Médecins Sans Frontières, an international medical
humanitarian association created in 1971, provides medical assistance to
populations whose lives are threatened: mainly in the event of armed conflicts,
but also of epidemics, pandemics, natural disasters or exclusion from care. The
French section of MSF is present in about thirty countries.
In the context of a project opening, we are looking
for a Paediatric capitalization and training expert for TACTiC – Treat, Avoid and Cure TB in Children F/M.
Mission
Children with tuberculosis (TB) are underdiagnosed and
undertreated, leading to high mortality and morbidity. Almost all MSF projects,
in almost all contexts see patients with TB and struggle with the challenges of
diagnosing TB, especially amongst children. In March 2022, the World Health
Organization (WHO) Global Tuberculosis Program published new recommendations
for children with TB including an integrated treatment decision algorithm to
diagnose pulmonary TB, a shorter 4-month treatment for non-severe TB and shorter
treatments for TB prevention. These recent WHO recommendations present a unique
window of opportunity that cannot be missed to transform the way that children
with TB are diagnosed and treated across MSF projects, and to have a truly
meaningful impact on mortality and morbidity from TB in this population.
In order to achieve this, MSF has built a project to
scale up the use of the new recommendations, both within MSF projects and
beyond, as well as to provide evidence to ease their further use and
improvement.
All MSF operational
sections are involved in this multidisciplinary, inter-working groups,
transversal and integrated project which will roll out along 3 main axes of
work:
- Implementation : Offering support and
guidance to MSF teams and their partner Ministries of Health/National TB
programs (MoH/NTP) to assess, plan and design adapted management of pediatric
TB incorporating WHO recommendations. Strengthening the capacities of medical
and paramedical staff in setting and projects not specialized in TB through
training and development of tools.
- Operational research (OR ): In some contexts, MSF projects will conduct operational research (OR) on
the feasibility, acceptability, and validation of new recommendations in
different contexts and populations.
- Advocacy: With Access Campaign, developing
evidence-based advocacy at international, national and local levels, for the
implementation and scaling-up of the recommendations, as well as for enhanced
access to diagnostic tools and the development of cheaper, more adapted ones.
The project should be user-centered (MSF teams, MSF/MoH clinicians and
other health staff) and have a special focus on patient experience and
coordination/continuity of care, anticipating dialogue with populations at
every stage and inform what is left to do beyond medical needs. The main
deliverables are a toolkit for implementation and advocacy and a roadmap for
scale up.
MAIN RESPONSABILITIES
The main role of
the pediatric capitalization and training expert will be to develop tools to
support projects in the implementation of the WHO recommendations. In
particular, he/she will be responsible for development of a comprehensive implementation
toolkit including training tools to support successful field implementation
of the WHO recommendations building on previous experiences of missions
supported by TACTiC and to allow larger scale roll-out and support field team capacity.
In addition, the capitalization officer will actively contribute to the
development of a roadmap for effective global scale up across MSF,
including an impact analysis.
- Capitalization work:
The pediatric
capitalization and training expert will:
- Develop elements of an implementation toolkit, based
on the experiences of projects and technical referents already implementing the
new recommendations and the documentation done as part of the operational
research in some sites. The tools will support
the projects in the i) needs identification, ii) preparation and adaptation to
local context, iii) planification of needed resources, iv) implementation of
the WHO recommendations (training, kickoff of activities, integration into the
business-as-usual), and v) monitoring framework, for a continuous improvement
of the management of pediatric TB incorporating WHO recommendations. It will
provide project teams enough guidance for autonomous preparation, deployment,
and adoption of the WHO recommendations (with usual support from HQ referents and cells).
- Develop an adapted learning package with training
tools and contribute to a learning strategy, in collaboration with relevant
internal and external actors (for example WHO, EGPAF, Union) (medical
referents, learning and development (L&D) units, TACTiC national and
international implementation officers), targeting initial training and continuous
learning, adapted to the local staff skills. These training modules/tools should
be easy to transpose to as many contexts as possible. A methodology to measure
the trainees’ progress and to collect their feedback should also be developed.
- Prepare an analytic report on implementation i n targeted sites which can be used
for capitalization. Tools will be built by preparing a compilation of and by improving
upon any existing and relevant tools (trainings, supporting tools, local
advocacy etc.) collected from targeted sites and the documentation done as part
of the operational research in some sites. The implementation report will
include an analysis of the impact of the implementation of the recommendations
as well as identifying common barriers and potential solutions. Note that some
sites are participating in operational research which is documenting the
implementation and the impact of implementation. The capitalization officer
will work in close collaboration with the OR team to transform this work into
practical tools.
- Contribute to the broader roadmap development with the
project team that will be developed for the effective scale up of
recommendations within MSF through the report on implementation and a summary
of the learning experiences.
