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Strengthening practices of leadership and management in Tanzanian primary health care is essential to improve the quality of services and is a priority for the government.  Many primary healthcare (PHC) managers in Tanzania lack formal pre-service training in leadership and management. Given the limited resources in health facilities, equipping these managers with essential skills is crucial for optimizing resources and maintaining care quality. Additionally, the rapid adoption of digital health tools like electronic medical records (GoTHOMIS) requires leaders who can effectively guide their teams through technological transitions. 

While investments have been made in training managers at different levels, it is well-recognized that capacity is only one determinant of practice. Based on the COM-B model that poses a change in behaviour to depend on capacity, opportunity, and motivation, a proof-of-concept bundled intervention to improve practices of leadership and management was developed and modelled in two districts of Kigoma region. The intervention bundle, labelled Lead4PHC, consists of three distinct but connected interventions: capacity building through in-service training in leadership and management, provision of integrated PHC mentorship in PHC facilities, along with the application of performance contracts. The approach was conceptualized and co-created by UNICEF, the Ministry of Health (MoH) and the President's Office, Regional Administration and Local Government (PORALG). 

The modelling in Kigoma was monitored using implementation research principles and the results indicate that the in-service training clearly responded to the challenges and tasks of health facility managers in everyday practice. The role of integrated PHC mentorship was perceived as critical in translating the imparted knowledge into action to overcome implementation challenges, and the performance contracts were described as providing clear guidance and serving as a monitoring mechanism. Synergies between the intervention components were clearly defined and positively experienced. The main challenges identified included insufficient time allocated for the training vis a vis the content of the training; insufficient consideration for contextual realities such as staff shortages; insufficient engagement of high-level leaders to support the Lead4PHC implementation; bias of iPHC mentors towards their own area of expertise.  

Overall, the Lead4PHC bundled intervention is a promising proof of concept that with a few modifications is ready for further scale-up across Tanzanian Primary Health Care. 

How can you make a difference?  

Purpose of Assignment 

The next phase for Lead4PHC will involve some modifications and planning to enable national scale. This process needs a dedicated professional who can support this process with strong technical skills. The output from this work will inform and enable the national scale of Lead4PHC as a crucial intervention to improve PHC services in Tanzania. 

Scope of Work 

Based on the insights generated from the modelling of Lead4PHC in Kigoma, the consultant will review and finalize the training guidelines and package, ensuring that they align with identified needs. Additionally, the consultant will develop a comprehensive implementation plan to inform the rollout of Lead4PHC nation-wide, and more specifically in additional districts of Kigoma region as well as in Katavi, Songwe, Dar es Salaam and Mtwara regions. The consultant will work to deliver this under the overall guidance of the Immunisation and Integrated PHC Specialist in the UNICEF Health section. Specific activities will include: 

Revise the training package for health management and leadership based on the modelling of Lead4PHC in Kigoma 

The consultant will comprehensively review experiences, stakeholder feedback, and the Lead4PHC documentation report to enhance the existing training package. The revision process will answer three key questions: (1) What lessons were learned from the implementation of the Lead4PHC initiative in Kigoma, and how can these be incorporated to improve the training package for health management and leadership? (2) What specific revisions are needed in the training guidelines, slides, assessment tools, and program structure to enhance the quality, relevance, and effectiveness of the materials? (3) Finally, how can the revised training package ensure that health managers and leaders are better equipped to address challenges and improve health outcomes at the primary healthcare level? 

Specifically, the consultant will: 

• Revise the training guideline to incorporate updated content, methodologies, and best practices identified during the Kigoma implementation. 

• Update the training slides to reflect new information, case studies, and improved instructional design. 

• Develop or revise Pre- and Post-Training Assessment/Evaluation forms to better measure participant knowledge, skills, and attitudes before and after the training. 

• Refine the training program agenda to ensure alignment with key objectives, sufficient coverage of topics, and efficient time allocation. 

• Review and update any other relevant documents related to the training package, ensuring they are practical, user-friendly, and aligned with the lessons learned and recommendations. 

Develop Lead4PHC implementation manual and Monitoring Framework 

This task focuses on creating a comprehensive implementation manual and monitoring framework for the Lead4PHC initiative. The implementation manual will serve as a step-by-step guide for planning, financial resources required, executing, and managing the implementation of Lead4PHC, ensuring consistent and effective application across the country. The monitoring framework will provide tools and processes to measure progress, evaluate outcomes, and promote accountability throughout the program's lifecycle. Three key questions will be answered by this work: (1) What are the step-by-step processes and best practices for successfully implementing the Lead4PHC initiative at different levels of the health system based on the Kigoma learning? Answering this question will facilitate the development of a clear, practical guide to support uniform implementation. (2) What indicators, tools, and methods are needed to effectively monitor, evaluate, and track the progress and outcomes of the Lead4PHC initiative? This will provide a systematic approach to assess the initiative's performance and identify areas for improvement. (3) How can the manual and monitoring framework support stakeholders in sustaining and scaling up the initiative to improve health leadership and management? This ensures the materials are adaptable and provide long-term value for broader impact. Specifically, the consultant will: 

• Develop the Lead4PHC Implementation Manual, a user-friendly guide detailing the goals, objectives, and principles of the initiative. It will include step-by-step instructions for planning and managing the program, practical tools and templates to support processes, and examples or case studies from Kigoma to illustrate successful practices and lessons learned. The manual will also include a costing component to guide users about the financial resources required for implementation. 

