Senior Gavi EAF Application & Urban Health Policy Dialogue Consultant (NOD)

A. Purpose  
The purpose of the consultancy is to review the draft Gavi EAF Application and revise this application along with activities and budget in consultation with EPI, MOHFW, and partners.This consultancy will also support in organizing a high-level event among MOHFW, MOLGRDC, and 12 City Corporation Mayors.This consultancy will significantly contribute to leveraging UN Agencies priority results through DGHS, MOHFW, MOLGRDC and City Mayors to ensure equity, identifying zero dose and partially immunized children and harmonize with other Gavi windows like CDS, HSS3, TCA, and NUVIs (HPV, TCV, JE) & OCV applications. In addition, this would contribute to a feasible and sustainable solution for urban immunization program.

B. Background

Despite overall progress toward the achievement of the EPI objectives, inequities persist. In particular, the program does not yet reach all children equally across different socioeconomic groups and geographical locations. According to the Coverage Evaluation Survey (CES), EPI performance varies significantly between districts. For example, the gap in coverage of the valid Fully Vaccinated Child (FVC) between the district with the highest (95.6% in Bhola) and the lowest (64.9% in Khagrachari)  coverage was 30.7%. In terms of FVC, the gap between the hard-to-reach (HTR) (81.4%) and non-HTR (84.6%) areas was more than 3%. The immunization coverage of urban areas (79%) of Bangladesh lags  by 5 percent compared to national coverage (84%). This is mainly due to the dichotomy of the health service delivery, i.e., MOH&FW, local government Institutes, and the lack of dedicated vaccinators in the big Cities. A critical challenge for the immunization program in Bangladesh is reaching the remaining pockets of unvaccinated and unreached children. UN Agencies is supporting MOH in developing a comprehensive social and behavior change communication (SBCC) strategy focusing on equity in accessibility and quality by ensuring reaching out to vulnerable, hard-to-reach, and excluded populations at the sub-national level. EPI, DGHS is planning to expand individual tracking for Immunization based on the OpenSRP platform with equity focus District Evidence-Based Planning and Budgeting (DEPB) in 16 low-performing districts and 8 city corporations under Gavi HSS3 and MACP support after successful pilot phase implementation of Immunization Tracker in Moulvibazar, and DSCC. UN Agencies has received the funds from the donor and is responsible for implementing these activities. This TOR has been developed to recruit Jamalpur and Netrokona District consultants to support EPI and DGHS. Amid high coverage at 84 % at national level (CES 2019), 16 % Bangladeshi children didn’t receive all recommended antigens as per national immunization schedule. In addition, there are huge in equities among rural ( 85% ) and Urban areas ( 79 % ) along with significant in equities prevailed among rura districts and big cities. Three districts having <75 % coverage ( Sherpur, Khagrachari and Bandarban) while eight ( 08) districts ( have more than 90 % a coverage. Similar inequities are evident among major cities – Rajshahi city corporations have FIC more than 90% while Chottogram and Sylhet CC coverage are under 70 %. As of 2022 ( DHIS2) Penta1 dose coverage is 99% and that of Penta3 is 93% nationally. Currently the prevalence of ZD children (ZDC) is 1% (33,451) using the WUENIC and 2022 birth cohort estimate. With a drop-out rate of 6% from DTP 1 to DTP3, there are estimate 200,742 under immunised (UI) children at in 2022. In this backdrop, and communication from Gavi to EPI, MOHFW for a new window support known Equity Accelerated Fund ( EAF) to identify ZDC and IUC, EPI, DGHS and partners have submitted the application package ( Situation Analysis,TOC, SN and budget) October 2023 , EPI/DGHS submitted EAF application to Gavi ( Theory of chance Strategic narratives ,rejected by Gavi with lot of feedbacks, and advised link with HSS3 and other Gavi windows as this will be the last window from Gavi for Bangladesh. The latest deadline is September 2024 to re-submit the application. However, after the submission , Gavi provided rounds of feedbacks to the application and budget.The urban population is expected to grow from its current level of 53 million people to 79.5 million in 2028, an expected increase of 50% in 14 years. However, urban immunization coverage lags behind rural coverage. The national immunization coverage is 84%, and rural coverage is 85%, whereas urban coverage is 79.2%. There are several key challenges or bottlenecks to low immunization coverage: 1.Absence of PHC/ immunization sites in certain areas or insufficient sites per population 2. Lack of appropriate HR (Number & trained/specifically assigned) 3. Demotivating factors among existing staff 4. Limitation of the private sector 5. Insufficient funding (for capital investment or recoveringoperational/recurrent costs) 6. Reliance on NGO/Private sector vaccinators 7. Suboptimal budget allocation for Urban Primary Health Care & Immunization 8. Slum dwellers and a working parent can’t vaccinate their children during the daytime. One of the major bottlenecks is the Lack of proper coordination between service-providing organizations (LGI, MOHFW, NGOs) and other stakeholders.  To mitigate these enormous challenges as a partner, UN Agencies must continue its advocacy for High-level coordination among Ministries and secretaries of MOHFW, MOLGRDC, and all City Mayors. Also needs to continue the advocacy to implement and follow the National Urban Immunization Strategy to achieve the overarching goal of NUIS to develop a sustainable system of provision of immunization services for children and child-bearing age women living in urban areas all over Bangladesh to bring up the immunization coverage with all antigens above 95% in 90% of the urban units by 2023 and beyond up to 2030 in line with the National Immunization Policy. Following are the recommendations according to the NUIS, which should be implemented to improve urban immunization coverage, achieving the UHC and IA2030 goals-

 Development of public health infrastructure, including PHC centers in urban areas (1 center per 50,000 populations or 1 center in one ward of a City Corporation) and immunization outreach posts 
 Development of a long-term organizational development plan to ensure the sustainability of urbanhealth functions and structures, including human resources plans and gradual Recruitment of Immunization HR as per IUS 2019 
 Implement Costed Action Plan of National Urban Immunization Strategy (IUS) 2019
 Scaling and sustaining the digital innovations
 Implement Costed Action Plan of National Urban Immunization Strategy (IUS) 2019

C. Objectives and Expected Results

The purpose of this consultancy is to provide expert support in the revision and finalization of the Gavi EAF application and budget. This will ensure that the application aligns with the goals of expanding and
equitably distributing immunization services in Bangladesh. The consultant will also play a critical role in facilitating high-level policy dialogue among key stakeholders, including MOHFW, MOLGRDC, and city mayors, to address urban immunization challenges and implement strategic initiatives. Additionally, the consultancy aims to support UN Agencies efforts in enhancing the effectiveness and reach of immunization programs by aligning with other Gavi funding windows and strategic priorities. 
Objectives:

a) Review and Revise Gavi EAF Application:
 Critically review the draft Gavi Equity Accelerator Fund (EAF) application and make necessary revisions in consultation with key stakeholders, including EPI, MOHFW, and partners.
 Revise the application budget to ensure alignment with the program goals and requirements. 
b) Support High-Level Coordination:
 Facilitate organizing a high-level event involving MOHFW, MOLGRDC, and the mayors of 12 City Corporations to enhance urban immunization efforts. 
c) Enhance UN Agencies Priority Results:
 Leverage UN Agencies strategic priorities through DGHS in EPI-HQ to ensure equity in immunization, focusing on identifying zero-dose and partially immunized children.
 Harmonize efforts with other Gavi initiatives, including CDS, HSS3, TCA, and new vaccine introductions (HPV, TCV, JE, OCV). 
Expected Results:

a) Revised and Enhanced Gavi EAF Application: 
 A thoroughly reviewed and revised Gavi EAF application, including a detailed and accurate budget, submitted to the relevant authorities for approval. 
b) Successful High-Level Coordination Event:
 A well-organized high-level event involving MOHFW, MOLGRDC, and 12 City Corporation mayors, resulting in strengthened coordination and commitment to urban immunization initiatives. 
c) Improved Immunization Equity:
 Increased identification and coverage of zero-dose and partially immunized children in urban and hard-to-reach areas.
 Enhanced alignment and integration of efforts with other Gavi initiatives and funding windows to ensure a comprehensive approach to immunization. 
d) Strategic Implementation of Urban Immunization Strategy:
 implementation of the National Urban Immunization Strategy, including developing public health infrastructure, recruiting immunization human resources, and scaling of digital innovations.
 Achievement of the target to bring immunization coverage with all antigens above 95% in 90% of urban units by 2023 and beyond, in line with the National Immunization Policy.

D.  Key Tasks and Responsibilities

The consultant, during the contracting period, will work with EPI, DGHS, MOLG, City Mayors, UN Agencies BCO ad FOs, and partners to:

