge of identifying secure facilities and follow explicit methods for storage of study records to ensure confidentiality of respondents.

Main Activities:

Adolescent mental health data collection: Adolescents at the Population level (MMAP) tool

Translation/adaptation and back translation of English and Spanish-language tools

  • Identify and work with a team of 3 bilingual independent translators to review the validated English and Spanish-language versions of the tool
  • Facilitate back translation of the tool for the original language/setting

Review of the tool with local mental health experts and discussions

  • Coordinate review of a revised version of the instrument with mental health clinicians
  • Documentation of suggestions and recommendations
  • Identify suitable pathway and process for referral of participants in case of emergency

Focus group discussions with adolescents

  • Coordinate focus group discussions with 4 target groups: boys aged 10-14 and 15-19, girls aged 10-14 and 15-19. Additional focus group discussions will include parents or other target groups of interest.
  • In coordination with HQ focal points, consolidate feedback received for incorporation of revisions into the tool, and maintain clear process documentation

Cognitive interview

  • Coordinate a cognitive interview with each of 12 adolescents (3 boys ages 10-14, 3 boys 15-19, 3 girls 10-14, 3 girls 15-19) to garner their understanding of the questionnaire items and to validate the response options
  • Document all responses and summarize findings
  • Draft report on the results of the cognitive interviews with adolescents

Pilot testing

  • Coordinate and facilitate activities related to pilot testing and validation activities including training of interviewers, listing of households for interviews, all related field activities.

Validation with diagnostic tool by trained counselor or mental health worker

  • Work closely with ministry of health and clinicians to coordinate sampling process of high- and low-risk individuals for validation of the tool
  • Coordinate with mental health nurses, counselors, or social workers, including scheduling interviews for validation of the tool
  • Maintain documentation process for results of validations, Consolidate results

Data management: data entry, data cleaning and statistical analyses

  • Identify with national counterpart the process for managing and storing data
  • Facilitate the data entry, data cleaning and statistical analysis

Communication and findings dissemination

  • Support for development of communication materials such as stories, videos, documentation etc.

Integration of MMAP module with Multiple Indicator Cluster Surveys (MICS) Plus

  • Work with Monitoring and Evaluation Specialist and coordinate HQ mental health team to integrate the MMAP module with MICS Plus
  • Facilitate data collection on adolescent mental health in the field of Belize

Adolescent Health Norms and Standards:

Capacity building of healthcare providers

  • Work with Ministry of Health to facilitate training and sensitization of healthcare providers on adolescent health norms and standards

Pilot of adolescent health norms and standards

  • Coordinate with Ministry of Health and facilitate activities related to pilot of the adolescent health norms and standards at health facility level
  • Document experience and summarize findings

M&E for adolescent health norms and standards

  • Prepare a M&E plan for using a WHO online tool for monitoring the effectiveness of routine adolescent health check-up
  • Coordinate with Ministry of Health and WHO to facilitate data collection at health facilities based on the M&E plan

Communication and findings dissemination

  • Support for development of communication materials such as stories, videos, documentation etc.

Helping Adolescent Thrive (HAT) Initiative:

  • Coordination for global consultation
  • Coordinate with UNICEF HQ and Ministry of Health for participation in a global consultation on guidelines of mental health promotion and preventive interventions for adolescents
  • Document experience and summarize findings
  • Focus Group Discussions with adolescents
  • Coordinate with Ministry of Health and Department of Youth Services to facilitate Focus Group Discussions with adolescents to identify priorities through promoting inter-personal skills, emotional regulation, problem solving and stress management• Document experience and summarize findings
  • Communication and findings dissemination
  • Support for development of communication materials such as stories, videos, documentation etc.

Capacity building of Community Health Workers in Corozal:

  • Work with Ministry of Health to facilitate training of Community Health Workers on pre-natal care, including sensitization of ANC, medical laboratory testing, pre-natal nutrition in Corozal district.

Knowledge management and documentation:

  • Respond to regional and HQ request on mapping exercise of progress of programmes related to adolescent health and mental health
  • Develop programme digest on adolescent health and mental health every three months
  • Work with UNICEF country team on peer reviewed publications related to adolescent health and mental health