• Develop a Monitoring and Evaluation Framework, which will outline key indicators to assess the progress, outputs, and outcomes of the initiative. It will provide data collection tools, reporting templates, and guidance on evaluation methods, as well as a feedback mechanism to promote continuous improvement and adaptation. 

• Develop a Stakeholder Engagement and Capacity-Building Plan. This will include a strategy for training and engaging key stakeholders to effectively utilize the manual and monitoring framework, ensuring smooth implementation and scalability of the initiative. The capacity-building plan should also include a costing component to guide users about the financial resources needed in implementation of the plan 

These deliverables will collectively equip stakeholders with the necessary resources and knowledge to implement, monitor, and scale the Lead4PHC initiative effectively, contributing to stronger leadership and management within the Primary Health Care system 

DELIVERABLE, TIMELINE, AND PAYMENT 

 

Work Assignments Overview	Deliverables/Outputs	Delivery deadline	Estimated Budget
Revise the training guidelines, slides, assessment tools, program agenda, and other materials to enhance quality, relevance, and effectiveness	Revised training package for health management and leadership based on the learning in Kigoma	By the end of March 2025	50%
Develop a comprehensive manual and framework to guide consistent implementation, measure progress, and ensure accountability. The monitoring framework will include indicators, data collection tools, reporting templates, and a feedback mechanism for continuous improvement	• The implementation manual  • Monitoring and evaluation framework  • Stakeholder engagement and capacity-building plan	By the end of April 2025	50%

PAYMENT SCHEDULE.    

UNICEF reserves the right to withhold all or portions of payment if performance is unsatisfactory, if work/output is incomplete, not delivered or for failure to meet deadlines.     

ASSESSMENT / SELECTION PROCESS AND METHODS     
Evaluations: The applicant should submit both technical and financial proposals which clearly stipulate how the work will be conducted. The Financial Proposal should include all costs of this assignment including fee, travel costs, accommodation as UNICEF will not pay any DSA.      

Proposals will be both technically and financially evaluated. The technical part will carry a weight of 75%, in which the consultant will put clear his/her technical approach to ensure quality attainment of each deliverable and the consultancy in totality. The financial part will take 25% showing the proposed budget breakdown of consultancy cost for each deliverable (fees, travel, and accommodation) and eventual total consultancy cost.      

LOCATION, DURATION & LOGISTIC    
The consultancy is home-based but would require travelling to Dar es salaam and Dodoma for liaising with the government and UNICEF during the implementation. One (1) trip to each region is expected. The work is expected to commence on 3rd of March and end on 31st of April 2025. The wok is under the supervision of UNICEFs Primary Health Care (PHC) specialist and in close collaboration with PHC manager 

To qualify as an advocate for every child you will have…  

• Advanced university degree in Public Health, Epidemiology, and other relevant fields with a background in health (MD, DDS, Nursing, Pharmacy, or other relevant health disciplines) plus a master, or higher degree in public health or related field 

• Five (5) years of professional work experience at the national and/or international programming, implementation monitoring, and evaluation of health 

• Proven expertise in capacity-building initiatives such as training, mentorships, coaching, supervision 

• Proven experience in developing guidelines and strategic documents 

• Proven work relations with national (MoH, PORALG), regional, district, and sub-district structures (RHMT and CHMT level)  

• Excellent communication skills (both written and verbal) to be able to liaise with a wide variety of people, good attention to detail 

• Excellent writing, facilitation skills, negotiation skills, and oral and written communication  

• Fluency in written and spoken English and Swahili is required 

• Strong analytical skills 

For every Child, you demonstrate…  

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

To view our competency framework, please visit  here.  

UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious or ethnic background, and persons with disabilities, to apply to become a part of the organization. To create a more inclusive workplace, UNICEF offers paid parental leave, breastfeeding breaks, and reasonable accommodation for persons with disabilities. UNICEF strongly encourages the use of flexible working arrangements. Click here to learn more about flexible work arrangements, well-being, and benefits. 

According to the UN Convention on the Rights of Persons with Disabilities (UNCRPD), persons with disabilities include those who have long-term physical, mental, intellectual, or sensory impairments which, in interaction with various barriers, may hinder their full and effective participation in society on an equal basis with others. In its Disability Inclusion Policy and Strategy 2022-2030, UNICEF has committed to increase the number of employees with disabilities by 2030. At UNICEF, we provide reasonable accommodation for work-related support requirements of candidates and employees with disabilities. Also, UNICEF has launched a Global Accessibility Helpdesk to strengthen physical and digital accessibility. If you are an applicant with a disability who needs digital accessibility support in completing the online application, please submit your request through the accessibility email button on the UNICEF Careers webpage Accessibility | UNICEF. 

UNICEF does not hire candidates who are married to children (persons under 18). 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 based on gender, nationality, age, race, sexual orientation, religious or ethnic background or disabilities. UNICEF is committed to promote the protection and safeguarding of all children. All selected candidates will, therefore, undergo rigorous reference and background checks, and will be expected to adhere to these standards and principles. 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, and selected candidates with disabilities may be requested to submit supporting documentation in relation to their disability confidentially. 

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.