TERMS OF REFERENCE FOR CONSULTANT
A) Background and Justification
Ghana’s maternal mortality ratio stand at 319/100000 lives births, and has consistently reduced over the past 16 years. However, Ghana did not meet the Millennium development goal (MDG5) of 185 by 2015. There are significant inequalities in access to maternal health services between urban and rural areas; 91% and 59% respectively (DHS, 2014).One of the key interventions to further lower maternal mortality is ensuring quality nursing and midwifery services are available, accessible and utilized throughout the country. Countless evidence attests to the fact that Nurses and midwives are the frontline workers not only in Ghana but globally. Nurses and midwives constitute more than 60% of the skilled health work force; as such lack of policies, guidelines and strategic directions at country level for this huge percentage of human resource for health can greatly compromise current and future delivery of quality health services.
In 2011, a 6-year strategic plan for midwifery and nursing was developed, which ended in December, 2016. In this regard, the Ministry of Health (MOH) reviewed the old strategy and conducted a nursing and midwifery needs and gap analysis to inform the development of the new plan. Findings from the strategy review pointed to a strategy that was largely unknown by stakeholders, unimplemented as planned and poorly coordinated. Although a number of monitoring and quality assurance tools were developed during the course of implementation of the strategy, they were largely not used. Fundamental issues relating to the workforce including restructuring of key positions in Nursing and Midwifery in the MOH, streamlining career pathways and opportunities for nurses and midwives and strengthening of the working relationships among the Quadriad of nursing and midwifery remained unresolved. Whilst the gap analysis was on-going, the MOH, Jhpiego and ICM collaborated to undertake a Midwifery Strengthening initiative using the Midwifery Services Framework (MSF) approach for developing Sexual, Reproductive, Maternal and Newborn and Adolescent Health (SRMNAH) Services by Midwives. Consequently, Ghana embraced the midwifery service framework model. Subsequently, a core working group (CWG) established by MoH and partners reached a consensus and agreed to apply the MSF model in the development of the nursing and midwifery strategic plans (2018-2022). To effectively implement this activity, the Ministry of Health needs to engage the services of a consultant to facilitate the process.
B) Goal: To produce a Nursing and Midwifery Strategic Plan and Services Framework built upon consensus from technical working groups and stakeholders that will contribute to the holistic strengthening of nursing and midwifery systems towards quality health improvements for Universal Health Coverage.
C) Specific objectives:
1. Provide guidance on how to set up and/or develop nursing and midwifery services that fit Ghana’s specific health system, health workforce, and population needs.
2. Operationalize the common understanding of the fundamental role that nursing and midwifery services play in improving the health of women, their families and the population in general.
3. Build on the current commitment to reducing maternal, newborn and child mortality and morbidity with a practical approach to making access to nurses and midwives and nursing/midwifery services available to all women and families.
4. Develop a five-year nursing and midwifery strategic plan for Ghana
D) Methodology
A consultant procured for the purpose will conduct literature review and facilitate stakeholder meetings including policy makers, health care professional organizations, associations, unions, educators and regulators, UN agencies, NGOs or CSOs that have and/or work with nurses and midwives to use the MSF to mainstream equity-based approaches through consensus building to expand the availability, accessibility, acceptability and quality (AAAQ) of midwifery services and the essential interventions for SRMNH.
The Scope of work for the consultant
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No: |
Activity |
Output |
Timeline |
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1 |
Review notes and reports from the 2017 MSF Ghana country needs assessment and 2016 MOH Nursing and Midwifery gap analysis to serve as basis for the nursing and midwifery strategic plan and must identify the issues, validate and prioritize them |
Issues, content and strategic plan design in place |
31st October 2017
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2 |
Conduct literature review of international, regional and national nursing and midwifery policies, frameworks, strategic plans and best nursing and midwifery practices to inform the design of the strategic plan |
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3 |
Develop a content outline for the Strategic Document for review and endorsement by the CWG |
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4 |
Conduct/facilitate the first Technical Working Group (TWG) meeting in collaboration with CWG |
Issues, content and strategic plan design approved |
15thNovember,2017 |
|
5 |
Facilitate the design and prioritization of strategic options to address the issues during the TWG meeting |
Priority strategic options set |
|
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6 |
Develop a First draft Strategic and operational plan using the MSF approach |
A First draft Strategic and Operational plan developed |
30thNovember,2017 |
|
7 |
Conduct/facilitate the second Technical Working Group (TWG) meeting in collaboration with CWG |
First draft Strategic plan presented to and discussed by the TWG |
13th December,2017 |
|
9 |
Conduct/facilitate a Stakeholders validation meeting |
Second draft strategic plan validated |
14th December, 2017 |
|
10 |
Submit the validated draft strategic plan to CWG for review |
Validated draft strategic plan reviewed |
18th December, 2017 |
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11 |
Present the validated draft strategic plan to the National Steering Committee |
Draft strategic plan approved by the NSC |
20th December, 2017 |
E) Key Deliverables
· An inception report with implementation design, tools and timelines
· Draft report of the nursing and midwifery strategic plan for Ghana.
· A national Nursing and Midwifery stratefic plan for Ghana
F) Duration
The duration of the planned activities to develop the nursing and midwifery strategic plan including time required for meetings, drafting and submission of the final strategic plan shall be 30 days spread as presented in the scope of work for the consultant.
G) Qualifications for the Consultant
· The Consultant should be a Nurse, or a Midwife or a Nurse/Midwife.
· Should have extensive experience in strategic planning and policy development with previous stakeholder engagement at national and regional levels.
· Should be conversant with nursing and midwifery related issues and the health delivery system in Ghana
· Registered with the Nursing and Midwifery Council of Ghana
· Preferably a holder of a Master’s degree in Nursing, Midwifery or a related field.
· A PhD degree in a related field will be an added advantage
· Knowledge of the International Confederation of Midwives (ICM) Midwifery service framework (MSF) tool is an added advantage.
H) Remuneration
The remuneration package for this consultancy will be payable to the consultant upon successful completion of the key deliverables according to terms and conditions of contract.
I) Reporting
The consultant will submit the work to the office of the Chief Director of the Ministry of Health through the Core Working Group (CWG). The chairperson of the CWG (MoH) will be the focal point for technical execution of the consultancy and also responsible for circulating all communication and clarifications made by the consultant to all stakeholders. UNFPA shall provide a focal point for the managerial execution of the consultancy to the consultant. The final approval of the report lies with the office of the Chief Director.
Closing Date: 13th October, 2017
