UNICEF UZBEKISTAN

TERMS OF REFERENCE FOR CONSULTANTS AND CONTRACTORS

ToR for inception report writing consultant for Phase II of the Project on
Improvement of Mother and Child Health Services in Uzbekistan
I. BACKGROUND INFORMATION
Uzbekistan is a landlocked country in Central Asia with nearly 30 million inhabitants. An estimated
63% of the population lives in rural areas. More than 2.8 million of Uzbeks nationals are children
below five years of age. The Government of Uzbekistan places considerable emphasis on the health
and wellbeing of young children.
Though Uzbekistan has made progress in a range of key social indicators, especially in the health
sector, challenges remain in sustaining this progress and keeping on track to achieve the Millennium
Development Goals (MDGs) by 2015. These challenges are due to the health system which has
limited skills and capacity to effectively mobilise the available human and capital resources. The
country has inherited the extensive infrastructure and human resources developed during the Soviet
era. It is essential to streamline these resources and human capital through reform of the health sector
to make it more efficient and effective following evidence based standards and quality health service
delivery.
In 2003, the Government initiated a sector reform programme to improve maternal and child health
services. The Programme, supported by World Bank, ADB, UNICEF, WHO, UNFPA and others,
addressed the gaps within the primary health care, supply and in-service training system.
With technical support from UNICEF, the Ministry of Health (MOH) piloted the innovative Newborn
Survival Programme in Ferghana region. The objective was to develop evidence-based training
materials on newborn care, neonatal resuscitation, perinatal healthcare surveillance and the
International Live Birth Definition and to introduce them through systematic training and supervision.
The evaluation showed that the package had an impact on reducing neonatal morbidity and mortality.
The latter recommended scaling up the Ferghana model in transitional health systems with established
primary care and referral systems. The MOH and UNICEF worked together to plan the expansion and
scale-up in other 8 regions. Additional components of child survival, health management and the
introduction of maternal child healthcare were included in pre-service training.
As a result of this process and in a partnership between MoH, UNICEF and financial support by the
European Commission, the Improvement of Mother and Child Health Services (IMCHS) project was
designed, aiming at improving health care providers skills on quality of care in eight regions of
Uzbekistan.
The project commenced in July 2008 and was completed within thirty six months in July 2011. The
IMCHS Project has been implemented in close partnership with national and international partners
active in MCH sector.
Capacity building activities of the first phase of the project has covered 8 out of 14 regions of the
country. The selection of the project regions was based on the analysis of the other partner targeted
regions.
UNICEF Uzbekistan commissioned external formative evaluation of the first phase of IMCHS project
in September, 2011. The findings and recommendations were used to inform Phase II as well as for the
on-going development of the MCH strategy.
Following the successful implementation of Phase I, partners have agreed to extend the project to the
second phase with the duration of 42 months starting from August, 2012.

