Adhoc Staff for Health Facility Assessment

Nigeria continues to bear one of the highest burdens of maternal, newborn and child mortality globally. Many of these deaths are preventable through the provision of high-quality, evidence-based reproductive, maternal, newborn, child and adolescent health plus nutrition (RMNCAH+N) services, timely referral, and functional emergency obstetric and newborn care. To support the Government of Kebbi State in improving the quality of RMNCAH+N services, UNICEF, through Jhpiego, is implementing the project titled: "Strengthening Reproductive, Maternal, Newborn, Child and Adolescent Health plus Nutrition (RMNCAH+N) Quality of Care in Primary Health Care Facilities of Kebbi State." The project will strengthen the quality of maternal and newborn healthcare services across 10 MAMII-priority Local Government Areas (LGAs) through health system strengthening, quality improvement (QI), supportive supervision, mentorship, Maternal and Perinatal Death Surveillance and Response (MPDSR), emergency referral systems, and capacity building of healthcare workers.
As part of the project inception activities, Jhpiego will conduct a comprehensive baseline Health Facility Assessment (HFA) to determine the readiness of participating facilities to deliver quality RMNCAH+N services.
The assessment will cover:

• 108 Primary Health Care Centres (one PHC per ward)
• 10 General Hospitals (one per participating LGA)
• Kalgo Medical Centre (KMC)
A total of 119 health facilities will therefore be assessed.

Purpose of the Health Facility Assessment
The baseline Health Facility Assessment seeks to determine the readiness of participating health facilities to deliver high-quality RMNCAH+N services and identify priority gaps requiring intervention during project implementation. Specifically, the assessment will provide baseline information on:
• Infrastructure readiness
• Human resources for health
• Availability of essential medicines and commodities
• Equipment functionality
• Infection Prevention and Control (IPC)
• Water, Sanitation and Hygiene (WASH)
• Laboratory capacity
• Blood transfusion services
• Maternal and newborn emergency care
• Referral systems
• MPDSR implementation
• Quality Improvement (QI) structures
• Adolescent and Youth-Friendly Health Services
• Nutrition services
• Health Management Information Systems (HMIS)
• Digital readiness for quality improvement interventions

Assessment Coverage
The Health Facility Assessment will be conducted in:
Facility Type Number
Primary Health Care Centres 108
General Hospitals 10
Kalgo Medical Centre 1
Total 119

Assessment Team Composition
A total of 24 Health Facility Assessors will be recruited.
The assessors will work in 12 assessment teams, each comprising:
• Two Assessors
Each team will assess approximately 10 health facilities during the field exercise.
Assessment teams will be supervised by Jhpiego Technical Staff and representatives from:
• Kebbi State Ministry of Health
• State Primary Health Care Development Agency (SPHCDA)
• UNICEF

Under the supervision of Jhpiego, the Health Facility Assessors will conduct standardized assessments of assigned health facilities using the approved electronic Health Facility Assessment Tool.
The consultants shall:
• Conduct comprehensive assessments of assigned health facilities.
• Verify infrastructure, equipment, medicines and commodities.
• Observe service delivery areas.
• Review facility registers and records.
• Interview facility managers and healthcare workers.
• Verify implementation of RMNCAH+N Quality Improvement structures.
• Assess emergency obstetric and newborn care readiness.
• Assess referral systems and emergency transport arrangements.
• Assess MPDSR committee functionality.
• Assess infection prevention and control measures.
• Assess availability of adolescent-friendly services.
• Assess nutrition service readiness.
• Upload complete and accurate electronic assessment data daily.
• Participate in daily debriefing meetings.
• Ensure confidentiality and integrity of all data collected.

Specific Responsibilities
The adhoc shall work closely with Jhpiego Technical Staff to:

1. Participate in Training
• Attend a one-day Health Facility Assessment training.
• Participate in field pre-testing of assessment tools.

• Demonstrate competency before deployment.

2. Conduct Facility Assessments
Visit assigned facilities and complete all assessment modules, including:

Facility Profile
• Ownership
• Level of care
• Catchment population
• Staffing
Infrastructure
• Buildings
• Electricity
• Water supply
• WASH facilities
Human Resources
• Skilled Birth Attendants
• Medical Officers
• Midwives
• CHEWs
• Laboratory personnel
RMNCAH+N Services Assess availability and quality of:
• ANC
• Labour and Delivery
• EmONC
• Postnatal Care
• Family Planning
• Child Health
• Nutrition
• Adolescent Health
Equipment Assessment
Verify availability and functionality of:
• Delivery beds
• Oxygen
• Suction machines
• Sterilizers
• Newborn resuscitation equipment
• Blood pressure machines
• Weighing scales
• Ultrasound (where available)
Medicines and Commodities
Assess availability of:
• Oxytocin
• Magnesium Sulphate
• Misoprostol
• Antibiotics
• IV fluids
• Iron/Folic Acid
• Family Planning commodities
• Nutrition commodities
Laboratory
Assess availability of:
• Hemoglobin testing
• Urinalysis
• Blood grouping
• Cross-matching
• Malaria testing
Quality Improvement Assess:
• Facility Quality Improvement Teams
• QI meetings
• QI projects
• Clinical audits
MPDSR Assess:
• MPDSR Committee
• Meeting frequency
• Review documentation
• Action tracking
Referral System Assess:
• Ambulance availability
• Referral protocols
• Referral documentation
• Emergency transport linkages
• Communication systems
Digital Readiness Assess:
• Computers
• Internet access
• Tablets
• HMIS functionality
• Electricity reliability

3. Data Quality Assurance
The consultants shall:
• Complete all electronic forms.
• Validate data before submission.
• Resolve inconsistencies immediately.
• Upload data daily.
• Maintain confidentiality.

4. Daily Debriefings
Participate in daily review meetings with Jhpiego Technical Team to:
• Review progress.
• Discuss challenges.
• Resolve data quality issues.

Deliverables
Each Health Facility Assessor shall submit:
• Completed electronic Health Facility Assessment forms for assigned facilities.
• Daily progress reports.
• Data quality reports.
• Field observation notes.
• Final field activity report.

The preferred adhoc staff should possess:

Education
• Bachelor’s degree in Medicine, Nursing, Midwifery, Public Health, Health Sciences, Health Information Management or related field.

Experience
• Minimum three years' experience in health facility assessments, RMNCAH+N programmes, surveys, monitoring and evaluation, or quality improvement.
• Experience using electronic data collection platforms (ODK, KoboCollect, SurveyCTO or REDCap).
• Experience in maternal and newborn health programmes.

Skills
• Excellent interviewing skills.
• Knowledge of EmONC and RMNCAH+N.
• Good analytical skills.
• Ability to work in remote communities.
• Strong report-writing skills.
• Familiarity with Kebbi State health system is an advantage