Background

Within the context of the Malawi Growth and Development Strategy (MGDS), the United Nations collective objective is to assist Malawi to achieve the Millennium Development Declaration and the Millennium Development Goals and contribute to improved health delivery throughout the country by strengthening the health systems in capacity development and social services.

Malawi is a densely populated poor country with a population of approximately 13 Million, 85% of which live in rural areas. Eighty five (85%) percent of the nation lives in at least 8 km distance from a functional health centre. Fewer than 4 per cent of the Malawian Health Centers have the required Human Resources. The average vacancy rate of key health personnel at district level is 70% and at Central Hospital level the rate is at 56% due to high attrition rate and low recruitment of health workers exacerbated by sickness, deaths and emigration. As a result there is only one doctor for every 62,000 Malawians.

The shortage of quality medical services affects both men and women in Malawi. However the maternal role of women makes their vulnerability highly significant. Women’s access to health care is also affected by their poverty, their social status and their impeded power to make decisions about their own health.

The vision of the Ministry of Health is to improve the health status of all Malawians through the provision of effective, efficient and safe health services. The Ministry’s mission is to stabilize and improve the health status of Malawians by improving access, quantity, cost effectiveness and quality of the essential health package. The essential health package entails the minimum services to be provided free of charge at the point of delivery to all Malawians. The Ministry is aware that there is a need to address the lack of Human Resources in the health sector in a long term systematic manner. However, the crisis is so great that the Ministry and donors felt that it was important to put in place a short term mechanism to try to relieve the immediate need while other long term solutions are being designed and implemented.

It was against this background that the Southern Africa Capacity initiative was initiated in 2004. The same year the government of Malawi developed a six year Plan of Work (POW) for the health sector supported by multiple donors including the UNDP under the umbrella of a sector wide approach in which more long term solutions are developed.

United Nations Volunteers (UNV) doctors have been working in Malawi since the initial UNV doctor program started in 2004 which fell under the Southern Africa Capacity Initiative (SACI). UNDP recruited nine international medical specialists to fill crucial gaps in the medical service sector. The project was developed within the framework of the Public Sector Management Reform Programme. In 2005 the programme grew as the Ministry of Health made available funds from the Global Fund to fight against AIDS, Tuberculosis and Malaria (GFTAM) to recruit Medical Doctors for the district hospitals and Anti Retroviral Therapy (ART) supervisors for the Central Hospitals. The project has been seen as achieving results and is one of the biggest successes emerging from the original SACI. The Ministry of Health has remained committed to the programme’s success and the number of UNV doctors has increased. Thanks to the programme there is now at least one doctor working in every district in Malawi. The program is no longer a part of public sector management reform and has been formulated as Capacity Development in Health Project.

The objective of the programme is to improve the capacity of the Ministry of Health to deliver health services in Malawi. This objective is being met by recruiting UNV doctors and pharmacists to work in the Malawian health sector. UNV doctors with various specialties are recruited and supported to work in Central Hospitals while District Medical Officers work in the district hospitals. Five Anti Retroviral Therapy (ART) supervisors have been recruited and work in five zonal offices. To date 51 doctors have been recruited and are serving in over 12 hospitals. Reports indicate that UNV doctors are making a big impact on the delivery of health services in the country.  Apart from their routine activities, the doctors are also involved in capacity building initiatives to transfer skills and knowledge to national personnel.

The programme has been very successful in the sense that the level of UNV doctors has steadily increased and they continue providing services in Malawi. However, it has proven difficult to move beyond a mere gap filling and assist with more permanent Capacity Development. Some transfer of skill has undoubtedly taken place at the hospital level but not on a desirable scale. A number of factors have contributed to this. First of all, the lack of support staff, most staff at the hospital level is overworked because of high vacancy rate and high absenteeism. The doctors have complained that it is hard to teach staff that is absent. Some problems can also be attributed to attitude problems and the before mentioned lack of understanding of the role of UNV doctors. Secondly, the environment of the UNV doctors is complicated and they find it hard to base their work on their TORs. With the need for their service delivery being high and the lack of support staff, they don’t have ample time to systematically develop capacity of national counterparts.

There are a number of lessons to be learned from previous programme. Most importantly communication and coordination between UNDP, the Ministry of Health and NAC needs to be improved. Support to the hospitals also needs to be increased so that the hospitals can prepare better for the arrival of UNV doctors. Experience has shown that hospital staff is often not ready for the UNV doctor’s arrival, they do not have an understanding of what the UNV doctor’s role should be and how UNVs fit in the system. Within the Ministry, the programme has also suffered for lack of communication. It has proven important to document all communication and keep all stakeholders well informed of all decisions. UNDP and the UNV unit also need improved information sharing with the Ministry of Health mainly in performance assessment of UNV doctors.

There is a need to recruit more doctors in order to reach the target of 75 by the end of the project in 2011. Recruitment and replacement of doctors who have left has continued but has faced some major challenges. There are a number of issues that need to be addressed in order to retain these doctors. Issues such as lack of career professional development, schooling and Volunteer Living Allowance (VLA) are key among them and need to be addressed.   To this end, the UNDP Country Office in Malawi is looking for an experienced and dynamic individual with a combined knowledge and skills in programme management, capacity development, public health and human resources management to provide advisory and technical support to the UNDP Country Office and the Ministry of Health’s Clinical Services Department in the implementation of the Capacity Development in Health Project.
 
The Programme Manager would be able to support capacity development aspects of this programme and systematize these aspects as we develop the new programme in the next Malawi Growth and Development Strategy (2012 – 16).  The Programme Manager will be supervised by the Assistant Resident Representative responsible for capacity development and work in close contact with the Director of Clinical Services in the Ministry of Health.

Duties and Responsibilities

  • Support smooth and effective of management of the Capacity Development in Health Project to improve the quality of health care services including the preparation of Annual Work Plans and Budgets, quarterly and annual progress reports, monitoring and evaluation, resource mobilization and other initiatives;
  • Provide technical guidance to project teams including ART supervisors;
  • Organize quarterly project board meetings and annual Tripartite Review meetings;
  • Ensure effective human resources management and development for timely recruitment, high productivity and retention of UNV doctors including facilitating rapid recruitment of the UN volunteer doctors to reach the target, facilitate resolution of administrative issues affecting the UN volunteer doctors in close collaboration with the UNV Programme Officer and the UNV Country Operations Assistants; undertaking performance appraisals;
  • Facilitate continuing medical education for UNV doctors to acquaint them with current medical advances;
  • Facilitate the induction and orientation of the UN volunteer Doctors on the goals of Capacity Development in Health Programme and its expected results;
  • Facilitate co-ordination between the Ministry of Health and UNV Bonn for effective communication and smooth implementation of activities including maintaining regular contact with UNV Bonn, providing updates on UNV doctor activities to UNV Bonn and local partners;
  • Attending relevant meetings between UNDP/UNV, Ministry of Health, donors and other partners in the health sector including Health Sector Wide Approach (SWAp) meetings and events.
  • Follow up with hospitals prior to the arrival of UNV doctors to make sure all stakeholders are ready once the UN Volunteer arrives in the duty station. Constantly liaise with the UNDP Programme Analysts for Health to follow up on operational issues that require UNDP/host organization action;
  • Facilitate capacity development initiatives for improved access and quality of clinical services by target groups including arranging for the disbursement of funds for UNV doctor initiatives, arranging for process procurement of equipment and supplies, participating in monitoring of capacity development initiatives;
  • Provide technical and advisory services to UNDP and the Ministry of Health on any key policy issues with regard to the UNV Doctors project including staying abreast of latest developments within the health sector, UNDP, GFTAM, and the region, distilling and synthesizing relevant information and informing the Director in Clinical Services and other Capacity Development Health staff, identifying implications and opportunities for this project and building the requisite staff capacity.

Competencies

  • Professionalism – Comprehensive knowledge of and exposure to a a wide range of recovery, development and humanitarian issues; conceptual and strategic analytical capacity, to analyze and articulate complex issues that require a coordinated UN response; demonstrated problem-solving skills and ability to use sound judgment in applying technical expertise to resolve a wide range of complex issues/problems; strong negotiating skills and ability to influence others to reach agreement; ability to work under extreme pressure; very good knowledge of institutional mandates, policies and guidelines;
  • Team building and Leadership – Excellent leadership and interpersonal skills, including ability to operate effectively across organizational boundaries; ability to establish and maintain effective partnerships and working relations in a multi-cultural, multi-ethnic environment with sensitivity and respect for diversity and ability to empower colleagues and strengthen their performance;
  • Communication – Excellent communication (spoken and written) skills including the ability to convey complex concepts and recommendations to staff at senior levels, both orally and in writing, in a clear, concise style;
  • Planning & Organizing – Ability to coordinate the work of others, work on tight deadlines and handle multiple concurrent projects/activities. Strong analytical and organizational skills and attention to detail;
  • Commitment to continuous learning and willingness to keep abreast of new developments;
  • Technology Awareness – Fully proficient computer skills and use of relevant software and other applications, e.g. word processing, spreadsheets, internal databases, Internet, etc.
  • Ability to work flexibly at the senior and strategic level, provide practical support at the operational level;
  • Must have strong team skills and foster cooperation with project staff and government colleagues.  Experience in mentoring colleagues and seek to transfer skills and build capacity of local staff, and ability to communicate in a multi-cultural environment;
  • Must be able to build and maintain effective relationships with clients and external actors;
  • Advanced computer skills in common office programmes (Word, Excel Power-Point, etc) and good knowledge of relational databases at user level.

Required Skills and Experience

Education:

  • A minimum of Masters Degree in Health Economics, Public Health or Public Administration from a recognized institution.

Experience:

  • Minimum of 5 years of project management experience in the health sector in the African region;
  • Prior experience of working within Government and/or agencies in the health sector;
  • Knowledge of human resources management, public health and capacity development issues;
  • Strong teambuilding and leadership skills;
  • Ability to network and liaison;
  • Well developed counseling and stress management skills;
  • Strong writing and presentation skills;
  • Experience in the usage of computers and office software packages and web based information systems;
  • Good analytical and organizational skills.

Language Requirements:

  • Fluent spoken and written English.