Consultant - Safe and Affordable Surgery/NCD Specialist, Solomon Islands

Purpose of the Consultancy

In collaboration with the Ministry of Health and Medical Services and WHO Representative Office the consultant will:

• Improve screening and management of diabetes and diabetic foot at primary care facilities by: further developing and scaling-up the diabetes and foot care primary care policy guidelines, clinical coaching, assessment and planning guidelines, quality improvement and facility and national planning, strategy development; and associated country and Regional dissemination and documentation through peer-reviewed publications;
• Contribute to further introduction of the Safe and Affordable Surgery (SAS) program by reducing the surgical burden of late diabetic foot presentations by: scaling-up of clinical coaching and associated systems to support improved diabetic foot screening and early management practices; improving hospital diabetic foot outcome monitoring and use of data for action; and continued development of facility team-based approaches to improving the quality of sterilization services.
• Contribute to the development of a functional national diabetes programme through improved policy development, strategic planning, coordination and collaboration both within and outside the MHMS; and by beginning the process of development of evidence-based accreditation standards for pre-service education and facility licensing.

Background

NCDs
In the context of NCDs, the WHO Country Office (CO) in Solomon Islands supports implementation of strategies that address access to services, determinants of health, and availability of essential medicines and devices for primary health care. The WHO CO NCD Team provides technical and administrative support to the MHMS Noncommunicable Diseases (NCD) programme and related assignments. Additionally, the WHO CO NCD Team coordinates activities to strengthen NCD prevention and monitoring of key NCD risk factors. The team collaborate closely with key partners across and outside the MHMS.

This activity continues and builds on the development and implementation of a new clinical-coaching-based approach to improving diabetes and diabetic foot screening and management now being scaled-up in Honiara Capital District. It focuses on development, testing and scale-up of clinical PHC coaching, a data-based approach to PHC quality improvement and systems support for improving practice.

SAS
The MHMS in Solomon Islands is committed to building a safe and affordable surgery (SAS) programme using public health principles. A focus of this approach is building a grounds-up programme, based on local needs. As a first phase, the National Referral, Kilu’ufi, Good Samaritan, Gizo and Kirakira hospitals were selected for early implementation and development of quality improvement tools and methods. Sterilization services were prioritized as a first step because of their foundational importance to SAS and general IPC. Improving sterilization services requires the introduction of a multi-stakeholder approach for continuous quality improvement at district hospital level and above – critical to building quality SAS services and staff engagement over time. Sterilization is an essential foundation of all SAS and IPC activities.

This activity will support development of a revised patient data collection approach for the NRH surgical foot ward for hospitalized diabetic case numbers and outcomes. Data will be used to develop approaches to managing the problem of high surgical case-load and associated morbidity and mortality by reducing late diabetic surgical presentations. Peripheral screening, prevention and early management of diabetic feet will be strengthened in core facilities responsible for the majority of diabetic surgical referrals to NRH. This activity will continue support for strengthening sterilization services, implement a diabetic foot monitoring database and facilitate the use of data for decision-making; and for targeting primary care actions.

Deliverables

The consultant will support training of facilitators and multi-stakeholder teams in diabetes assessment and planning methods and tasks at focus facilities. The consultant will provide direction on: completion of diabetic audit checklists and reviews of outpatient services; observation of environments and practices for diabetes management; review of hospital SAS resources; SAS multistakeholder formative interviews; development, testing and implementation of diabetes practice coaching at facilities in collaboration with stakeholders; data entry, analysis, synthesis, interpretation; and use of data for short, intermediate and long-term planning. The consultant will develop a summary report of the main findings.

Methods (s) to carry out the activities

The consultant will provide remote or in-person support to coach and mentor local staff in: 1) review of the status of outpatient diabetes screening and management practices; 2) use of data to develop 6-12 month facility plans to strengthen systems and improve quality of care; 3) field testing of clinical coaching methods and checklists using small group coaching; 4) hospital facilitator training to conduct coaching and then facilitate the process for other staff.

