Background
The USAID Jalin Project (hereafter
referred to as “Jalin” or the “Project”), USAID/Indonesia’s Flagship Maternal
and Newborn Health Activity, is a five-year initiative contracted to DAI Global,
LLC and its consortium of partners – including Intra Health and Vital
Strategies – to support a maternal
and newborn health (MNH) movement in Indonesia that will result in better
health outcomes nationally by: (a) bringing together actors, including those
traditionally outside the health system, to use local evidence and global best
practices to co-create, test and adapt local solutions; (b) addressing evidence
gaps by identifying where and why maternal and newborn deaths are happening and
using that information to co-define and create local solutions; (c) engaging
the public and private sectors to co-finance scalable local solutions across
Indonesia to support partnerships and ensure that the poor and vulnerable have
access to essential services. Jalin works in six provinces including North
Sumatra, Banten, West Java, Central Java, East Java, and South Sulawesi.
Jalin’s Theory of
Change is as follows:
If MNH evidence
is available and compellingly communicated, and influential MultiStakeholder
actors are engaged, then constructive and inclusive partnerships, solutions,
and advocacy can flourish…and these efforts can spur an MNH movement that
contributes to reducing maternal and newborn mortality in Indonesia,
specifically for the poorest and most vulnerable.
Recently
Jalin has undertaken a revisioning exercise to ensure that local solutions are
well embedded in a broader framework of action. The aim is to influence national level programs and guidance, where
Jalin-supported innovations are embedded in a more systemic framework, there is
a systematic approach to learning and dissemination, there is greater potential
for sustainability and scale-up, and higher-level support is attained where
needed (for example, regarding regulations, national guidelines, etc.). To
support this process, five working groups have been established in Jalin to
take forward thematic areas that include the wide range of local solutions
emerging to date. These groups are:
1. Community MNH
2. MNH in the workplace
3. Quality Improvement for MNH
4. Referral systems
5. National MOH support
The
technical team within Jalin is taking the initial lead on the Quality Improvement
and Referral Systems groups, with participation from other teams to ensure
cross-collaboration and synergy. There are a number of sub-themes within each
of these groups that emerged from the current workplan for 2019. These
sub-themes may change over time and may be consolidated into a smaller number
of sub-themes once the working groups get underway. In addition, there is
considerable overlap between the themes of quality improvement and referral
systems as a functional referral system is an integral part of a quality health
system and its effectiveness is strongly linked to other elements of quality of
care, such as sufficient knowledge, skills and performance of health providers
at each level of the health system.
In
the Quality Improvement group, the current sub-themes that include both local
solutions and national level activities are:
· Improving the
quality of ANC for screening and early detection for high risk pregnancy
· Quality improvement in treating high
risk pregnancy in hospital
· Quality improvement in essential
newborn care and newborn emergency
· Improving the capacity of health
workers/ professionals in MNH service through training/ mentoring
· Improving access of private MNH service
providers to essential medical equipment and medicine supplies for MNH service
provisions
· Human resources (capacities and
competencies in emergency)
· Improving blood supply system for
maternal haemorrhage case
· Improving health workers’ compliance
to clinical standards/guidelines in service
· Improving access of private health
workers to training
· Supporting provision of quality care
· Access to care
In
the Referral Systems group, the current sub-themes are as follows:
· Improving access
to continuum of care for the poor and vulnerable (disadvantaged population),
including access to health promotion and education
· Improving access
to MNH care in health facilities
· Support
communication and transportation
· Improving
protocol and mechanism for referral, including reducing multiple referral
· Improving public
spending for MNH
More
details on these sub-themes and the activities and local solutions under each
heading are available in separate documents and will be supplied to the
consultant on commencement of this assignment. The task of the working groups
is to develop an overarching strategy for the thematic area
outlining how the proposed intervention areas contribute to improving maternal
and newborn health and identify a couple of expected outputs and outcomes from
this area of work.
