New Job Vacancies at Save the Children

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Introduction

• Nigeria has the largest population in Africa with a currently estimated population of over 175 million people1, increasing at 3.1 percent annually (2006 census). The total population of female aged 15-49 years, which constitute women of reproductive age, represents 51 percent of the total population of women; while adolescent girls aged 15-19 constitute over 11 percent of the same population.
• These segments of the population are major contributors to fertility as explained by the prevailing high Total Fertility Rate of 5.5; which ranges from as low as 4.7 in the urban to as high as 6.2 in the rural areas.
• Based on the 2013 NDHS, 13.7percent of teenage girls in Nigeria are already mothers or pregnant with their first child and most of these girls lack access to appropriate health care arrangements for safe conditions during pregnancy, labour and delivery and the post-partum and neonatal period.
• This persistence of high maternal and perinatal mortality calls for a review of existing strategies. Adopting the Maternal and Perinatal Death Surveillance and Response (MPDSR), which is a veritable process of identifying both direct and indirect causal factors of these deaths, will enhance the efforts at preventing further deaths and provide more credible data than currently exists.
• The country’s health system has two broad categories: the public and the private-for-profit facilities. The public health facilities are stratified into three levels: the primary, secondary and tertiary.
• These are respectively operated by the Local Government Area, State and Federal Governments. It is estimated that the private sector accounts for about 72% of the secondary level health care facilities in Nigeria.

Background

• The expected medical and social outcome of every intended pregnancy is to have a healthy mother with a baby that is endowed with full potentials for its own existence and survival. This outcome is cherished in Nigeria that is home to one-in-five Africans, with its population of over 175 million, an estimated 1% of global population.
• Incidentally, the country accounts for a disproportionate 10% of global maternal deaths; with the death of 33,000 women each year, and for every maternal death at least seven newborns die and a further four babies are stillborn. If the country’s quests to attain the Millennium Development Goals 4 & 5 by 2015 and be ranked among the top 20 leading global economies by 2020 are to remain on course, these mortalities must be sharply reduced.
• Recent global estimates suggest that annual pregnancy-related deaths of more than 4.3 million continue to outstrip the combined burden of deaths from AIDS, Tuberculosis and Malaria of 3.9 million, despite international efforts. Almost 99% of these deaths occur in the developing countries while Sub-Sahara Africa accounts for more than half of all.
• A similar pattern applies to perinatal deaths. A major reason for the wide disparity in these burdens of maternal and perinatal deaths across countries rest in the manner the problem is confronted; whereas known evidence-based interventions are deployed into preventing maternal and perinatal deaths in the developed countries, this is less applicable to their developing counterparts.
• Secondly, for every maternal and perinatal death that occurred in the former, a review is carried out to understand and identify gaps in services that warranted the death with a view to preventing recurrences.
• This medical audit process, which compels the health system to reflect on what might have gone wrong at each maternal death is non-existent in many developing countries including Nigeria.Researches on maternal and perinatal mortality in Nigeria and elsewhere have shown that the leading causes of both are linked and are preventable.
• In Nigeria, the common causes of maternal deaths are haemorrhage, infections, hypertensive diseases, obstructed labour and unsafe abortion; similarly, most perinatal deaths result from perinatal hypoxia, preterm delivery and infection.
• Although these factors prevail in both developed and developing countries, the issues are compounded in the latter by the socio-cultural milieu, poverty, lack of essential amenities and deficient health care services.
• Although these sporadic surveys have given these broad insights into the determinants of maternal and perinatal deaths, their findings fall short of the needed information for preventing future deaths in the different locations and settings of Nigeria where large numbers of deaths of mothers and newborns occur.

Purpose of Consultancy

• The Purpose of this consultancy is to Edit The National Guidelines and tools for Maternal and Perinatal Death Surveillance and Response in readiness for printing. This will in turn facilitate the scale up of its implementation.

Key Skills/ Experience and Tasks

• An experienced Editor with specialisation in Health or related fields, of not less than 10 years in practice.
• Have been involved or managed MNCH projects in the past.
• Past experience in development/ review of similar documents will be a major advantage.
• Must have sound communication, analytical and writing skills
• As at when necessary liaise with the State Ministries of Health, NPHCDA, FMOH, NGOs and other key stakeholders in the process of executing this consultancy.

Deliverables:

• Revised National Guidelines and Tools on Maternal and Perinatal Deaths surveillance and Response in electronic versions.
• A comprehensive report of the consultancy.
• All submissions shall be in both electronic and hard copies.