Consultant / Firm to Develop Strategies that Address Zerodose and Under-Immunized Children for Routine Immunization Services at John Snow Incorporated (JSI)

John Snow Incorporated (JSI) - We are public health care and health systems consultants and researchers driven by a passion to improve health services and health outcomes for all.

Applications are invited for:

Job Title: Consultant / Firm to Develop Strategies that Address Zerodose and Under-Immunized Children for Routine Immunization Services

Locations: Nigeria

Introduction

• Immunization is one of the most successful and cost-effective public health initiatives that prevent deaths every year. Although the routine immunization coverage rates in Nigeria have progressed 33% in 2017 to 57% in 2021, coverage rates still fall below the Global Vaccine Action Plan (GVAP) target of at least 90% coverage for the proxy antigen (Penta 3). A recent WHO report revealed an estimated 6.2 million children missed out on receiving first dose of the DTP-containing vaccine from 2019 to 2022.
• This was further exacerbated by the COVID-19 pandemic which disrupted immunization services and availability by hindering RI supply chain and elevating economic hardships to access services. Surveys have revealed high zero-dose children living in missed communities located in rural, urban slums and conflict-affected areas.
• To expedite progress, the National Emergency Routine Immunization Coordination Centre was established in 2017, focusing on implementing strategic interventions towards improving immunization coverage. Furthermore, Nigeria launched the Strategy for Immunization and Primary Healthcare System Strengthening in 2018 which aims to establish a transition plan from Gavi financing by 2028 further strengthening the system. 

Project Background

• Nigeria and 10 other countries accounted for 11 million of the zero-dose population in 2021. Out of the 100 priority LGAs recommended with the highest zero children, Alimosho Local Government Area (LGA) in Lagos State, had the highest number with over 35,000 zero-dose children.
• To reach these zero-dose eligible children, the government of Nigeria through the National Primary Healthcare Development Agency (NPHCDA), in collaboration with the World Health Organization (WHO) and its partners, including Gavi, the Vaccine Alliance is intensifying various strategies to optimize “Big Catch-up campaign” to improve vaccination coverage across the country. These strategies include a recovery plan which involves the implementation of periodic intensification of routine immunization (PIRI) activities to provide every eligible individual with an opportunity to receive routine immunization.
• USAID Nigeria, through the M-RITE project, aims to strengthen the RI program and address barriers to reaching zero-dose and under-immunized children with vaccines and other health services. In this project, M-RITE Nigeria will be supporting the GON with context-specific strategies that identify, reach, monitor, measure and advocate for zero-dose and under-immunized children in six prioritized zero-dose LGAs in Jigawa and two in Lagos. It is also a deliberate and coordinated approach that would ultimately lead to health systems strengthening, targeting both public and private facilities with capacity.

Goal

• The overall project goal is to increase immunization coverage within selected LGAs in Jigawa and Lagos by ensuring all children/caregivers have access to routine immunization services regardless of their locations or security status

Objectives

• The Consultant/firm will be responsible for planning, implementing, and monitoring strategies to ensure that children can access routine immunization services within their settlements.

The specific objectives include:

• Identify and map all settlements based on their populations within select LGAs in Jigawa and Lagos states
• Develop tailored strategies to address zero dose and under-immunized children in these LGAs
• Collaborate with stakeholders to develop strategies to enhance access to immunization services in zero dose settlements especially those with limited proximity to healthcare facilities
• Map all immunization partners and define their roles and responsibilities across the levels of the health system; identify potential areas of synergy

Scope of Work

• Conduct a comprehensive analysis of the current immunization status in select LGAs in Lagos and Jigawa states, identifying areas with the high concentrations of zero dose and underserved children
• Assess existing barriers to immunization including cultural, logistical and awareness-related challenges
• Develop a Theory of Change with recommended key performance indicators (KPIs) to track progress towards reaching the identified zero dose and under-immunized children
• Develop a tailored strategy to increase immunization coverage with a focus on reaching zero dose and underserved population
• Collaborate with local stakeholders, including community leaders, health workers and NGOs to ensure the cultural sensitivity and effectiveness of strategies
• Empower community health workers to actively engage with communities, dispel myths and promote the importance of vaccination
• Establish a robust monitoring, evaluation and learning system to track the progress of immunization initiatives
• Regularly assess the impact of strategies and make necessary adjustments based on real time data
• Map key decision makers and influencers to advance prioritization of zero dose children in the selected LGAs.

Project Deliverables

• Deduce the Theory of Change with recommended key performance indicators (KPIs) to track progress toward reaching the identified zero dose and under-immunized children.
• Report of the estimated number of zero dose and under-immunized children by antigen per State/LGA/Ward/Settlement/Catchment Health facility.
• High-quality hard and soft copies of QGIS enabled map with the distribution of zero-dose children.
• Report on the health systems and gender-related barriers to immunization and sustainable context-specific strategies that address these barriers.
• Geo-enabled master facility list for public and private health facilities in the focused LGAs.
• Interactive dashboard(s) with key performance indicators developed.
• A proposed plan for a community-centered monitoring system and how to integrate community-centered insights from users, beneficiaries, and CSOs.
• Propose key recommendations on enhancing programmatic efficiencies and financial accountabilities among immunization partners and other key influencers
• An outline of Zero dose monitoring and learning plan that addresses key zero dose learning questions developed and a proposal to track the implementation of course correction measures
• A comprehensive catalog of cost-effective approaches in evaluating the strategic outcomes in the TOC.
• A plan of action for the use of geostatistical modeling with socio-economic indicators at the focus LGAs.
• List of key decision makers and influencers of zero-dose prioritization in the focus LGAs.
• An outline for behavioral transformative strategies that engage communities improve RI services.
• Proposed advocacy and engagement strategy to engage sub-national and community leaders in the focus LGAs

Project Workplace:

• The primary focus area will be six LGAs in Jigawa and two LGAs in Lagos state. However, coordination and collaboration may extend to neighboring areas as needed.

Expected Duration of Assignment:

• The assignment is expected to be completed within six months.

Payment Terms and Conditions

• Payment will be structured based on the achievement of predefined milestones. An advance will be provided upon project commencement, followed by subsequent payments tied to the successful completion of key deliverables.

Application Closing Date
30th November, 2023.

How to Apply
Interested and qualified candidates should submit their proposals, including a detailed work and budget to the Technical Manager to: [email protected] using "Consultant / Firm to Develop Strategies that Address Zerodose and Under Immunized Children for Routine Immunization Services" as the subject of the mail.

Note: Applications will be reviewed on a rolling basis.