Consultant at the United Nations International Children’s Emergency Fund (UNICEF)

JOB TITLE: Consultant: Study on Lessons Learned on Integrating COVID-19 Vaccine into High-risk Group Routine Care in Guyana

JOB LOCATION: Nigeria

JOB DETAILS:

• The ‘base-case’ scenario of WHO’s November 2023 Roadmap for COVID-19 vaccines is that the virus continues to evolve but does not become more virulent. Periodic spikes in transmission may occur as a result of an increasing proportion of susceptible individuals over time if waning immunity is significant; this may require periodic boosting at least for high-priority populations
• The Roadmap recommends that high-risk groups receive COVID-19 vaccine annually. High risk groups are older adults with co-morbidities that put them at higher risk of severe COVID-19; adults, adolescents, and children older than 6 months with moderate to severe immunocompromising conditions; pregnant women, and health care workers.
• While COVID-19 vaccine was primarily delivered through mass vaccination during the pandemic, the recommended and more sustainable approach is now to integrate COVID-19 vaccine delivery with routine health services. Hence, in line with the WHO Roadmap, the COVID-19 vaccination programme should transition to prioritize high-risk groups.
• Following WHO and UNICEF guidance, countries have started integrating COVID-19 vaccines into routine immunization services and the broader health system. Some countries have already taken steps to integrate COVID-19 vaccine into care pathways of high-risk groups, such as pregnant women and people living with HIV/AIDS (PLWHA). However, so far there is little evidence on opportunities and constraints for integrating COVID-19 vaccination into the clinical services that serve these populations.
• The primary purpose of this study is to assess the acceptability, feasibility, uptake, costs, and sustainability of integrating COVID-19 vaccination into routine care of two vulnerable groups – pregnant women and people living with HIV/AIDS (PLWHA) in Guyana. The overall intended programme of work will involve four countries in total, including Guyana. Eswatini and Malawi will examine integration of COVID-19 vaccine into antiretroviral therapy services and Cote d’Ivoire into antenatal care. 
• The secondary objective will explore key informants’ reflections on the pandemic COVID-19 vaccine rollout and lessons learned that could be applied in a future pandemic scenario. This aspect of the study will only be conducted in Guyana and not in the other three countries.
• These TORs are concerned with the study taking place in Guyana, which has been integrating COVID-19 vaccination within antenatal care services and ART services for PLWHA. In Guyana, COVID-19 vaccine is routinely offered to pregnant women along with the Td vaccine. It is available both at antenatal clinics and primary care level, but not in pharmacies. Health promotion and health education activities to support COVID-19 vaccine delivery are carried out at clinic level. Despite availability, acceptance rates have been reported to be low. COVID-19 vaccination policy in Guyana follows WHO recommendation, but to date there is no official government policy recommendation. Similarly, Guyana recommends and offers COVID-19 vaccination to PLWHA as part of their routine care. 

Study aims and objectives:

• The study aims to draw lessons from the COVID-19 pandemic, both for its pandemic roll-out and post pandemic routinization of COVID-19 vaccines to high-risk groups. The study will have two overall aims: Study A will examine lessons learned from the COVID-19 vaccine roll-out in Guyana during the pandemic. Study A will aim to evaluate the integration of COVID-19 vaccination into routine care of high-risk groups (post pandemic);

Aim of study A:

• To explore lessons learned from the COVID-19 pandemic vaccine rollout to inform future planning for pandemic preparedness through a limited number of key informant interviews.

Aim and objectives of study B:

• To assess the acceptability, feasibility, uptake, costs, and sustainability of integrating COVID-19 vaccination into routine care of two vulnerable groups – pregnant women and people living with HIV/AIDS (PLWHA).

Detailed objectives of Study B are: 

• To describe the existing COVID-19 vaccination delivery model(s) in pregnant women and PLWHA
• To identify the barriers and facilitators of COVID-19 vaccine delivery to pregnant women and PLWHA. 
• To assess the uptake, timing/timeliness and associated determinants of COVID-19 vaccination in pregnant women and compare these with maternal tetanus vaccination.
• To assess the uptake, and associated determinants of COVID-19 vaccination uptake, in PLWHA.
• To describe how COVID-19 vaccine delivery is integrated within ANC services and clinical care models of PLWHA. This involves examining integration of broader health systems functions (e.g. governance, financing, supply, health information system, supervision, etc..) as well as characterizing the level of integration at facility level – including mapping the delivery of COVID-19 vaccine within the care pathway(s).
• To explore health care professionals’ (HCPs) and program managers’ experience and views of the feasibility, of integrating COVID-19 vaccine delivery into ANC services and PLWHA care.
• To explore the experience and views of pregnant women and PLWHA on COVID-19 vaccination and their satisfaction of the integrated delivery
• To quantify the additional cost of delivering COVID-19 vaccine as part of existing ANC services and PLWHA care services.
• This work is funded by Gavi to provide evidence on integrated COVID-19 vaccine delivery as part of the Gavi COVID-19 vaccine learning agenda.

Requirements
To qualify as an advocate for every child you will have:

• A Master’s Degree in Health policy/ health systems/ health economics/ epidemiology.
• Experience of public health/health policy – at least 5 years
• Research experience including mixed methods – quantitative and qualitative skills – at least 5 years
• Publication record (reports and peer reviewed publication)
• Ability to communicate effectively with a wider range of audiences.
• Excellent interpersonal skills to develop and maintain good working relationships.
• Fluency in English Language is required (oral & written).

HOW TO APPLY
To apply for the ongoing UNICEF job opening, visit the  APPLICATION PORTAL to submit your application!