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UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. To save their lives. To defend their rights. To help them fulfill their potential. 

Across 190 countries and territories, we work for every child, everywhere, every day, to build a better world for everyone. 

And we never give up. 

For every child, vaccination 

How can you make a difference? 

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 ([1]). 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:
1. To describe the existing COVID-19 vaccination delivery model(s) in pregnant women and PLWHA
2. To identify the barriers and facilitators of COVID-19 vaccine delivery to pregnant women and PLWHA.
3. To assess the uptake, timing/timeliness and associated determinants of COVID-19 vaccination in pregnant women and compare these with maternal tetanus vaccination.
4. To assess the uptake, and associated determinants of COVID-19 vaccination uptake, in PLWHA.
5. 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).
6. 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.
7. To explore the experience and views of pregnant women and PLWHA on COVID-19 vaccination and their satisfaction of the integrated delivery
8. 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.

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)

UNICEF's values of Care, Respect, Integrity, Trust, Accountability, and Sustainability (CRITAS). 

To view our competency framework, please visit  here. 

  Please access the complete ToR here:  TOR Lead Consultant Lead Consultant for study on Covid-19 vaccination in Pregnant women and PLWHA Guyana.pdf

UNICEF is here to serve the world’s most disadvantaged children and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, age, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, or any other personal characteristic.

UNICEF offers reasonable accommodation for consultants/individual contractors with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment. 

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check. 

Remarks:  

Only shortlisted candidates will be contacted and advance to the next stage of the selection process. 

Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures, and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws. 

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts.