Referral Systems Consultant

Reports to: Health Program Coordinator
Position: Referral systems establishment consultant
Location: Fish Town, River Gee County, Liberia
Timeframe: 8 Weeks
Deadline to Apply: 21 August 2015

COUNTRY PROGRAM DESCRIPTION
In view of the mission to improve access to quality education, healthcare, safe water, sanitation, and nutritious food and vision of communities empowered to improve their lives in southeastern Liberia, starting in November 2014, with OFDA, ARC set up, equipped, staffed and managed an Ebola Treatment Unit (ETU) in Fish Town, River Gee County to respond to Ebola virus disease (EVD) and prevent the spread of the disease. With Liberia pronounced Ebola free in May, the Government of Liberia has shifted strategy from EVD response and treatment to restoration and strengthening of regular health service delivery, infectious disease preparedness and response. ARC in Liberia supports the national strategy through the following areas:

• Providing an EVD rapid response capability by staffing, managing and operating an isolation and treatment unit for infectious diseases at a Community Care Center (CCC) on an on-call basis and in the hospital isolation unit when the CCC is decommissioned.
• Strengthening IPC, triage and isolation procedures, and infrastructure in targeted health facilities
• Strengthening infectious disease surveillance and referral systems
• Improving WASH infrastructure in targeted health facilities
• Facilitating the government’s expanded program of immunization (EPI) in targeted remote areas
• Engaging and educating communities on prevention, response and mitigation of EVD and other epidemic-prone infectious diseases
• Building local/community health capacity to prevent, respond, mitigate and treat epidemic-prone infectious diseases
• Support community based surveillance for infectious diseases through general community health volunteers (gCHVs) and selected lower level health facilities in River Gee County.
  Additionally under OFDA funding, ARC also provides capacity building in infection prevention and control, surveillance and referral systems, and emergency preparedness planning to the River Gee County Health Team (CHT). ARC also focuses on strengthening the services and capacity at Fish Town Hospital, which has been designated by the Ministry of Health as the Infectious Disease Referral Hospital for the counties of River Gee, Maryland, and Grand Kru. Furthermore, ARC implements emergency water, sanitation, and hygiene (WASH) activities at the community and health facility level, as well as community outreach and education about Ebola.

PROJECT ACTIVITY
The Liberian Ministry of Health (MOH) has designated the Fish Town Hospital as the regional referral facility for infectious diseases in southeast Liberia (including River Gee, Maryland and Grand Kru counties). ARC is seeking a proactive, highly-motivated individual to develop a functioning referral system for this three-county area as an integral component of delivering timely, quality, and proactive surveillance and early warning system and response to Ebola and other infectious diseases.

The referral system should focus on operationalizing the community event-based surveillance (CEBS) standard operating procedures (SOPs), as designed by the MOH. CEBS is the organized and rapid collection of information from community events that are a potential risk to public health, including Ebola and other infectious diseases. This system improves timeliness of reporting suspected cases, and thus, response times. CEBS should ensure a seamless system from identification of cases at the community level, alerts to DHOs, and deployment of rapid isolation and treatment of Ebola (RITE) teams as necessary.

The consultant is expected to use a systems thinking approach to referral and its corresponding polices, guidelines, and networks to ensure a continuum of surveillance, referral and care for patients with infectious diseases. There is a need to develop a dynamic system responsive to seasonal changes and the varying context in the subregion and the country at large. Reporting systems and tools should also ensure seamless communication and coordination with the national level. The referral system should be developed through a consultative process with stakeholders, including CHOs, Fish Town Hospital administrators, DHOs, and gCHVs in selected villages.

SPECIFIC TASKS
Under the supervision of the Health Program Coordinator, the consultant will be expected to perform the following activities:

• Establish a functioning referral system that serves the three-county catchment area, through a consultative process with stakeholders. This system should:
• Follow the CEBS SOPs developed by the MOH for Ebola and adapted more broadly for epidemic-prone infectious diseases specific to local epidemiology.
• Function in seamless coordination with national surveillance and data collection systems, ensuring summary reports are exportable in acceptable formats and submitted on a timely basis.
• Will require capacity building with the CHT M&E Officer to ensure consistency and efficiency in this activity following the consultant’s engagement.
• Establish a CEBS implementation team to plan, implement, and maintain the CEBS system. This team should consist of CHOs, DHOs, and representatives of the partners that will be supporting the CHT with implementation of CEBS. Within this team should be a smaller team responsible for the ongoing data analysis and reporting.
• Conduct a GIS mapping exercise using data from the Liberian Institute Geo Information Services (LIGI) to approximate distances between health facilities, transportation times, road conditions, and seasonal barriers, as well as to identify local resources and gaps related to referral pathways. The results should be subsequently analyzed by a consultative process with stakeholders to develop referral innovations.
• Ensure a functional communication system to ensure CEBS alerts can be communicated rapidly from gCHVs to DHOs, RITE teams can be deployed quickly, and lower‐level health facilities and communities are able to communicate with referral facility (Fish Town Hospital).
• Support CHT to develop a complete package of referral system toolsappropriate to CEBS in accordance with MoH and/or WHO templates. This may include, but is not limited to:
• A decision‐making guide and procedures for transport for initiating referral facility
• Referral forms and logbooks for both initiating and receiving facilities based on WHO and/or MOH templates.
• Counter-referral forms to accompany the patient back to the initiating facility for follow-up, in order to complete the referral loop between the two facilities
• Referral indicators that can be reviewed quarterly to assess referral system performance
• Referral forms for use by gCHVs
• Weekly and monthly reporting forms for gCHVs
• Conduct a training for all actors implicated in the CEBS system to ensure they understand their role and functionality of the referral system, including event triggers, communication mechanisms, transportation options, RITE team functions, and relevant referral system tools.
• Conduct simulations of infectious disease events to ensure comprehension and operationality of the CEBS system. Provide feedback to strengthen capacity of actors and stakeholders in the CEBS system.
• Provide on-the-job mentoring and capacity building of CHTs (including and especially the M&E officers), county RITE teams, Fish Town Hospital staff, and CEBS implementation team to ensure comprehension and functionality of the referral system.

DELIVERABLES

• Bi-weekly narrative on progress and challenges
• Referral system based on CEBS SOPs applicable to the three-county region of Southeast Liberia (River Gee, Maryland, Grand Kru). This system should be described in a written guide, as well as pictorial guide for low literacy actors in the system.
• Training & simulations report
• Final report summarizing tasks accomplished, lessons learned, and future programming needs

REQUIRED EXPERIENCE

• Master’s in Public Health or related field
• At least 5 years of professional experience in epidemiology/public health research, infectious disease surveillance or public health programming in developing country and/or emergency/humanitarian settings
• Proven track record of establishing or improving effective referral systems for improved health outcomes.
• Solid knowledge of health care system in Liberia
• Experience in working with rural communities with low health care utilization rates

REQUIRED SKILLS

• Verbal and written fluency in English
• Strong comprehension and creativity skills
• Self-motivated and proactive, able to work with a high degree of autonomy
• Strong time management skills with an ability to plan ahead, anticipate requirements, problems and obstacles, and an ability to juggle competing priorities successfully, and to work to tight deadlines
• Good interpersonal and communication skills, ability to perform in a multifunctional team setting
• Fully committed and motivated to achieve the aims and objectives of ARC-Liberia.
  HOW TO APPLY
  Interested qualified candidates can submit their Motivation Letter together with a detailed CV. Only shortlisted candidates will be notified.
  Deadline for applications: August 21, 2015

HOW TO APPLY:

Click here to apply