Overall Objective of the Phase II of the project is to support Uzbekistan in meeting the targets of the
Millennium Development Goals numbers 4 and 5, with a focus on improving the quality of Mother
and Child Health care.
Projects Specific Objective is to support the Ministry of Health to increase the quality of mother and
child health services and to increase the capacity of families to make informed choices about health
and nutrition
Expected Results are:
Result 1: Institutional strengthening - Skills and operational capacity of the Ministry of Health and
its three tiers have been enhanced to effectively support the health reform process concerning the
Mother and Child health services in accordance with international standards.
Result 2: Capacity Development and Empowerment - A comprehensive education-training process
dealing with mother and child health care has been developed and put in place, at medicalinstitutional and family level. Improved skills of staff on effective perinatal care, newborn and
child care in maternities, village level health facilities (SVP) and polyclinics.
II .OBJECTIVES OF THE CONSULTANCY
To assist the UNICEF country office and the Ministry of Health in preparation of the inception phase
and the drafting of the inception report, through a participatory process. The report will adjust
activities for the 14 regions and for the MoH/MCH , defined the spectrum of other donors' assistance
complementary to the project, prepare the project work plan, adjust the budget and the log-frame
according to existing project and assess requirements for international expertise. The inception phase
will also include a detailed description of the project environment including an up-date of the health
reform and a visibility plan. Consultant shall also assess the needs for equipment and supplies for
separate tender which will be undertaken by the donor directly. The Inception report shall be submitted
for approval to the Steering committee.
III. SCOPE OF WORK
3.1. Requirements for the inception report
The inception phase is considered as one of the critical elements of the project cycle for collecting
basic information needed for the effective implementation of project activities and making decisions
for the methodology to be used. The inception report is a main planning document for the project that
shall include comprehensive situation analysis and detailed work plan outline.
The inception report shall include suggestions for adjusting the activities outlined in the Description of
Action, defining the detailed project work plan, assessing the requirements for international expertise
and assessing the needs for equipment and supplies for separate tender.
The report shall also include a detailed description of project environment including an up-date of the
health reform development in Uzbekistan and a visibility work plan.
The work-plan will define the activities including associated benchmarks or indicators of
achievement for each component and demonstrate how those relate to the programs overall goal and
specific objectives, preferably in the form of logical framework matrix. It shall also describe relevant
risks and assumptions and means for verifying achievement of project results and objectives. In
addition, the inception report has to include detailed description of the project environment including
up to date health sector reform process with a particular focus on MNCH sub-sector, the contribution
of all international stakeholders involved in the sub-sector and a visibility work plan. It is important to
prepare work-plan for the entire project, broke down by components. This shall include expected

outputs for each component, methodologies to be applied and the inputs as well as possible risks and
assumptions. The report has to provide very concrete information regarding different project activities
such as type of activity, target audience, location and time frame, methodology to be used and other
information as requested. Inception report shall also contain key annexes containing table for inputs,
budget, Gant chart and others.
3.2 Specific tasks:
Under the overall supervision of the Health section chief (UNICEF Uzbekistan) and in cooperation
with MoH officials, the Consultant will be responsible to draft the inception report which imply:
Desk review of all available project documents including materials related to the previous
activities as well as other donor activities in related field;
Facilitate group discussions with key stakeholders for achieving consensus on key elements of
the operational plan;
Meet with all stakeholders (MoH, National project coordinator, regional and district health
professionals) to discuss the policy environment and analyze previous project activities to come
up with a baseline for the inception phase;
Meet with other donors and review their activities to ensure that the project is coherent with
other interventions in related field and to avoid possible overlap;
Based on all discussions, prepare a revised and adjusted work-plan in the new log frame with
timing so as to reach a critical mass needed for sustained systems change and expansion to all
14 regions.
Integrate a health promotion component (using behavioral change communication and demand
creation component) into the work-plan to increase the capacity of families to make informed
choices about health and nutrition.
Ensure a strong equity focus in the workplan by integrating a monitoring framework for
bottleneck analysis and for measuring results achieved.
Propose adjustments to the preliminary budget:
Make presentations on findings of the analysis and main elements of the Inception report to the
partners of the project such as MoH, Steering committee members, etc for consensus building
and for final approval by the Steering committee. Prepare a list of equipment and supplies to be
procured by the EC as part of the project (with the amount of 1.8 million Euros): rationale for
the procurement, technical description and list of equipment for distribution.
3.3 LIST OF DESK REVIEW MATERIALS TO BE PROVIDED TO CONSULTANT
IMCHS first phase documents (inception report, progress reports, evaluation reports, monitoring
reports, QoMNHS report).
Evaluation report on Fergana Region Pilot conducted by a UNICEF-hired independent
consultant (Z. Bhutta, Aga Khan Medical University Karachi, Pakistan);
Baseline study for IMCHS conducted by Tashkent Postgraduate Medical Institute under MoH;
Result-Oriented Monitoring Mission reports, based on the monitoring conducted by external
consultants hired by the donor (EC);
Project documents and reports, including Quarterly Narrative and Mission report
(UNICEF internal monitoring documents);
Projects monitoring database, including FUAT (Follow Up After Training) findings (joint
monitoring conducted by MoH, UNICEF, WHO);

 QoMNHC (Quality of Maternal and Newborn Health Care) hospital care for mothers and newborns system) report, based on the independent monitoring conducted by a UNICEF-hired
consultant (G. Tamburlini, Burlo Pediatric Hospital Trieste, Italy);
Available administrative data (from MoH and/or State Statistics Committee) and survey data
(MICS) on relevant indicators;
IMCHS Phase I Independent Evaluation and Final reports;
IMCHS II logframe.
Literature on participatory community processes and concept note on parenting schools
prepared by UCO in coordination with partners.
Other information sources will include relevant Government Decrees and available policy and
planning documents on MCH sector and its reform.
IY.THE EXPERT QUALIFICATION
The successful candidate should have the following qualifications:
Solid analytical, result based planning and report writing as well as academic writing skills;
At least 12 years of progressive professional experiences in the field of mother and child health
or Public Health;
Experiences in health administration, programme coordination, planning, monitoring and
evaluation;
Excellent knowledge of health systems of former Soviet Republics or CIS countries (health
systems in transition);
Familiarity with the new born and child survival packages in the Central Asian region;
Knowledge of bilateral/multilateral technical cooperation, particularly in MCH;
Familiarity with health promotion, demand creation and community participation strategies
Fluency in English with working knowledge of Russian language.
V. PLANNING AND IMPLEMENTATION ARRANGEMENTS
The Consultant may be briefed and debriefed on the project by UNICEF office in Tashkent. UNICEF
shall elaborate and make available to the Consultant an up-to-date status of the project. The UNICEF
Representative of Uzbekistan and his staff will also provide necessary substantive and administrative
support. Although the Consultant should be free to discuss all matters relevant to its assignment with
the authorities concerned, it is not authorized to make any commitment on behalf of UNICEF or the
Government. The Consultant will submit its report to UNICEF. The draft inception report should be
discussed with the Governments of Uzbekistan, the donors of the project and, to the extent possible,
with other parties of the project. The consultant, while considering the comments provided on the
draft, would use its independent judgment in preparing the final report.
The final inception report should be submitted to UNICEF no later than four week upon completion of
the mission. The inception report should be no longer than 50 pages, excluding annexes and the
executive summary. The report will be distributed by UNICEF as required to the governmental
authorities and respective donors.
The timetable for inception report Consultant as follows:
5 working days for desk review (three at home, 2 in Tashkent) and preparation of the field
mission;
22 working days in the field;

 10 working days for writing the draft inception report including the procurement component,
presentations and inter-action with stakeholders (consensus building) and 3 working days for
final report (at home);
Suggested dates for the field mission: Mid-September-November, 2012
The filed mission will include visits to the following localities:
Tashkent and selected regions of the Country to be agreed with UNICEF and MoH
End products:
The Inception Report, which should include executive summary, updated log frame, revised
budget calculations, assessment of methodology (including limitations), findings,
conclusions, recommendations, attachments with developed list of indicators and
questionnaires;
The report should be provided in both hard copy and electronic version in English in the
required UNICEF format;
Completed data sets (filled out questionnaires, records of individual interviews and focus
group discussions, etc.);
Equipment assessment report;
A power point presentation ready for the project launch in regions.
Deadline for submission: all end products to be submitted in one week after the completion of
mission
Estimated Cost of Consultancy:
The rate per day of professional fees will be in accordance with the complexity of the TOR and the
level of the expertise required, which is estimated at P4 level. UNICEF will pay for the Consultants
travel to and from Tashkent, Uzbekistan, DSA as well as for travel within Uzbekistan (if required), as
per UNICEF rules. Daily Subsistence Allowance will be provided for travel days as per UNICEF rules.
Professional fees will be paid on the successful completion of specific tasks and the satisfactory
approval of deliverables.
UNICEF reserves the right to withhold all or a portion of payment if performance is unsatisfactory, if
work/outputs is incomplete, not delivered or for failure to meet deadlines.
All materials developed will remain the copyright of UNICEF and that UNICEF will be free to
adapt and modify them in the future
VI. PERFORMANCE INDICATORS

Timely and accurate submission of the documents;

Substantive and linguistic quality of the documents prepared;
Conformity of the inception report with the format provided by UNICEF.
Report should contain recommendations for future course of action