National Individual Consultant for Pediatric HIV Data Review, Kigali, Rwanda

• Organization: UNICEF - United Nations Children's Fund
• Country: Rwanda
• City: Kigali, Rwanda
• Office: UNICEF - United Nations Children's Fund in Kigali
• Follow @UNjobs

 

Closing date: Tuesday, 5 December 2017

Job no: 509212
Position type: Consultancy
Location: Rwanda
Division/Equivalent: Nairobi Regn'l(ESARO)
School/Unit: Rwanda
Department/Office: Kigali, Rwanda
Categories: HIV/AIDS, Consultancy

• Background and Purpose

In 2009, the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched a global call for elimination of mother-to-child transmission of HIV (eMTCT) that aimed at reducing new HIV infections to less than 5% by 2015 and keep mothers alive. Rwanda committed to achieving the targets and developed and implemented the strategies countrywide. Following the adaptation of option B+ [i] for PMTCT program in 2012, data collection tools were revised and longitudinal registers were designed to monitor HIV infected mother-infant pairs. Key indicators were integrated in the registers and are monitored at 6 weeks, 9 months and 18 months, the time when exposed infants are offered HIV testing. Data abstraction from these registers are being used to estimate the impact of ART in reducing vertical transmission of HIV. On annual basis, data from a three month retrospective cohort of HIV exposed children aged 18 month is analyzed to determine retention in care and health outcomes of the children: MTCT rate (new HIV infections in children), rate of loss to follow-up and deaths. Results of the analysis has consistently shown MTCT rates of below 2% at 18 months - lower than the global target. However, retention is low due to high loss to follow-up of children before they knew their HIV status.
Justification
Since 2013, the Rwanda Biomedical Centre/HIV Division collects data on key indicators to determine programme performance on annual basis. The data collection activities include all health facilities (HFs) providing PMTCT services. Results of the data analysis has revealed that the number of children born to HIV-infected mothers who are infected by 18 months substantial, however, it is not clear whether these children are enrolled in care or not. Similarly, the circumstances behind those who are lost to follow-up are unknown, neither their HIV status. This review will assess the factors associated with these findings, and we hope the results will inform strategies to strengthen retention of mother and children within the continuum of care, improve uptake of quality eMTCT services and provide more accurate estimates of MTCT rates.
Objectives
The purpose of this assignment is to support RBC to review the data to better determine HIV transmission among HIV-exposed infants in Rwanda.
Duration
The consultancy duration is 30 working days.
Specific objectives

• Determine Mother to Child Transmission Rate of HIV by 18 months after birth
• Assess the factors influencing HIV infection among HIV-exposed children by 18 months;
• Assess the determinants of lost to follow up among HIV-infected children
• Determine health-related outcomes among HIV exposed children (alive or dead and VL suppression) of HIV infected children

Methodology
In collaboration with RBC, the consultant will consolidate the database of all HIV infected children, HIV negative and HIV exposed infants known to have been lost to follow up.
All HIV positive children will participate in the review and will constitute the cases, while control group will be randomly selected among the HIV negative children. For every case, there will be two HIV negative control randomly selected from the same or the closest facility. All children lost to follow-up will be traced by social workers and referred for HIV testing, and linked to care and treatment as appropriate.
A workshop will be convened for the nurse and social workers from all health facilities to present the objectives of the data review, define their roles and discuss data collection methodology and strategies for retracing children who are lost to follow up and how to link them for testing and treatment services.
Administrative data on attendance to ANC, mode of delivery, maternal factors like viral load, etc. will be obtained from registers at the health facility. Health providers and social workers will conduct interviews with parents/guardians using a structured questionnaire. Individual data will be entered into a template using a unique identification number. Once the data is entered it will be analysed, the technical working group will be convened to discuss the preliminary findings and a workshop will be held for validation.

• Major Tasks, Sub-Deliverables, & Timeframe

Major Tasks
Deliverables
Timeframe (days)
1. Conduct a desk review on Mother to Child transmission of HIV in line with the data review Protocol
Inception report detailing the activities and time lines for the review
5
2. Develop an action plan for conducting the review including analysis
3. Design a tool for tracing the lost to follow up and reporting mechanism for the social workers
Final data collection tools and training report staff trained on data collection submitted
2
4. Conduct a pre-test in selected facilities to finalize tools and in collaboration with the districts, plan a workshop for training facility staff
2
5. Facilitate the workshop to train health providers and social workers on the questionnaires and reporting tools
5
6. Coordinate tracing of HIV exposed infant who are lost to follow up and link them to HIV Program for HIV testing and treatment
Report on children traced and linked to treatment
8
7. Supervise date collection and cleaning: data extraction from records and interviews
Data collection report and final database available
8. Conduct data analysis and submit preliminary findings to the review
Draft report on preliminary findings
4
9. Report writing
Draft of data review report available
2
10. Convene a Technical working group for validation.
Power Point presentation of results, conclusion and recommendation.
Final detailed Report
2
Main Deliverables:

• Report on data collection and final database cleaned
• Draft report on preliminary findings for validation by TWG and stakeholders
• Final report on the results, conclusion and recommendation.

Stakeholder Participation
RBC, UNICEF, Muhima Hospital, participating health facilities and Prevention Technical Working Group
Qualification and Requirements

• Advanced degree in public health, medical sciences, statistics, sociology/other social sciences or related technical field.
• Five years or more of experience working on national surveys, disease surveillance and in HIV and AIDS related research studies/evaluations/
• Familiar with national data on HIV and tools and indicators used for routine monitoring of the programme on prevention of mother to child transmission of HIV.
• Demonstrated skills in analyzing data and developing data driven evidence strategies and action plans for HIV
• Demonstrated experience in the areas of HIV with social and behavior change communication and/or monitoring and evaluation expertise an advantage
• Excellent analytical and report writing skills as well as good negotiation and communication skills
• Excellent command of spoken and written English
• Strong presentation and facilitation skills including with multiple stakeholders.
• Computer skills: Experience in Microsoft Word, Excel and PowerPoint

Supervision
The consultant will be supervised by UNICEF HIV and AIDS Manager. He/she will be expected to work in close collaboration with the programme manager at RBC who will facilitate the logistics required at district and facility level.
[i] Initiation of ART for life to all HIV infected pregnant mothers regardless of the level of CD4 count, and ART prophylaxis for the baby for 6 weeks from the date of birth
Advertised: Nov 29 2017 South Africa Standard Time
Application close: Dec 05 2017 South Africa Standard Time

Read more