United Nations International Children's Emergency Fund (UNICEF) works in some of the world’s toughest places, to reach the world’s most disadvantaged children. To save their lives. To defend their rights. To help them fulfill their potential. Across 190 countries and territories, we work for every child, everywhere, every day, to build a better world for everyone.
We are recruiting to fill the position below:
Job Title: Individual Consultant - Review and Documentation of Lessons-Learned arising from GAVI Support to HHS in 8 Selected States in Nigeria
GAVI's Health Systems and Immunization Strengthening (HSIS) support is a key instrument for achieving GAVI's strategic goal of increasing the effectiveness and efficiency of immunization delivery as an integrated part of strengthened health systems.
The current project (2022-2025) in Nigeria represents a significant investment in health system strengthening across eight selected states, focusing on multiple intervention areas including governance, service delivery, community engagement, and health information management.
The project aligns with GAVI's broader approach to HSS support, which aims to demonstrate results in three key areas: increasing immunization coverage and equity, strengthening health systems to deliver integrated primary health care, and improving the sustainability of national immunization programs.
Context of Immunization and HSS in Nigeria
Nigeria has the highest number of unimmunized children in the world, estimated at 4.3 million children in 2018. In recent years, the coverage of DPT3/Penta 3, a key indicator of a country’s performance of Routine Immunisation, has fallen from 52 per cent in 2014 to 33 per cent in 2016.
Fluctuations have also been observed in the coverage of other antigens given in the country.
Evidence form 2016 MICS/NICS surveys indicated that wide variations exist in RI performance across the Country’s zones with the South East and South West zones showing high RI performance, while the North East and North West show low performance.
The disparity is driven by several factors which include socio-economic status, and personal beliefs of the care givers.
The decline in DPT3/Penta 3 in Nigeria from 52% in 2016 to 33% in 2018 has left more than 3.2 million children under the age of 12 months under immunized in 2018, adding to the already existing huge pool of susceptible under-fives which has led to outbreaks of vaccine-preventable disease across the country. Implementable and sustainable strategies to vaccinate very eligible child are critical if we are to save the lives of every Nigerian child.
Bottlenecks to the low immunisation coverage include poor community sensitization on available routine services with prioritization of immunization campaigns rather than on health system strengthening and provision of commodities for routine services; frequent and prolonged public sector health worker strikes in some states; prolonged periods of non-payment of salaries; inadequate funding and fund disbursement delays; insecurity in the north-eastern states affecting the most marginalized communities; inadequate integration of routine immunization services with broader PHC services; poor community linkage, trust and community engagement, which slows the Reach Every Ward immunization approach; weak demand at community level due to low awareness of benefits of immunization; poor quality of immunization data at LGA and health facility levels; and poor maintenance of cold chain equipment.
The Government of Nigeria, in partnership with GAVI, implemented a Health System Strengthening (HSS) project to improve immunization and primary healthcare (PHC) services in 8 states: Bayelsa, Katsina, Jigawa, Kebbi, Zamfara, Niger, Gombe and Taraba. Six results areas are attached to the project:
Leadership, governance, and coordination of integrated RI and PHC services
Service delivery with a focus on PHC and community including outreach to hard-to-reach settlements / Zero Dose communities
Demand generation and community engagement to drive utilisation of integrated RI and PHC services
Data management and surveillance – data collection, analysis,and use for programming
HRH – actions taken to build capacities of critical HRH, recruitment of HRH
Supply chain including procurements done through the grant, excluding support under CCOP.
Review and Documentation of Lessons-Learned arising from GAVI Support to HHS in 8 Selected States in Nigeria
Establishment of a dedicated and seasoned roving team for financial assurance at UNICEF that will enforce supportive supervision with the IPs for on-site/remote reviews, training, and capacity development. Terms of reference for the team will be developed and communicated to Gavi.
Embedding a dedicated consultant within each IP acting as the first line of reference on financial management. The consultant will also conduct frequent verifications and local round-table capacity development sessions at the State, LGAs, and Ward levels.
Enhanced financial management training and assurance reviews both on-site and remotely.
