Every year, about 6 million children die globally before they reach their fifth birthday, many during the first year of life (UNICEF, 2016). Half of these deaths are due to acute respiratory infections, diarrhoea, measles, malaria, malnutrition; or often to a combination of these conditions which are largely preventable and treatable conditions. The risk of a child dying before completing five years of age is highest in the WHO African Region (81 per 1000 live births), about 7 times higher than in the WHO European Region (11 per 1000 live births) according to statistics from WHO (2005). Various factors bordering on socioeconomic determinants of health have been proposed as possible underlying factors for these outcomes. Reducing these inequities across countries and saving more children’s lives by ending preventable child deaths are therefore important priorities.
As part of efforts to address these challenges, Save the Children with funding from GSK is currently building the capacity of frontline health workers in the delivery of MNCH interventions. The project aligns with the National Strategic Health development plan (2010–2016), the Integrated Management of Maternal, Newborn and Child Health Strategy (IMNCH) 2013, and IMCI and ICCM guidelines and implementation strategies.
The IMCI guidelines which was developed by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) promotes prompt identification of childhood illnesses in the outpatient settings and provides appropriate treatment and referrals when necessary. The guideline also helps to improve the quality of care of sick children at the referral level by providing an effective link between the care provided at the community and the management approach in the facility and promotes the rational use of resources. Currently, the number of health workers trained on the IMCI guideline in Gombe State is low. This situation coupled with the deficit in human resources for health in the state and the high cost associated with traditional IMCI trainings (6 days training) increasing the pool of health workers with the requisite skills in IMCI at facility level is challenging.
To address this challenge, Save the Children has developed an On-site training and mentoring approach which aims to increase the number of health workers with knowledge and skills to manage common childhood illnesses at the PHC level, that involves multiple visits to health workers’ at their respective facilities for the purpose of building/strengthening their individual capacities in IMCI.
To increase the number of health workers with knowledge and skills to manage common childhood illnesses at the PHC level using the IMCI guidelines.
To enhance the skills of frontline health workers from selected health facilities in Lagos state in tackling common childhood illness at the facility level.
To use an on the job approach for reinforcing learning and addressing skills gap of trained health workers for the purpose of building/strengthening their individual capacities on IMCI.
Purpose of the Assignment:
The purpose of this consultancy is to conduct a rapid spot assessment of the health workers in identified facilities that are underserved and hard to reach. Based on the findings of the assessment, Consultant would conduct an on the job training on IMCI for the health workers using the IMCI guidelines (IMCI chart booklet and exercise booklets)
Approach for the OJT activity
The consultancy period will be for 50 days spanning from 30th September 2017 to 30th March 2018
Initial assessment of health workers ability to properly manage a child with childhood illnesses – malaria, pneumonia, diarrhea. This will be by onsite observation of health workers in the child welfare clinics using a skills checklist.
After the clinic session, the consultant will review the skills checklist findings with the health workers and agree on the findings.
A training plan would be developed for the health facility workers, the plan would include dates of the training, names of health workers that would be trained and the training course curriculum for each day
The training plan would be shared with the MNCH Advisor before commencement of the facility visits
The consultants using the IMCI chart booklet trains the health workers on how to appropriately assess, classify and treat a child presenting in the facility with malaria, diarrhea and pneumonia. Also the health workers will be trained on how to counsel the caregivers on appropriate home management for the illnesses and when to return.
The consultant will pay six (6) visits to the same health facility to ensure that the health workers have been fully trained on the necessary skills required to properly manage a child presenting with Malaria, Pneumonia, Diarrhoea and be able to check for malnutrition and initiate treatment, give vaccines that are due or missed. Under the supervision of the Consultant, trainees would undergo clinical sessions in nearby secondary health facilities or comprehensive flagship health facilities.
Consultant then leaves behind a chart booklet for the use of the health workers
Consultant will also conduct a follow up visit to selected health workers based on their performances during the training. (within six weeks of training completion) to assess the knowledge and skills change amongst the health workers in that facility
During the follow up visit, the consultant will observe the health workers again using the skills checklist and feedback provided to the health workers.
During and after the OJT sessions in the health facilities, assessment would be carried out by MNCH Advisors using the training quality checklist.
After the training sessions in each facility, the consultants would also be assessed for quality by applying training evaluation forms on all trained health workers.
Consultants will keep the attendance of all health workers mentored or trained in the health facilities in a format that will be determined by Save the Children.
The consultants will keep an activity timesheet which will be shared with the MNCH Advisor every week.
Training reports are at the end of the satisfactory training will then be developed by the consultants and shared with SCI office.
The Consultant is expected to train 140 health workers on IMCI
All trained health workers have skills in tackling common childhood illnesses at community and facility level
Monthly report of activities from the consultant
A comprehensive report of the training activity upon completion.
Photos and Attendance list of all health workers reached with OJT, indicating the following - Names, Name of health facility, Cadre, Gender, phone number, email address, others.