JOB DESCRIPTION

Purpose of consultancy:

UNFPA  DRC seeks to recruit a national consultant to lead the undertaking of the strategic assessment on unintended pregnancies, contraception and abortion care services and sexual & gender based violence. The consultant is expected to carry out tasks mentioned below and will work closely with the MOH-SRH officials at both national and district levels, the UN team (UNFPA and WHO), and other partners in the planning, coordination, implementation, and monitoring of this assessment.

A strategic Assessment as the first stage of the WHO Strategic Approach is a country-led process that facilitates a national team to identify and prioritise needs and potential follow-up actions related to critical sexual and reproductive health issues, such as prevention of unintended pregnancy, meeting clients needs for contraception services; prevention and management of sexual and gender based violence; and strengthening programming on comprehensive abortion care within the confines of national laws.  It provides the foundation for planning, developing, and testing policy and service-delivery interventions (Stage II) and scaling up regional or national programmes (Stage III).

Furthermore, a strategic assessment generates information, understanding, and consensus about sexual and reproductive health needs as well as a national mandate for addressing them.

CONTEXT

At 427 deaths per 100,000 live births in 2023, maternal mortality ratio (MMR) in the Democratic Republic of Congo remains higher than the global Sustainable Development Goal target d of 70 deaths per 100,000 live births. Although efforts have been made since 2000 to reduce MMR, the average annual reduction rate estimated at 1,6% is very low. In 2022, the maternal and perinatal death surveillance and response (MPDSR) national report showed that the leading cause is obstetric hemorrhage (60,3%), and one out of three deaths was associated with multiple pregnancies, closed pregnancies, etc. The last harmonized health facility assessment (HHFA)  highlights the low availability of sexual and reproductive health and rights (SRHR) services, among them abortion care services(22%) and less available for adolescents (1% for services given without consent). In attempts to reverse the trends of maternal mortality, The President Felix Tshisekedi Tshilombo launched the free-of-charge maternity initiative to implement the universal health coverage strategic plan to prevent pregnant women from dying because of financial barriers. Actions have also been taken to make contraceptive methods available by budgeting at the national level, thanks to the involvement of the Socioeconomic Commission of the Parliament.

To improve access of adolescents to family planning methods, a decree has been promulgated to determine conditions of access by age. Apart from that, many strategies have been implemented to improve the quality of care and try to leave no one behind, such as the Emergency Obstetric and Neonatal Care (EmONC), integrated management of childhood illnesses (IMCI), MPDSR, the small dose high-frequency training approach. To address causes of maternal deaths in a holistic approach, the Ministry of Public Health, Hygiene and Social Security  devised and rolled out a number of intervention strategies, programs and initiatives such as the Comprehensive Post Abortion Care, Maternal Mortality Reduction Initiatives and introduction of Long Acting Reversible Contraceptives in the form of contraceptive implants- all of which focused on ensuring care to avert preventable maternal deaths. Despite all these efforts, the country continues to observe the abortion statistics remaining among the leading causes of maternal deaths in the Democratic Republic of Congo.

One of the areas on which consensus was reached at the landmark International Conference on Population and Development (ICPD) was the recognition of unsafe abortion as a major threat to the health and lives of women, hence the need for research to understand and better address the determinants and consequences of induced abortion, including its effects on subsequent fertility, reproductive and mental health, contraceptive practice and the treatment of complications of abortions and post abortion care.. It is within this context that WHO and UNFPA are supporting the MoH in undertaking a Strategic Assessment on unintended pregnancies, contraception and abortion care services and Sexual & Gender-Based Violence (SGBV) in DRC.

Expected contribution of the assessment

The findings of the assessment are expected to contribute to strengthening national policies, programmes and services as follows:

• Strengthen the delivery of contraceptives, comprehensive abortion care services, including post-abortion care and referral systems;
• Reduce unintended pregnancies, the recourse to abortion and maternal mortality;
• Provide information and services that respond to women’s needs; and
• Strengthen integration of SRHR services, including Family planning, HIV, GBV with other sexual and reproductive health services

Purpose and Objectives of the Strategic Assessment

The overall objective for the national strategic assessment on unintended pregnancy, contraception, SGBV and abortion is to document the unintended pregnancy, contraception and abortion status in the country and to understand the barriers and bottlenecks to the delivery of quality services at national and subnational level and use the information to inform programming.

The specific objectives of the assessment are as follows.

1. Assess existing policies, strategies, guidelines, programmes including services, and research related to unintended pregnancies, contraceptives and abortion and the extent to which HIV, SGBV services are integrated.
2. Build national consensus about strategies and interventions to reduce unintended pregnancies, improve access to modern contraceptives, reduce unsafe abortion and fully integrate comprehensive care for women within maternal, new-born and child health, HIV and SGBV programmes in the country.
3. Generate recommendations for improving access to, availability and quality of comprehensive care including: provision of contraceptive counselling and methods; safe termination of pregnancy within the context of the laws of the country and linkages to other needed sexual and reproductive health services, in particular HIV prevention, counselling and testing and treatment programmes and clinical and psychosocial support services for the survivors of gender based violence.

Specific tasks for the consultancy

The consultant will perform the following tasks.

• Serve as focal point for the assessment activities to liaise with WHO  and UNFPA and provide technical support to MoH and partners.
• Develop an inception report with timelines and budget to conduct the assessment.
• Work with UNFPA and WHO focal points to support the team leader of the MoH to identify and facilitate a core team of national stakeholders to undertake the strategic assessment.
• Support facilitation during the national stakeholder planning workshop working closely with the Background Paper consultant and the technical assistance team from UNFPA and WHO.
• Lead development of interviews and observation guides and relevant data collection tools to oversee field data collection.
• Provide technical support in the identification of data collection (field work) sites, coordinate the logistical efforts to support data collection, supervise data collection, recording, storage and analysis.
• Collate, analyse data, discuss findings and recommendations, and develop a draft comprehensive Strategic Assessment report.
• Develop a PowerPoint presentation and facilitate the validation of the draft Strategic Assessment report.
• Finalise and submit the final Strategic Assessment report.

Time frame

The assignment will require a total of 39 dedicated  working days over a period of 2.5 months disaggregated as follows: