* National Consultant - Development of the 4th edition and costed National Strategic Framework for the Elimination of Obstetric Fistula in Nigeria (2024-2030)

Background

Obstetric Fistula is one of the most devastating of all pregnancy-related disabilities which developed annually by some women in the act of trying to procreate and Nigeria accounts for 40% of fistula cases worldwide. The major cause of Obstetric Fistula results from prolonged obstructed labour due to the womanâs pelvis being too small, the babyâs head is too big, or the baby is badly positioned and has no access to a caesarean section. Usually, the baby dies and if the mother survives, she is left with extensive tissue damage to her birth canal which has life shattering results.

Obstetric Fistula is a preventable and treatable condition, one that no woman should have to endure. Thus, the need to put an end to Obstetric Fistula and address the circumstances that perpetuate it, which includes poverty, lack of access to health care, child marriage and early childbearing and this is a priority for the Federal Ministry of Health as part of her commitment to improve the reproductive maternal health indices in the country.

While the prevalence of Obstetric Fistula still remains high and unacceptable, the Nigerian Demographic Health Survey 2018 reported that the percentage of women with knowledge of fistula has remained stagnant at 31% over the last decade and this calls for a greater attention for sustained effective awareness creation to ensure the prevention of new cases and also to encourage women and girls with obstetric fistula to come out for treatment towards the elimination of this deadly scourge in the country. 

Justification

The National Strategic Framework for the Elimination of Obstetric Fistula in Nigeria is an important policy document which was designed to act as a roadmap to ensure a holistic approach to implementation of fistula interventions across a broad continuum of prevention, treatment, rehabilitation and reintegration that is expected to be reviewed on 5-yearly basis. 

Consequently, the third (3rd) edition of the costed National Strategic Framework (NSF) for the Elimination of Obstetric Fistula in Nigeria (2019 â 2023) with seven priority areas is due for a review as it has lasted for 5 years.

In addition, the National obstetric fistula technical working group, the coordination framework for facilitating dialogue and alignment of strategies and interventions, has not been able to meet since 2019. This is critical to the objective review of progress made, gaps and the challenges to ending obstetric fistula by 2030 in Nigeria.

Objectives

To review progress made during implementation of the costed NSF (2019-2023) and identify gaps and challenges To develop a draft costed NSF (2024-2030) with novel innovative strategies and interventions for ending fistula by 2030 in Nigeria. To reconvene the VVF Subcommittee of the National Technical Working Group to ensure the preeminence NSF (2024-2030) is consistent and effective for the elimination of obstetric fistula in Nigeria.

Methodology

Engagement of two (2) consultants to produce the zero draft of the updated and costed National Strategic Framework (2024-2030) and one (1)consultant to harmonize all comments and edits after validation. Conduct a VVF Subcommittee of the National Technical Working Group meeting to inaugurate the new executives and review the zero draft costed NSF 2024-2030. Conduct second review meeting of 20 technical experts & stakeholders to review the first draft costed NSF 2024-2030.  Conduct a virtual VVF Subcommittee of the National Technical Working Group meeting to finalize and validate the costed NSF 2024-2030.

Expected Outcome

Validated copy of the fourth costed National Strategic Framework for the Elimination of Obstetric Fistula in Nigeria (2024-2030) ready for Honourable Minister of Healthâs consideration and approval. VVF Subcommittee of the National Reproductive Health Technical Working Group functional and executives inaugurated 

How you can make a difference:

UNFPA is the lead UN agency for delivering a world where every pregnancy is wanted, every childbirth is safe and every young personâs potential is fulfilled. UNFPAâs strategic plan focuses on three transformative results: to end preventable maternal deaths; end unmet need for family planning; and end gender-based violence and other harmful practices. 

In a world where fundamental human rights are at risk, we need principled and ethical staff, who embody these international norms and standards, and who will defend them courageously and with full conviction. UNFPA is seeking candidates that transform, inspire, and deliver high impact and sustained results; we need staff who are transparent, exceptional in how they manage the resources entrusted to them and who commit to deliver excellence in programme results.

Purpose of consultancy

To provide leadership and technical expertise for development of the costed National Strategic Framework for the Elimination of Obstetric Fistula in Nigeria (NSF) 2024-2030. The updated NSF 2024-2030 must address development of strong partnerships and resource mobilisation initiatives and how to more effectively engage communities and the private sector towards realisation of the vision of ending obstetric fistula by 2023 in Nigeria.

Specific Objective: to (1) review the progress made during implementation of the costed NSF (2019-2023) and identify gaps and challenges; (2) conduct field missions to assess progress and challenges in the NSF implementation at national, state and community levels; (3) review and draw from other countryâs best practices for elimination of obstetric fistula; and to (4) develop a draft costed NSF (2024-2030) with novel innovative strategies and interventions for ending fistula in Nigeria by 2030. 

Scope of work: (Description of services, activities, or outputs

Under the overall guidance of the UNFPA Deputy Representative and direct supervision of the Gender/RH Specialist working closely with the MH/RH Technical Specialist, and the Director/Head of VVF Branch of the Federal Ministry of Health. 

