Associate, Service Delivery & New Vaccine Introduction at Clinton Health Access Initiative

Program (Divison): SRMNCH - Global Vaccines

Overview of CHAI's Vaccines program

• Immunization is one of the most successful public health interventions in history. National immunization programs reach >100 million infants every year and have averted globally two to three million deaths every year since the launch of the Expanded Program for Immunization (EPI) in 1974 , whilst the pneumococcal conjugate vaccine (PCV) and rotavirus vaccines could save ~1 million lives per year.
• Furthermore, great advances in discovering and financing new vaccines provides a great opportunity for countries to further reduce burden of disease such as human papillomavirus (HPV). Despite these successes, 1.5 million children still die each year of vaccine-preventable diseases, many of them in low-income countries, as immunization programs there face unprecedented challenges.
• Since 2010, the Clinton Health Access Initiative (CHAI) has worked to save lives and reduce the burden from vaccine preventable diseases by improving access to immunization services in resource-limited setting by strengthening national immunization programs and by leveraging its experience in-country to improve the global immunization ecosystem.

CHAI is pursuing six complementary strategic goals:

• Improving affordability and supply security of immunization products;
• Accelerating the uptake of new or under-utilized vaccines;
• Enhancing the performance of vaccine cold chain and logistics systems to increase effective immunization coverage;
• Improving the design and implementation of service delivery to reach the unreached;
• Supporting successful transition from Gavi support; andStrengthening the management system and capacity of immunization programs;
• CHAI's vaccine program very closely supports the national immunization programs in 11 focus countries - Cameroon, Ethiopia, India, Indonesia, Kenya, Lao PDR, Lesotho, Nigeria, Tanzania, Uganda and Vietnam- and also engages with global stakeholders such as Gavi, WHO and UNICEF to inform global policies and practices.

Immunization Service Delivery:

• Despite significant gains made in immunization coverage from 21% in 1980,[1] global DTP3 coverage has stalled at approximately 85% since 2010, while in 2018 DTP3 coverage in West and Central Africa stagnated at 70%, and in East and Central Africa was at 81%[2].
• As a result, nearly one quarter of children under-5 in the region are under- or unimmunized. Immunization coverage is generally much lower for vaccines that are delivered via weaker or complex delivery platforms, such as maternal, neonatal, 9-month, second year and adolescent - whether current vaccines or those slated for introduction.[3] For example, West and Central Africa has stagnated at ~70% measles conjugate vaccine / measles rubella vaccine first dose (MCV1/MR1)[4] coverage since 2010.[5]
• CHAI therefore will develop, test, and scale innovative service delivery interventions in focus countries, with the objective to increase coverage in priority populations in a way that can be scaled and sustained by governments. CHAI will support governments to:
  • Improve the planning and the performance management of immunization sessions;
  • Improve the linkages of maternal and newborn health services with immunization to increase routine immunization coverage and strengthen the neonatal platform used for OPV, BCG, and HepB birth dose;
  • Increase the routine coverage of the nine-month platform (when vaccines against measles, yellow fever, meningitis A or Typhoid should be administered); and
  • Develop better informed coverage plans and support the implementation of key service delivery strategies to target unimmunized children. CHAI will distill the tools and lessons learned from this work in focus countries and disseminate them to the global community. 

Position Overview

• We are seeking an Associate to join the Global Vaccines Delivery team and support CHAI's work in improving coverage and equity through new vaccine introductions and enhancing service delivery across focus countries.
• We are seeking a motivated and mission-oriented individual with strong analytic, problem-solving, and cross-cultural communication skills.
• The candidate should be experienced at presenting data and messages powerfully through written documents and presentations; working collaboratively in a fast-paced, multi-cultural environment; and functioning independently with minimal guidance.

This role will be based in a CHAI program country, pending country team leadership approval.

• CDC. Global Routine Vaccination Coverage, 2016. https://www.cdc.gov/mmwr/volumes/66/wr/pdfs/mm6645a3-H.PDF
• WHO. Regoinal Immunization Snapshots, 2020. https://data.unicef.org/resources/regional-immunization-snapshots/
• Since 2011, the uptake of impactful new vaccines, including Pentavalent, PCV and Rotavirus, has significantly progressed, enabled by financial support from Gavi and partners. However, these vaccines relied upon the most effective delivery platform in most countries, one that reaches children between the second to fourth month of life.
• Please see Appendix 4: Acronyms for guidance with acronyms and abbreviations
• WHO. Regoinal Immunization Snapshots, 2020. https://data.unicef.org/resources/regional-immunization-snapshots/