- Contribute to the Monitoring
and Evaluation framework of the project in order to i) continuously
document the projects inputs and outputs, ii) regularly evaluate the effects of
the implementation in the targeted countries (number of children diagnosed,
number of children put on timely and effective treatment, prevention of new
cases etc.) iii) evaluate the impact of the intervention on staff confidence. This
work will be conducted in collaboration with operation, medical and L&D
departments, and with external institutions working on management of pediatric
TB, seeking opportunity for harmonization in indicators and methodology. Developing
tools for record keeping and data collection, improving the data structure,
defining key indicators, and developing visualization tools to make them easily
accessible to both supervisors and health workers, will support monitoring
activities.
The pediatric
capitalization and training expert may also contribute to but not be
responsible for:
- the development of the communication strategy to
engage communities/patients in the intervention, including information on
patients’ rights, in collaboration with relevant working groups (health
promotion, health education etc.)
- the development of advocacy tools to support project teams
to engage with MoH/NTP for the implementation and scaling-up of the
recommendations.
2. Project level implementor role:
In order to become
familiar with the implementation process firsthand, the pediatric
capitalization and training expert will travel to the project to support the implementation of the WHO
recommendations in at least one project site as per the needs of the hosting
MSF Mission/Project. The implementor works closely with an appointed TB focal
point from the project with the goal of training, mentoring, and supporting the
TB focal point who will be responsible in the long term for support to TB
activities in the project. Therefore, all activities as described below are
performed in collaboration with the project teams and TB focal point:
1. Preparation phase (estimated time required: 1 month – preparation
can start before departure)
- A brief assessment, including:
- a mapping of current practices (i.e. diagnosis, treatment and prevention
of TB in children) in the MSF project and in the wider context of the country
relevant to the project for MSF (all sections), MoH/NTP and other key
implementation partners,
- the identification of barriers to implementation of the WHO
recommendations both at MSF and MoH/NTP levels, the identification of solutions
to overcome those barriers,
- the identification of the routine indicators on TB already followed up
by the MSF project.
- Development of a plan of action for the implementation of the WHO
recommendations with the team, including:
- a projected timeline and evaluation of what resources and tools would be
needed,
- in collaboration with the MSF HQ pediatric advisor, MSF Mission’s
Medical Coordinator and/or Project’s Medical Referent, and MoH/NTP relevant
representatives, a proposition of where the TB diagnostic algorithms articulate
with the current pediatric algorithms, and how to integrate the two,
- a plan for advocacy at local level as pertinent
- In coordination with the MSF HQ TB, pediatrics and diagnostic advisors,
the MSF Mission/Project medical management team and the MoH/NTP focal point and
other relevant key stakeholders (MSFeCARE, etc.), the development of
user-centered training and support tools, or the adjustment of existing ones,
to facilitate the implementation in the targeted project as well as in other
MSF/MoH projects in the country.
2. Implementation phase (estimated time required: 1 month - can include
follow up after a period of implementation)
- Active support as required and requested by the MSF Coordination/Project
for dialogue with MoH/NTP and other key external stakeholders on the
introduction of the WHO recommendations, including, where relevant,
participation to the organization and animation of inclusive design
workshops.
- Organization, animation, follow-up and potential adjustment of inclusive
(MSF, MoH) training sessions for targeted health and other staff, including the
measurement and analysis of training outcome, e.g. (projected) effect on
practice.
- Feedback on training and first days/weeks of implementation outcomes
(staff practice, patient’s adherence, etc.) and impact (link to programmatic
indicators: number of patients diagnosed, treated, followed-up, etc.). Lessons
learned and identification of adjusting measures if/where relevant.
- In coordination with MSF sections active in the country, identification
of and support to additional MSF implementing sites in country through:
- Transposition of training and support tools for tailored use in
additional sites
- Where possible, direct on-site training and/or training of trainers
- Identification of peer-to-peer support possibilities from “pilot” site
to subsequent sites in country
The time estimated for supporting kick-start of
implementation is project dependent but can be estimated as 8 weeks on average.
DELIVERABLES
- Implementation package/toolkit
including contribution to M&E framework
- Adapted training
/learning package/tools
- Analytic report on
implementation in targeted sites.
- Compilation of relevant
tools (training, support, local advocacy) collected from targeted sites.
- Contribution to broader roadmap
for scale up in MSF
ORGANIGRAM
Hierarchical manager : The Project Manager
will supervise the pediatric capitalization and training expert to ensure a
good integration with key MSF internal stakeholders, respectful of the
project’s objectives, scope and budget.
The project leader will
guide the capitalization office in the type and content of the tools developed
and their transposability to other projects and will be the link with the
technical groups.
The research
coordinator will facilitate the work of the pediatric capitalization and
training expert to leverage the documentation done a part of the operational
research in the tools.
Spécificités du poste
Status: The post is 4 months based in
country with MSF representation but with the possibility to work according to Central
European Time zone and ability to travel to the field.
Salary conditions: According contracting section MSF
Position to be filled: Current October 2024
Our
wish is to promote inclusion and diversity. We also wish to improve the
representation of people with disabilities in our workforce.
Seul(e)s les candidat(e)s dont les dossiers auront été retenus seront contacté(e)s.
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