In-person and remote meetings, discussions and reviews will be used to continue support for all country programme activities; liaising with partners and MHMS staff to fund plans; advising the country office on effective strategies to accelerate progress with diabetes, SAS and IPC; advocating for on-going support for diabetes, SAS and IPC; supporting the development of updated strategic plans for diabetes, SAS and IPC.

Literature and desk reviews, data analyses and synthesis will be used for development of: diabetes and SAS supporting materials; diabetes hospital assessment and planning approaches; a data entry platform for diabetic foot data collection in the surgical care wards with a national database and dashboard using the DHIS2 platform; review and use of data for decision-making; papers on diabetes screening and management progress, sterilization, and the status of surgical practices and services; and local programme and Regional reviews.

Output 1: Diabetes programme support

Deliverables
1.1 Finalized national clinical coaching checklists for diabetes, diabetic foot and foot wounds;
1.2 50-100% of targeted PHC staff in scale-up provinces coached;
1.3 PHC diabetes assessment and planning done at diabetes implementation facilities in targeted areas for facility, provincial and national planning and quality improvement;
1.4 PHC assessment and planning database, dashboard operational for all implementation provices; updated national M and E framework;
1.5 Summary of quality improvement methods and approaches used in implementation areas;
1.6 National guidelines for diabetes and diabetic foot assessment and planning; and clinical coaching guidelines for diabeties and diabetic foot screening and early management.

Output 2: SAS programme development

Deliverables:
2.1 Sterilization follow-up reports – staff practices, progress with actions and next implementation
2.2 NRH diabetic foot ward database operational; with monthly reports and dashboard;
2.3 Final implementation guides for sterilization service assessments and for sterilization facilitator training.

Output 3: Policy, strategy and coordination

3.1 3 peer reviewed articles completed and submitted for publication – diabetes screening and management;
3.2 Programme support documents for diabetes and diabetic foot management (e.g. updated national SOPs, implementation strategy/action plans, national policy directives on organization of clinics and strategies for improving quality, health communication materials or approaches);
3.3 Reports of meetings, workshops, facilitator training, regional presentations or workshops; summary presentations on key data, findings and experience.

Qualifications, experience, skills and languages

Educational Qualifications

Essential: Degree in medicine and/or advanced university degree in nursing, midwifery.
Desirable: Master's degree in public health or other relevant field.

Experience

Essential: Over 10 years of practical experience at national and international level in supporting country and health facility level planning, implementation, scale up, monitoring and evaluation of newborn health programmes. Over 10 years of experience in developing country settings.
Desirable: Extensive working experience in PICs including PNG, Fiji, Vanuatu and Solomon Islands; experience in Western Pacific Region, including Cambodia, China, Lao PDR, Mongolia, Viet Nam desirable. Experience with NCD and SAS programming.

Skills/Knowledge

• Expertise in the gathering, analysis and use of epidemiological data – particularly in the area of SAS, diabetes care; and health systems.
• Knowledge and field experience with assessment, review, planning of IPC and sterilization services or SAS clinical services or systems; and diabetes PHC and/or other RMNCAH PHC
• High level technical skill in core areas such as programme planning, management, monitoring and evaluation
• Experience in planning and facilitation of meetings and workshops; writing and development of tools, methods and guidelines; publications in SAS, diabetes, RMNCH topic areas; and advocacy and discussions with senior country staff about programme financing, policy and advocacy.
• Ability to establish harmonious working relationships as part of a team, adapt to diverse educational and cultural backgrounds, and maintain a high standard of personal conduct.
• Ability to demonstrate gender equity and cultural appropriateness in the delivery of services to Member State.

Language requirements

English language: expert level required for reading - writing – speaking

Location

Off-site: Home-based

Travel

The Consultant is expected to travel to the country at least 3 times for up to month each time, with the work location to include implementation provices, Honiara and the Honiara Capital District, according to the itinerary and estimated schedule that would be agreed with WHO Country Office.

Remuneration and budget

Remuneration: Payband level C - USD 10,000 - 11,000 (monthly)
Expected duration of contract: 10 months, March to December 2025

Additional Information:

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