Roll-out of a cloud-based accounting system that will enhance accountability and records management. Currently, partners use manual hardcopy cashbooks to register transactions.
Purchase of equipment to allow electronic transaction recording and processing (laptops, scanners, cabinets for each of the eight Implementing Partners.
Purpose of the Review and LLE
The main purpose of this assignment is mostly on learning and less on accountability.
While some aspects of the review look at the merit and comparative advantages of strategic interventions in the GAVI’s HSS at the sub-national level in Nigeria, the findings from this assignment are expected to inform the Government of Nigeria (Federal and States), the GAVI Board and UNICEF about current and future investments in HSS, refine strategies and capitalize on lessons learned.
It will also serve two major uses: (a) objective assessment of achievements, implementation context, and risks; and (b) inform future stakeholders' engagement.
Therefore, the overall purpose of this review and lessons learned harvesting exercise is to facilitate the understanding of what worked/didn’t work, why it worked/didn’t work, and how interventions adapted to local contexts including innovations at the local level.
Objectives
The main objective is to conduct an in-depth review of the GAVI HSS project implementation in Nigeria, assessing its contribution to health systems strengthening and immunization program improvement. In other terms, this review will examine how the project has influenced health system effectiveness, immunization coverage and equity, and program sustainability while generating evidence-based insights for future design, and implementation of HSS/HSIS interventions.
Specific objectives of this review and documentation of lessons learned are to:
Conduct an in-depth program review to evaluate the program’s relevance, coherence, effectiveness, efficiency, and sustainability.
Review Program Implementation, context, and stakeholder’s roles and engagement.
Assess progress, and achievements, and identify systemic barriers, enabling factors, and unintended consequences for each result area.
Document and analyze lessons learned using structured reflective frameworks guided by Double-Loop Learning (DLL) to reflect on systemic assumptions and explore deeper insights on each result area.
Provide actionable recommendations for future programming and strategic decision-making in line with GAVI’s 5.0 strategy for 2021-2025.
This review will employ Implementation Research (IR) approaches and Schön's Double-Loop Learning (DLL) framework to understand both operational effectiveness and systemic changes achieved across eight states.
Scope of Work
The thematic, geographic, and chronological scope of this evaluation are described below, in line with the GAVI’s support to the implementation of the Nigeria Government Health System Strengthening Program.
The geographic scope of the assignment is limited to the states of Bayelsa, Gombe, Niger, Katsina Jigawa, Zamfara, Kebbi, and Taraba.
The period covered is from March 2022 to January 2025. However, experiences, insights and reflections from the senior Government Staff at the federal level will be sought to enrich the review.
The following thematic areas will be assessed thoroughly in different steps of the assignment:
Leadership and governance capacity with institutionalized accountability.
Immunization coverage and equity, and PHC service delivery.
Demand creation for immunization, and institutionalizing community engagement strategies.
Health Information Management Systems (HIMS).
Capacity Building, and adequate deployment of human resources in PHC.
Financial risk management, and accountability mechanisms at the federal and state levels under the PHC Strengthening Fund.
Healthcare Financing
Supply chain (availability of vaccines and essential commodities and services).
Monitoring health outcomes.
To qualify as an advocate for every child you will have…
Minimum 10 years' experience in health systems strengthening
Proven expertise in successful health program evaluations in the context of Nigeria
Proven expertise in implementation research
Strong understanding of double loop learning and reflective practice
Experience with GAVI HSS projects
Excellent analytical and writing skills
Experience in Nigeria's health system
Knowledge of immunization programming
Expertise in participatory evaluation methods
High level of professionalism and an ability to work independently and in high-pressure situations under tight deadlines.
Excellent written and spoken English skills required.
Experience in participatory approach is a must as well as facilitation skills and ability to manage diversity of views in different cultural contexts.
Ability to produce well-written reports demonstrating analytical ability and communication skills (consultant may be asked to provide sample work)
Developing country work experience and/or familiarity with emergency is considered an asset.
Fluency in English is required. Knowledge of another official UN language (Arabic, Chinese, French, Russian or Spanish) or a local language is an asset.
Application Closing Date
10th February, 2025 (W. Central Africa Standard Time).