Some
work has already been undertaken in Jalin regarding quality of care and
referral systems. A deep dive review of global literature was conducted in
October-November 2018 and provides a range of recommendations for different
levels of the health system that are relevant to Indonesia. A series of
evidence briefs has also been developed on specific topcis, some of which are
relevant to the sub-themes listed above. In January-February 2019 a further
review was conducted of several topics that had been supported by USAID in a
previous project – the Expanding
Maternal & Neonatal Survival (EMAS) project which ran from 2011 to 2017.. These
topics included referral
systems and mentoring as part of a quality improvement process. This assignment
should build on all these pieces of work. In addition, Jalin currently conducts
a research “Every Mother and Newborn Counts” (EMNC) and supports the MOH on the
Maternal and Perinatal Death Surveillance and Response (MPDSR) system which is
closely related to quality improvement initiatives. This work needs to be
linked appropriately with all relevant quality improvement initiatives for MNH.
Purpose
Scope of Work
i.
Support
the QI and Referral System Initiatves through coordination of internal
Initiative meetings, preparation of meeting slides and co-facilitation as
needed, review of meeting minutes, and documentation of progress and processes.
ii.
Support
the development of a strategy for both initiatives linking local solutions to
national activities and MOH priorities, also regocgnizing Jain’s MNH-Framework.
iii.
Work
as Focal Point contact for the regional teams through the Provinical Manager to
ensure that implementation of local solutions follows the overarching strategy for
QI and referral systems.
iv.
Support
the sub national team to strengthen their capacity to align with MOH as well as
with global and national evidence. Contribute to further discussions between
the MOH at sub-national level, the regional teams and their partners to
understand local priorities regarding quality improvement and referral systems,
current progress and future plans, to ensure that there is consistency with
national strategic directions.
v.
Document
challenges and local solutions as part of an overall program of learning and evidence
gaining that helps underline value of the local solutions implemented.
vi.
Maintain
close collaboration with the technical team and Jalin governance advisors, as
well as the wider Jalin team, to ensure that learnings are shared across the
departments.
vii.
Compile
relevant documents and summarize the current status of quality improvement
plans and initiatives of MOH (working closely with the Jalin technical team and
the two Jalin governance advisers) to ensure previous efforts are well
documented and there is a thorough understanding of the MOH strategic direction
and the roles of all key actors involved. It is crucial that Jalin’s quality
improvement plans and initiatives are in line with MOH Programs and Regulations.
viii.
Document
the key tools and processes that MOH is currently using or planning to use in
regards to Quality Improvement - including mentoring and referral systems. Explore
how previous USAID-supported investments and experiences can be utilized across
the country and assess what further support is required from Jalin, especially
regarding increased involvement of the private sector.
ix.
Document
the current status of referral systems for MNH in Indonesia and the 6 Jalin
supported provinces, including looking at IT systems used (like SijariEMAS)..
x.
Summarize
all findings into a comprehensive document and presentation on a regular basis
as requested by the Technical Director.
xi.
Be
in close communication with the Provicial Managers regarding implementation and
progress of referral and quality improvement local solutions.
xii.
Travel
to the 6 regions as required.
xiii.
Discuss
the findings with the Jalin team, and other partners including MOH, as
required.
xiv.
Ensure
that the technical team and working group members are kept up to date regularly
with progress.
Skills and experience required
· Expertise in
maternal and newborn health with a strong understanding of quality of care and
referral systems in Indonesia; clinical background desired
· In-depth knowledge
of the health system of Indonesia.
· Excellent
communication skills and ability to interact well with regional and national maternal
and newborn health stakeholders.
· Strong analytic
and writing skills
· Fluency in Bhasa
Indonesia and proficient in english
Deliverables Schedule
·
Start asap
·
Initially full time for three months, with the
option of extension
Reporting
The STTA will sit in Jalin’s office and works closely with the technical
team and other members of the working groups on quality improvement and
referral systems. S/He will report directly to the Technical Director.
Interested and qualified applicants could send the cover letter and CV at the latest on April 10, 2019 to indonesiamnh@dai.com with “STTA for Support for Quality Improvement and Referral Systems" in the subject line and specify the availability date in the CV. Only shortlisted candidates will be contacted directly.
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