1. Review and Revise Gavi EAF Application:
 Conduct a comprehensive review of the draft Gavi Equity Accelerator Fund (EAF) application.
 Collaborate with key stakeholders, including EPI, MOHFW, and partners, to gather feedback and make necessary revisions to the application.
 Ensure the revised application aligns with the program goals and requirements.
 Update and finalize the application budget in consultation with relevant stakeholders.
2. Facilitate High-Level Coordination:
 Organize and facilitate a high-level event involving MOHFW, MOLGRDC, and the mayors of 12 City Corporations.
 Prepare and disseminate relevant materials and presentations for the event. 
 Coordinate with stakeholders to ensure their participation and engagement in the event.
 Document key discussions, agreements, and action points from the event. 
3. Enhance UN Agencies Priority Results:
 Work closely with DGHS in EPI-HQ to identify and address equity issues in immunization, focusing on zero-dose and partially immunized children.
 Develop strategies to harmonize immunization efforts with other Gavi initiatives, including CDS, HSS3, TCA, and new vaccine introductions (HPV, TCV, JE, OCV).
 Provide technical  support  and  guidance  to  ensure  the  effective  implementation  of  these strategies. 
4. Support Implementation of Urban Immunization Strategy:
 Advocate  MOLGRDC  in  developing  public  health  infrastructure,  including PHC  centers  and immunization outreach posts in urban areas. 
 Advocate for  developing  a  long-term  organizational  development  plan  to   ensure  the sustainability of urban health functions and structures. 
 Advocate and Support the recruitment and training of immunization human resources per the National Urban Immunization Strategy (IUS) 2019. 
 Facilitate the scaling and sustaining digital innovations in immunization tracking and monitoring. 
5. Monitoring and Reporting:
 Establish a monitoring framework to track the progress of the revised Gavi EAF application andurban immunization initiatives.
 Regularly report on the status of consultancy activities and achievement.
 Provide detailed documentation and analysis of the outcomes of the high-level event and other key activities. 
6. Stakeholder Engagement:
 Maintain regular communication with all relevant stakeholders, including MOHFW, MOLGRDC, city mayors, and UN Agencies.
 Foster strong relationships and partnerships to support the successful implementation of the consultancy objectives.
 Address any issues or concerns raised by stakeholders in a timely and effective manner. 

These key tasks and responsibilities aim to ensure that the Senior Gavi EAF Application & Urban Policy Dialogue Consultant provides comprehensive support in improving immunization coverage and equity in Bangladesh, particularly in urban and hard-to-reach areas.

E. Deliverables

1. Reviewed and Revised Gavi EAF Application:
• A comprehensive, finalized Gavi EAF application incorporating feedback from EPI, MOHFW, and partners.
• An updated and detailed budget aligned with the program goals and requirements.
• Review, update and comply the IRC feedback for the EAF applicaiton 
2. Event Documentation:
• Agenda, presentations, and materials prepared for the high-level event involving MOHFW, MOLGRDC, and city mayors.
• Detailed minutes and a summary report of the high-level event, including key discussions,  agreements, and action points.
3. Strategic Reports and Plans:
• A  report outlining  strategies  for  identifying and addressing equity issues in immunization, particularly focusing on zero-dose and partially immunized children.
• A harmonization plan for aligning efforts with other Gavi initiatives (CDS, HSS3, TCA, HPV, TCV, JE, OCV).
4. Urban Immunization Strategy Implementation:
 Report on the long-term organizational development plan for city corporations' urban health functions and structures.
 Report on the recruitment and training plan for immunization human resources per the National Urban Immunization Strategy (IUS) 2019. 
• Report on the framework for scaling and sustaining digital immunization tracking and monitoring innovations. 
5. Monitoring and Reporting Framework:
• Developed a monitoring framework to track progress on the revised Gavi EAF application and urban immunization initiatives.
•   Regular progress reports detailing the status and achievements of the consultancy activities.
• A final consultancy report summarizing all activities, outcomes, and recommendations for future actions.

F. Payment

The consultant will get BDT 400,000 per month excluding DSA and travel.

G. Administrative issues:  

a) For payment by E-Zone on due time, the Supervisor will forward the certified attendance sheet and confirmation of receiving expected deliverables for the respective period.
b) The consultant will bear stationery and other office equipment.
c) The contractor/consultant will be responsible for paying all taxes as per government rules.
 
H. Qualification requirement of the company/institution/organization 

 A bachelor’s degree in medical science and a Master's / PhD in Public Health are required.
 A minimum of 20 years of professional work experience in EPI in both rural and urban health departments,
 Preference would be given to candidates with working experience in developing Gavi applications, equity focus EPI microplanning, strengthening immunization,
 Working experience and familiarity with the EPI program of the Ministry of Health and Family Welfare, Local Government Institutes, UN Agencies, and WHO, Gavi will be an asset
 International Immunization experience is desirable
 Knowledge of MS Office is an added advantage.

I. Language Requirements 
 
 Fluency in Bangla and good English communication skills are required. 

This position is open for Bangladeshi Nationals only. All candidates, irrespective of gender, religious and ethnic backgrounds can apply for the vacancies. 

The UN Agencey prides itself as fostering a multicultural and harmonious work environment, guaranteed by a zero-tolerance policy on sexual exploitation and abuse, and on any kind of harassment, including sexual harassment and discrimination. All selected consultants will undergo rigorous reference and background checks. 

Candidates with the required profile and proven experience, who meet these qualifications, are invited to submit their application in English clearly mentioning the Job Title along with a meaningful cover letter, updated CV, recent PP size photograph by uploading their application.

Last Date of Application: 15 September, 2024

No phone calls please. Only short-listed candidates will be contacted. All applications will be treated according to the merit and with strict confidentiality.