Historique

Context

With 93 cases per 100,000 inhabitants, Sao Tome and Principe has the 2nd highest tuberculosis incidence rate among small island states of similar characteristics. Furthermore, the country is confronted with a problem of under case detection. Only 66% of estimated cases are detected in the general population and among key populations (i.e. children, TB patient contacts, MDR-TB contacts and prisoners). The case notification system is weak. With a microscopy network lacking in quality control, the system struggles to manage a significant number of clinically diagnosed cases. Patient follow-up is irregular, which leads to a high failure rate in the first treatment (19%). Treatment outcomes among retreatment cases are not extremely positive either with a success rate of 31%, a failure rate of 37% and re-uptake rate of 25%, after dropping-out. Consequently, the number of MDR-TB cases is on the increase whilst the treatment success rate for new smear positive cases is rather low at 72%. Limited coordination of TB/HIV collaborative activities results in late diagnosis of co-infection and an extremely high mortality rate among TB / HIV cases (100%). Community sensitization activities are being carried out to promote treatment seeking behavior and treatment adherence.

Despite this challenging situation, the national response to Tuberculosis has made significant progress in the past four years, thanks to the Government’s efforts and the support of its development partners. The UNDP/Global Fund Project in particular has allowed for significant investments to be made in the provision of TB services to the population, in health systems strengthening and in organizational capacity-building of the National Tuberculosis Programme (PNLT). From 2011 to 2015, these investments have greatly increased the Programme results, under the Round 4 Tuberculosis grant. In 2014, in order to sustain the gains achieved, the Country Co-ordination Mechanism (CCM) mobilized and secured a new Global Fund grant for the 2015-2017, with UNDP as Principal Recipient.

Devoirs et responsabilités

Rationale

Named “Diagnosticar mais, Curar mais”, this new grant aims at scaling-up the response. As such, its two key components are fostering an increase in case detection and notification through the acquisition of new diagnosis technology; and improving treatment success rates. These two components are to be supported by enhanced communication, social mobilisation and community involvement strategies, under the technical leadership of the National Centre for Health Education (CNES).
In order to formulate and operationalize these strategies, the PNLT, UNDP and CNES, have jointly identified the need to revisit and strengthen the National Communication Strategy on Tuberculosis. The need for communication training among community-based actors and stakeholders was also identified as well as the need to review the content of TB-related messages. In order to capitalize on best practices from outside the country, the three entities agreed to respond to this need through an international consultancy.

Objective of teh consultancy

The objective of the consultancy is to support CNES in coming up with an enhanced National Communication Strategy on Tuberculosis

Expected outputs

An enhanced National Communication Strategy, focusing on social mobilisation and community involvement approaches
Training on communication on tuberculosis, aimed at community-based actors and stakeholders
Enhanced messages related to Tuberculosis
Knowledge on communication tools, techniques, guidelines transferred to the CNES and national technical team

Specific activities and approaches

In delivering these outputs, the Consultant will pay special attention to transferring his or her knowledge and skills on communication planning, programming and monitoring to the CNES leadership and technicians.

In designing the training for Tuberculosis community-based actors and stakeholders, the Consultant will address the following aspects:

  • The need for early TB diagnosis;
  • How to improve treatment adherence;
  • How to generate an increase in treatment success rate;
  • Principles of interpersonal communication and counseling;
  • The role of the Community worker in the fight against Tuberculosis.

In updating or developing new awareness-raising messages on TB, the Consultant will take into account:

  • The latest quantitative KAP survey results and barriers to treatment adherence;
  • The results of qualitative KAP survey that he will develop during the mission;
  • The role of community stakeholders as interlocutors between health facilities and the community;
  • Achieving impact through audience targeting by gender, age, communication techniques, scheduling of messages etc.

Compétences

Core Competencies:

  • Ability to model the Unites Nations values and standards;
  • Sensitivity and flexibility when faced with cultural, gender-based, religious, ethnic and other types of differences.

Functional Competencies:

  • Client-orientation;
  • Strong facilitation techniques;
  • Ability to work against tight deadlines and deliver results on time;
  • Diplomacy;
  • Excellent writing skills (structure, formatting, presentation).

Qualifications et expériences requises

Education:

  • Master degree in health communications / behavior change communication / health promotion / social mobilisation and / or related disciplines.

Experience:

  • At least 7 years of experience in designing messages addressed to the community, designing, implementing and monitoring communication / social mobilization, IEC or behavior change communication approaches in development projects;
  • Delivering training for community-based actors and stakeholders;
  • At least two instances of experience in preparing National Communication Plans, with a community component;
  • Knowledge of health systems especially on endemic diseases such as Tuberculosis, Malaria and HIV is an added value.

Language:

  • Fluency in Portuguese is essential.

Submit in one single document saved as one file the following three documents:

  • An up to date CV;
  • A 5-page maximum technical proposal describing the candidate’s understanding of the Terms of reference and his/her approach to executing them;
  • A financial proposal presenting the cost of the candidate’s consultancy services.