The National Consultant,  working in collaboration with the Lead Consultant, is expected to carry out the following tasks:

Development of the updated and costed National Strategic Framework for the Elimination of Obstetric Fistula in Nigeria 2024-2030. Carry out a âGapâ analysis to identify gaps in the existing National Strategic Framework for the Elimination of Obstetric Fistula (2019-2023), the Theory of Change, including laws and policies, resource mobilisation strategy and sustainability, map out the issues and identify the priorities for the NSF 2024-2030. Undertake desk review and analyse necessary documents, training materials and protocols including relevant national/international policies and frameworks to fully understand the situation and identify opportunities for acceleration.  Conduct stakeholders SWOT analysis and bringing out the roles and responsibilities of key players and institutions in fistula programming in Nigeria. Develop draft NSF 2024-2030 plan consisting of priority programmes and strategies with clear deliverables that address the constraints, create the needed support systems and align actions with existing relevant sectorsâ strategies informed by best practices from countries with similar environment.  Develop draft NSF 2024-2030 plan and strategies with clear deliverables, including outcome mapping for monitoring and evaluation, indicators and tools that address the constraints, create the needed support systems and align actions with existing relevant sectorsâ strategies informed by best practices from countries with similar environment. The draft NSF 2024-2030 plan should include outcome mapping for monitoring and evaluation, indicators, baselines and targets, timelines and resource allocations, and a monitoring plan and communication plan. Co-facilitate consultation with the National Fistula Technical Working committee including wider consultations with relevant stakeholders to receive feedback on the draft strategic plan 2024-2030. Present the draft costed strategic plan 2024-2030 including the log frame and detailed implementation plan to stakeholders for validation and finalization. Undertake any other related task to ensure the successful completion of this consultancy

The expected outputs are: 

An Inception/Design report , which should include: (a) the approach and methodology; (b) the final stakeholder map; (c) the needs assessment report; (d) a detailed work plan and agenda for draft NSF 2024-2030 development; and (f) an outline of limitations. Draft NSF 2024-2030 plan,  with theory of change, clear deliverables, key milestones and direct guidance on implementation to accelerate elimination of obstetric fistula by 2030. Validated and Finalised NSF 2024-2030 plan,  ready for printing and dissemination.

A PowerPoint presentation of the NSF 2024-2030 , to be submitted to UNFPA and FMoH.

Duration and working schedule:

WEEKS 1 2 3 4 5 6 Need analysis phase Design & development phase Evaluation & validation phase Reflection and facilitation of use

Place where services are to be delivered:

The consultancy would be conducted in the FCT and virtually. There may be field visits to some states.

Delivery dates and how work will be delivered ( e.g., electronic, hard copy etc.):

Soft copy of the finalised NSF 2024-2030 plan and PowerPoint presentation would be delivered to the Gender/RH Specialist and the Director/Head of VVF Branch of the Federal Ministry of Health within six weeks of commencement of the consultancy..

Monitoring and progress control, including reporting requirements, periodicity format and deadline:

The consultant will be supervised by the Lead Consultant with oversight of the Gender/RH Specialist and Maternal & RH Technical Specialist.

Supervisory arrangements: 

The consultant will be supervised by the Lead Consultant with oversight of the Gender/RH Specialist and Maternal & RH Technical Specialist.

Expected travel:

Minimum Travel expected.

Required expertise, qualifications and competencies, including language requirements:

Post-graduate or equivalent qualification/degree in public health, SRHR or any other relevant discipline. At least 5 years of prior work including clinical experience in SRHR/MH/Obstetric Fistula at national, regional and/or international level. Strong technical knowledge and experience in SRHR including FP, EmONC, Obstetric Fistula, MPDSR and gender social norms programming. Demonstrated experience in conducting need assessments, gap and SWOT analysis, development of strategic documents and training manuals, curriculum on obstetric fistula, safe motherhood, etc. Demonstrated experiences and skills in facilitating stakeholder and working group consultations and workshops. Experience working with a multidisciplinary and multisectoral team of experts. Excellent communication (written and spoken), facilitation and knowledge-sharing skills Familiarity with UNFPA and FMoH mandates and operations would be an advantage.

Inputs/services to be provided by UNFPA or implementing partner (e.g support services, office space, equipment), if applicable::

UNFPA shall provide the following:

Engage a co-Consultant to support with development of the NSF 2024-2030 Logistic support for field missions to assess progress and challenges from implementation of existing NSF 2019-2023 and opportunities for the NSF 2024-2030. Remuneration for engagement of a costing analyst for the NSF 2024-2030. Support with printing, launch and dissemination at the national level.

FMoH shall provide the following:

Convene the VVF subcommittee of the National Reproductive Health Technical Working Group and co-facilitate two review meetings for the draft NSF 2024-2030. Convene and host the virtual meeting to validate the NSF 2024-2030.

EngenderHealth shall provide the following:

Financial support for hosting the VVF Subcommittee first review meeting in Lagos. Financial support for hosting the VVF Subcommittee second review meeting in Kano. Engage a consultant to harmonize all comments and edits after validation and produce clean copy for printing and dissemination.  Support with printing, launch and dissemination at the national level.

Other relevant information or special conditions, if any:

The Consultantâs fees shall be paid in line with the following schedule and upon acceptance of key deliverables:

Upon approval of the design/inception report: 20% Upon submission of the draft NSF 2024-2030 of satisfactory quality: 40% Upon submission of the validated NSF 2024-2030 and PowerPoint presentations: 40%.