Position Description

Review of Task Shifting and Task Sharing Policy Consultant, Cardiovascular Health (6months)
Location Nigeria
Department Cardiovascular Health
# of openings 1
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Vital Strategies, headquartered in New York City, is an international public health organization. Our programs strengthen public health systems and address the world’s leading causes of illness, injury, and death. We currently work in 73 countries, supporting data-driven decision making, advancing evidence-based public health policies and programs, and mounting strategic communication campaigns. Our programs are concentrated in low- and middle-income countries and cities in Africa, Latin America, Asia, and the Pacific.
Resolve to Save Lives is a global health initiative that aims to save millions of lives by reducing preventable deaths from cardiovascular disease and preventing infectious disease epidemics. Resolve to Save Lives (RTSL) is housed within Vital Strategies. Since September 2017, Resolve to Save Lives has worked closely with low- and middle-income country governments, the World Health Organization, academic and other civil society partners to build capacity for and implement a core package of interventions to reduce cardiovascular disease. The Resolve to Save Lives Cardiovascular Health Initiative focuses on large-scale hypertension management, global elimination of trans fat, and effective interventions to reduce sodium consumption. Resolve’s cardiovascular health programming and surveillance is being supported in India, China, Thailand, the Philippines, Vietnam, Bangladesh, Ethiopia, Nigeria, Turkey, and the PAHO region in partnership with national governments and organizations. For more information about our cardiovascular health programming, visit: www.linkscommunity.org.
Resolve to Save Lives is seeking a qualified expert to undertake a review and expansion of the Task Shifting and Task Sharing policy to include management of NCDs. The aim is to identify specific tasks within the cascade of services for NCDs to be devolved to lower cadre health care workers. This would facilitate integration of NCD care and treatment into PHCs, promoting decentralization of care and improving access to high-quality basic NCD care and treatment services. The consultant would provide guidance to the NCD division of the FMOH. The work would be based in Abuja for a duration of 6 months (effort level of 10 days a month) starting in January 2021

BACKGROUND AND RATIONALE

The Task Shifting and Task Sharing Policy is one of the strategic policy documents of the Federal Government of Nigeria introduced in 2012 and launched in 2014, initially aimed at enabling the country to achieve the family planning 2020 contraceptive prevalence rate target of 27% and extended to Maternal and Child health, HIV and TB.

The WHO 2018 Non-Communicable Diseases (NCD) Nigeria country profile shows NCD prevalence to be 29%; Cardiovascular diseases at 11%, cancer 4% and diabetes 2%. A systematic review of the major NCDs and risk factors in Nigeria reported a prevalence of 27.6% for hypertensive heart diseases, while another recent study carried out in one state in each of the six geopolitical zones in the country reported a prevalence of 38.1%. Despite the rising prevalence of CVDs, diabetes and other NCDs, the majority of Primary Healthcare Centres (PHCs) in Nigeria do not manage NCDs.

To address the rising prevalence of NCDs, specifically hypertension in the country, the Resolve to Save Lives Initiative is supporting the Federal Ministry of Health through the World Health Organization to implement the National Hypertension Control Initiative (NHCI), which aims to strengthen the management and control of high blood pressure at the primary health care facilities. The NHCI initiative will be piloted in Kano and Ogun states and implemented through the FMOH in collaboration with the WHO, NPHCDA, the respective SMOH, SPHCDA/SPHMB and other key stakeholders.  

A key feature of the NHCI is the introduction of team-based care for hypertension management at the PHC level as it has been shown to improve patient follow-up support and adherence, blood pressure control and other patient outcomes, as well as patient and health care worker satisfaction. Team-Based care would involve the devolution and strategic redistribution of tasks and duties amongst the different cadres of health care workers at the PHC level.

NCDs are yet to be included into the task sharing policy despite its increasing prevalence in the country. It has become imperative to include NCDs into the task sharing policy to strengthen it, improve availability of NCDs healthcare services at the PHCs, as well as empower health care workers at the primary health care facilities to provide basic treatment and care for NCDs. Inclusion of NCDs into the task shifting and sharing policy would also accelerate progress towards Universal Health Coverage for all Nigerians, ensuring provision of comprehensive high-quality NCD services at the PHCs which serve as the initial point of contact with the health system for most Nigerians.

6 Months Consultancy 

Specific terms of reference
The consultant is expected to facilitate the process of the policy review and produce a final draft of the reviewed policy. The specific tasks of the consultant are as follows:

  • Undertake a desk review of task shifting global best practice and the current situation in Nigeria with emphasis on NCDs
  • Develop a policy brief and draft amendment outlining various tasks, roles, and responsibilities to be devolved to lower cadre health care workers for NCD management and care in Nigeria, with emphasis on hypertension treatment
  • Facilitate, support, and participate in all the stakeholder engagements for the process of establishing the amendments to the task shifting, task sharing policy in Nigeria
  • Record and evaluate the contributions and recommendations of the stakeholders during the process
  • Harness the views of stakeholders during the engagements to produce draft documents for review and validation as the case may be
  • Produce a final report of the process
  • Produce an accepted final draft of an amended national task sharing/ task shifting policy focusing on NCDs, particularly hypertension treatment

Deliverables

  • Develop policy case/brief containing proposed tasks to be devolved to lower cadre health care workers to be presented to stakeholders
  • Develop a draft of the expanded national task shifting and task sharing policy that includes management of NCDs, particularly hypertension treatment
  • Produce an acceptable final draft of the expanded national task shifting and task sharing policy that includes management of NCDs
  • Produce a final report detailing the entire process of the review of the task shifting and task sharing policy

Required Qualifications and Competencies:

  • 10+ years’ experience in the field of public health, health systems strengthening and/or management of clinical care services
  • Post-graduate degree in public health and/or clinical medicine or related subject such as clinical services management
  • Demonstrated experience developing health policies in Nigeria
  • Experience with clinical workflow concepts / analysis, care coordination, and/or healthcare process management
  • Knowledge of systems thinking
  • Exceptional written and oral presentation skills
  • Well-honed facilitation skills
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