Somalia: Development of Community based health care Strategy for Somalia

Title: Development of Community based health care Strategy for Somalia Contract type: Agreement for Performance of Work Duration: 4 months Duty Station: Somalia (Garowe, Hargeisa & Mogadishu) Organization: Primary Health Care (PHC)

Background: The Government of Somalia desires to have the highest possible level of health and quality of life for all its citizens, attained through the combined efforts of individuals, communities, organizations, civil society and the government, which will allow them to participate fully in the socioeconomic development of the country.

According to the World Health Report 2008, People- centered care focus and organize around the health needs and expectations of people and communities rather than on diseases. People- centered care extends the concept of patient centered care to individuals, families, communities, and society. Whereas patient- centered care is commonly understood as focusing on the individual seeking care - the patient – people- centered care encompasses these clinical encounters and also includes attention to the health of people in their communities and their crucial role in shaping health policy and health services .

This vision will be attained through guaranteeing every citizen access to comprehensive, quality, affordable and effective health care services. Extending from this vision, the mission of the Ministry of Health is to provide, administer, coordinate, promote and advocate for the provision of equitable, appropriate, accessible, affordable and acceptable quality health care services to its people while maximizing the use of available resources, in line with the Basic Package of Primary Health Care services. As part of its mandate to give strategic direction in health sector development, the MoH has developed Health System Strategy plans whose major thrust was to improve the quality of life of Somalis and set the agenda for launching the health sector into the new millennium. Recognizing that improvement in the health status of the population would not depend on health sectorial actions alone. This concept note address community engagement in needs assessment, priority setting, local and community based planning, implementation of activities that can result in improving access and utilization of the people of Somalia to PHC services. Community engagement as part of the follow- up processes of defaulters, delivery of simple health care services by the trained members of the community, community empowerment in local health related decision making processes and build linkages between community based health related actions with other levels of the health care system are issues that should be considered in achieving people-centered health services. In order to come out with this strategy a consultant will be hired for four months to assess ongoing activities, opportunities and challenges related to community engagement in health care delivery and propose a national strategy for moving towards people-centered health services in consultation with Government, civil society, UN agencies and key stakeholders.
Objectives of the consultancy: The purpose of this consultancy is to develop a people centered community based health services strategy for Somalia. People centered health strategy is to provide guidance and direction on how community development approaches are to be taken forward within the health care system. The strategy defines what to expect at every health and social care and incorporate in community development approach into programs. Currently Somalia does not have a strategy on People- centered health and if developed should address the following areas:

The strategy when developed will guide and support stakeholders to:

• Understand the Concepts in Health and development. • Develop Strategies to address the vicious cycle of ill Health and poverty. • Be able to address the elements that define Health of a community. • Ensure community Participation and bottom up approach in planning and implementing Health and development projects. • Empower communities to be able to take control of their own health issues. • Take stock of their approaches, attitudes, aspirations, and practice in relation to community development • Define the type of community based health workers needed and guide on the expected scope of work for each category of worker. • Systematically develop needs based community development approaches • Ensure a realistic progress route for community development and measure progress • Incorporate community development into overall performance management arrangements.

Community Development is about strengthening and bringing about change in communities. It consists of a set of methods which are broad in vision and capacity for social change a way of working, informed by certain principles which seek to encourage communities who live in the same areas or who have something in common to tackle for themselves. The aim is to empower them to change things by developing their own skills, knowledge and experience, and by working in partnerships with other groups and statutory agencies. Community dialogues and community conversations as a means of empowering the communities to come up with their problems, prioritize them and propose solutions to them. This could lead to positive behavior change and lead to the use of health facilities for deliveries, treatment of common ailments and healthy behavior including the abandonment of risky behavior and practices. Emphasis to include but not limited to prevention and promotion of activities at the community level that do not need referral and can have a big impact to health outcomes.

The principles of community development should pay special attention to the following areas: • Social justice, equality and human rights • Empowerment of individuals, families and communities from the bottom up • Maximizing the participation of service users and communities • Partnership approaches between the community and the voluntary sector, health and social care, and other agencies • Bringing about a sense of local ownership and control, through groups and communities taking action together • Strengthening the social fabric and support systems within disadvantaged communities and groups.

This requires skilled health workers who typically work on the ground facilitating and enabling community and group leadership. The journey from powerlessness to empowerment can go from blame and protest to confidence and partnership working. Health and Social Care agencies must understand and commit themselves to this process, and community development staff must be able to deal with tensions and dilemmas while keeping focused on the wider picture and maintaining a sense of optimism.

Successful partnerships are win-win mechanisms. With better health and well-being comes better ability for children to learn, with better community interaction come safer communities, and front-line staff of all agencies find their jobs easier when communities take greater ownership of their issues, conditions and greater care of themselves and each other. This will eventually translate to improved health within the community.

Brief Description of Tasks: Review of existing relevant policies and strategies developed for Somalia (WASH, Nutrition, FCHWs, HSSP, JHNP, JPLG) and develop a community people centered strategy to address community based health care delivery system. This will involve interaction with stakeholders at different levels to gain understanding of the Somalia health delivery system that will be incorporated into the strategy.

Duration: The timeframe to develop the strategy will be approximately 4 months.

Deliverables/Reporting: The consultant will submit the following documentation and reports;

1. Stakeholders meeting report
2. Prepare and submit final community based health strategy incorporating stakeholder’s feedback.
3. The strategy should cover training, governance, tasks and monitoring and endorsed by the three MOH.

Competencies: The selected candidates should have: • Substantive knowledge of public health issues in transitional and fragile environments and knowledge on community health strategies. • Experience in the design of community health strategy at country level • Ability to work under pressure • Initiative and independence  Adaptability  Excellent communication and proven leadership skills as a team leader

Corporate Competencies: • Demonstrates integrity by modelling the UN’s values and ethical standards • Promotes vision, mission and strategic goals of UNICEF, WHO and UNFPA • Displays cultural, gender, religion, race, nationality and age sensitivity and adaptability. • Treats all people without favouritism

Minimum qualifications and experience: Advanced university degree in Public Health, Community Health development, social sciences, Medicine or other related field  Ability to provided sound methodological technical skills and guidance  Excellent writing and presentation skills  Excellent inclusive facilitation and coordination skills  Excellent communication and negotiation skills, capable of developing and maintain effective working relations across fragmented teams and different organizations – ability to maintain high level buy-in.

• WHO is committed to workforce diversity.
• Any appointment/extension of appointment is subject to WHO Staff Regulations, Staff Rules and Manual.
• Only qualified candidates under serious consideration will be contacted.
• WHO has a smoke-free environment.

Application process: Interested candidates are kindly requested and strongly encouraged to apply in writing sending their CVs and motivational letters to:

Administrative Officer WHO Somalia recruitment@nbo.emro.who.int