Responsibilities
Key responsibilities for this role include, but are not limited to:

Provide strategic and programmatic support for the design and implementation of in-country work to improve immunization coverage and equity in a sustainable manner:

• Provide input on the approach needed to meet in-country grant and program objectives related to immunization management systems, in line with the program strategy
• Contribute to the design, planning and implementation of high-impact work with CHAI’s local country teams to sustainably transform service delivery in CHAI focus Projects could include:
  • Diagnose supply- and demand- side service delivery bottlenecks and developing strategies and interventions for improvement; re-design service delivery strategies for reaching unvaccinated children; develop robust monitoring and evaluation frameworks in which to assess impact of interventions; support governments in codifying results for advocacy to affect policy and practice changes; support governments in designing strategies for scale up
  • Support decision making on new vaccine introductions, robust planning and budgeting for new vaccine rollout, identifying risks to successful introductions, diagnose bottlenecks and designing bottleneck mitigation strategies pre- and post-introduction, identify concrete opportunities and best practices for simultaneously boosting new and routine immunization coverage
  • Explore and develop cross-country intiatives, for example sharing lessons and ideas between CHAI focus countries and exploring relationships/trends which inform CHAI’s work in several countries
• Drive continuous development and effective dissemination and use of programmatic "tool kit", lessons learned, and other know-how related to service delivery across CHAI's vaccines program focus countries. Elements of the tool kits may include, but are not limited to:
  • Resource allocation and planning of outreach sessions, including “rule of thumb” guidance for estimating resource needs for outreaches from available data (e.g. population distance to facility), especially in instances where bottom-up estimates from facilities or communities are unavailable
  • Improved global policies and guidelines to ensure better coordination across EPI and MNH programs (e.g. updating of WHO’s Safe Birth Checklist to include HepB birth dose vaccination prior to mother/newborn discharge from health facility)
  • Technical support (tools, information and lessons learned developed across CHAI’s work) provided to country governments and partners and through global mechanisms that support service delivery and/or new vaccine interventions

Inform national and global practices and policies related to immunization service delivery:

• Inform practices & policies based on robust evidence base, insightful analytical perspective, and lessons learned from CHAI and other partners to immunization service delivery and increase coverage & equity
• Develop relationships with key stakeholders in relevant areas (ie. Gavi, WHO, UNICEF SD, Bill & Melinda Gates Foundation, PATH, JSI, Sabin etc.) and establish yourself as a respected and trusted thought leader in this area of focus within CHAI and within the global immunization community
• Disseminate CHAI's programmatic insights to the global immunization community to inform policy and practices

Support the development of CHAI's vaccines program, in collaboration with program and country leadership:

• Support development of program-wide and country-specific objectives and strategies regarding immunization service delivery
• Support scoping and development of new grants
• Develop program thought leadership in immunization service delivery to deliver against current and future goals

Support program and grant management, in collaboration with program and country leadership:

• Assess progress against overall objectives & milestones in areas of focus and help prepare high-quality briefings for donors and CHAI management, including achievements to date, action plan going forward, and key risks & opportunities
• Assess effectiveness of CHAI's theory of change and approach related to immunization service delivery in focus countries and recommend improvements
• Contribute as a member of the global vaccine team to the effectiveness and collegiality of the team, help identify opportunities and improve CHAI’s vaccines program and team

Qualifications

• Bachelor's degree (Masters-level or above in business, finance, or health science preferred) + at least 3 years of relevant professional experience in public or private sector
• Exceptional problem-solving and analytical skills (qualitative and quantitative), including experience with quantitative modeling, data analysis, and study design
• Excellent interpersonal and cross-cultural communication skills, with proven track record of building strong & effective working relationships remotely
• Excellent ability to work independently, set and achieve ambitious targets with limited guidance, and manage competing and sometimes shifting priorities, often under tight deadlines
• Proficiency at Microsoft Excel or other data-analysis tools (specialized modeling or programing experience is NOT required)
• Excellent communication skills in English (including synthesis & presentation) with diverse audience
• Demonstrated capacity to synthesize evidence into an effective presentations and actionable recommendations for broad range of audience, including Ministries of
• Health, global donors and policymakers
• Ability to travel extensively (at least 35% of time) to focus countries and other locations as needed for work  

Advantages:

• Knowledge and experience in vaccines, health systems strengthening, and/or health financing
• Experience working in management consulting, investment banking, or similar fast-paced, output-oriented environments
• Experience working with government and in developing countries, notably in Sub-Saharan Africa
• Professional proficiency in a second language of a vaccine program country