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Background

Important gains have been made in the HIV and AIDS response for women and children globally resulting in a significant reduction of paediatric HIV infections. According to the Rwanda HIV Estimates 2023, there are approximately 230,000 people living with HIV in the country including 7,100 children below the age of 15 years. Rwanda has made significant gains in the elimination of vertical transmission of HIV, achieving reduced transmission rates through widespread prenatal screening, high coverage of antiretroviral therapy among pregnant and breastfeeding women, and integration of HIV services within maternal and child health care.

According to UNAIDS 2023 estimates, the vertical transmission rate is estimated at 6 per cent, with the biggest contribution from mothers who sero-converted during pregnancy and breastfeeding periods. On the other hand, the national program data estimates a national health facility based vertical transmission rate of between 1.5% and 1.7% over the last 5 years (1.5% in 2023). The discrepancy may be mainly due lack of data regarding mothers who drop off the program and those who get infected during pregnancy or breastfeeding period respectively, affecting the quality of estimates. Different surveys and data triangulations are ongoing to investigate the possible source of the discrepancy between both sources.

The Last Mile to EVT provides a roadmap for programmes seeking to systematically evaluate and optimize maternal and child health services at national and subnational levels. The four-step approach is not intended to be prescriptive; rather, the Last Mile to EVT provides a framework that can be used to structure and facilitate discussions that will help programmes identify gaps at national and subnational levels and prioritize evidence-based policies and interventions to address these gaps. The Last Mile to EVT framework is a data-driven cyclical process that is highly local in practice and allows national programmes to address local priority areas and achieve EVT in an efficient and directed manner.

Rwanda is dedicated to ensuring a future HIV-free generation as demonstrated through governments commitments, leadership and support, implementation of innovative strategies and enhanced partnerships with key stakeholders, including communities, development partners, the UN and civil society organizations. Furthermore, the Rwanda Biomedical Center is committed to offering evidence-based, high-quality healthcare and is working towards UNAIDS goal to eliminate HIV by 2030. As highlighted in the revised National HIV Strategic Plan 2024-2027, Rwanda has prioritized the triple elimination of vertical transmission of HIV, Syphilis, and Hepatitis B and is promoting the development of a cohesive strategy to improve mother and child outcomes, with a focus on last mile operationalization. The process emphasizes the importance of data driven decisions to inform and enhance health care strategies and initiatives.

RBC has further demonstrated its commitment towards elimination of vertical transmission through development of a domesticated Last Mile Framework. This process will be preceded by a data deep dive session to better understand the HIV situation in the country, including vertical transmission rates. Technical support will be availed from UNICEF for last mile operational planning through recruitment of a national consultant to support country process and for the data deep dive, through a support from UNICEF HQ.

In view of the above, these ToR are for the recruitment of a national consultant to facilitate the development and implementation of Rwanda’s Last Mile to EVT programming guide at national level. This will enable the adoption of evidence-based step by step approaches towards the achievement of EVT. It is expected that the consultant will work closely with MoH/RBC at national level, including TWG.

This will be accomplished through developing contextualized resource/orientation materials and programming tools on the use of the EVT Last Mile framework in collaboration with a team from the University of North Carolina (UNC). In addition, the consultant will provide technical assistance through regular workshops to support Rwanda’s MoH/RBC to plan and implement strategies that address critical gaps identified using context specific national and sub-national data sources. The consultant will also be responsible for documenting and disseminating the approaches for further implementation of cross-country experience sharing.

Purpose of Activity/Assignment:

The purpose of this consultancy is to provide technical assistance to the RBC HIV Division, with last mile operational planning and implementation for the elimination of vertical transmission of HIV. This will be achieved through the recruitment of a national consultant to facilitate country led processes in the development of Rwanda’s Last Mile Programming Guide at national level using evidence-based step by step approaches towards the achievement of EVT. The consultant will work in close collaboration with RBC at national level, the TWG, the UN (UNICEF, WHO, UNAIDS and UNFPA), PEPFAR and its implementing partners and other key stakeholders. The specific objectives of this assignment are to:

1. Develop contextualized resource/orientation materials and programming tools on the use of the EVT Last Mile framework in collaboration with a team from the University of North Carolina (UNC).
2. Provide technical assistance through regular workshops to support Rwanda’s MoH/RBC to plan and implement strategies that address critical gaps identified using context specific national and sub-national data sources.
3. Document and disseminate the approaches for further implementation of cross-country experience sharing.

Work Assignment Overview

Tasks/Milestone:

• Briefing from UNICEF and RBC on scope of the work and vision of expected results, undertake training and orientation, and development of inception report.
• Through a consultative process, develop a contextualized orientation package and operational tools including specific steps on the approach to programming for the Last Mile of EVT to guide Rwanda in selecting and implementing strategic interventions that address evidence informed gaps.
• With support of the Health & HIV Specialist at UNICEF Rwanda Country Office and RBC PMTCT focal person, convene and facilitate task team meetings through TWG and other existing government structures. The consultant will convene:
• Four sessions at national (and sub-national level as applicable) to build consensus on the priority interventions to be implemented based on the steps proposed in the Last Mile documents and informed by the epidemiology, data deep dive findings and recommendations, the spectrum stack analysis, national and sub-national surveys, program data and relevant studies.
• Document lessons learned in the programming approach as a resource for cross-country learning.

Deliverables/Outputs:

Payment 1: 15%

1. Inception report

Payment 2: 40%

2. A contextualized orientation package, slide decks and operational tools including specific steps on the approach to programming for the Last Mile of eMTCT in Rwanda.

Payment 3: 45%

3. Finalized national (and sub-national) reports highlighting EVT gaps and consensus on key prioritized interventions.
4. A finalized case study for Rwanda highlighting lessons learned in the programming approach.

Duration and Location

The consultancy will be for 5 months from June to November 2024 and the consultant will be based in RBC.

Selection Criteria

Applications shall be assessed based on their technical and financial proposals. Maximum scores for technical and financial applications will be 75% and 25%, respectively.

Successful candidates in technical evaluation will be requested to send their most competitive, all-inclusive financial proposals.

To qualify as an advocate for every child you will have…

• An advanced university degree (Master’s or higher) in public health, HIV pediatric health, family health, health research, global/international health, health policy and/or management, epidemiology, or other health-related sciences.
• At least 8 years professional experience in HIV and AIDS programming and/or research at national and sub-national levels
• Strong facilitation skills and proven ability to interpret new technical knowledge on HIV and AIDS considering the current knowledge on children and AIDS and trends in the field.
• Prior experience in developing tools and guidance for HIV programmes.
• Prior experience with the United Nations, or a multi-lateral or international health and development agency.
• Proven ability to communicate technical knowledge on AIDS in terms that are accessible to programme professionals, including non-specialists.
• Ability to work independently and in consultation with the UNICEF team.
• Ability to use good judgement incorporating feedback from various team members and partners.
• Punctual turnaround of work and ability to multi-task.
• Previous experience working with UNICEF and other UN agencies an asset.
• Cultural and gender sensitivity.
• Fluency in English is a must, and knowledge of French and Kinyarwanda an advantage.

For every Child, you demonstrate…

UNICEF’s values of Care, Respect, Integrity, Trust, Accountability, and Sustainability (CRITAS).

To view our competency framework, please visit  here.

UNICEF is here to serve the world’s most disadvantaged children and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, age, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, or any other personal characteristic.

UNICEF offers reasonable accommodation for consultants/individual contractors with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment.

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.

Remarks: 

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.

Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures, and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws.

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts.