Duration: 3-4 months

Project Background:

GAVI REACH (Reaching Every Child within Humanitarian settings) is implementing and innovative program is a 3.5-year project with the goal of ensuring that “systematically missed communities and Zero-Dose Children (ZDC)  in fragile, conflict and cross-border regions outside of government reach in countries from the Horn of Africa (Somalia, Ethiopia, Sudan and South Sudan) are sustainably reached by quality immunization services integrated with primary healthcare  (PHC) platforms.”  Zero-Dose Children refers to children who have not  received any routine vaccination antigen,  while under immunized children refers to those who, for different reasons, received one dose, but not a third protective dose. To realize this ambition, the project must develop, implement, and monitor various strategies for encouraging service supply and uptake by hard-to-reach populations.

The project has three distinct phases:

Identify: This phase seeks to identify and quantify ZDC: understand geographic distribution, barriers, and characteristics of ZDC communities.

Reach: This phase seeks to negotiate access, address supply and demand barriers and increase coverage of immunization services.

Monitor, manage & learn: This last phase seeks to use data for action, foster learning, and ownership for equitable and sustainable immunization outcomes and scale-up.

GAVI, the Vaccine Alliance, plays a crucial role in supporting the global immunization effort by providing funding to UNICEF. This funding enables UNICEF to procure and deliver vaccines at the national central warehouse level. Working closely with the ministry of health (MOH), UNICEF collaborates to determine the required quantity of vaccines, secure their procurement, and ensure proper storage at the central warehouses. Once the vaccines are ready, they are distributed through the MOH/UNICEF supply chain system, starting with the regional warehouses, and then extending to the district and sub-district levels. This comprehensive distribution network ensures that vaccines reach even the most remote areas. To ensure that zero-dose children and missed children in the GAVI-REACH target areas receive the vaccines, the International Rescue Committee (IRC) will access the vaccines from the MOH supply chain and take responsibility for delivering them to the last mile. This coordinated effort will ensure that life-saving vaccines reach those who need them the most, making a significant impact on global health.

GAVI REACH project rolled out implementation of various activities through a phased approach in October 2023, starting with those that were accessible, then gradually progressing to those partially accessible and inaccessible ones. Last mile delivery of vaccines remains critical to the success of the project across the 156 selected locations (districts, woredas, counties) in the four HOA countries. REACH has progressively engaged the MOH for supply of both cold chain equipment and vaccines. 

Purpose:

The purpose of this consultancy is to conduct a comprehensive assessment of the immunization supply chain (iSC) in four GAVI REACH countries (humanitarian settings) namely Ethiopia, Somalia, South Sudan, and Sudan. The assessment will cover various aspects, including quantification, procurement, warehousing, distribution, cold chain logistics, quality assurance, stock management and last mile delivery. The assessment aims to identify gaps, challenges, and opportunities for improving the efficiency and effectiveness of the immunization supply chain in the given contexts and make recommendations to strengthen immunization chain (iSC) to ensure last mile delivery within the project locations. The assessment will specifically be done for the national level, regional level (where the project is implements), and the subnational level REACH locations.

The consultant will work under direct supervision of the IRC Pharmacy adviser and technical the REACH project Immunization Adviser.

Objectives:

The consultant will be responsible for achieving the following objectives:

Assess the existing immunization supply chain system, including all relevant processes, stakeholders, and infrastructure.Identify strengths, weaknesses, and bottlenecks in the supply chain, from quantification and procurement to last mile delivery of vaccines.Evaluate the effectiveness of cold chain logistics, including storage, transportation, and maintenance of vaccines and related supplies.Review the quality assurance mechanisms and practices in place for vaccine storage, handling, and distribution.Identify capacity building needs and training requirements for supply chain personnel especially on cold chain management.Provide recommendations for improving the efficiency, reliability, and accountability of the immunization supply chain.Develop a comprehensive report outlining the assessment findings, recommendations, and an action plan for implementation.

Roles and Responsibilities:

The consultant will be responsible for the following tasks:

Review relevant documentation, policies, and guidelines related to the immunization supply chain.Conduct interviews and consultations with key stakeholders, including government officials, health personnel, logistics providers, and IRC staff.Develop a comprehensive methodology the immunization supply chain (iSC) assessmentConduct field visits to health facilities, warehouses, and distribution points to observe and assess the immunization supply chain processes.Collect and analyze data on vaccine consumption, stock levels, distribution patterns, and cold chain equipment performance.Collaborate with the relevant authorities to collect information on procurement processes, inventory management, and quality assurance.Engage in discussions with stakeholders to identify challenges, gaps, and potential solutions for improving the immunization supply chain, particularly for hard-to-reach areas.Develop an action plan with specific recommendations for addressing identified gaps and challenges.Present the assessment findings, recommendations, and action plan to key stakeholders.

Deliverables:

The consultant will be expected to deliver the following:

Inception report: Outline the consultant's understanding of the assignment, proposed methodology, and work plan.Assessment methodology: Develop a comprehensive immunization supply chain assessment methodology.Assessment report: A comprehensive report highlighting the assessment findings, including strengths, weaknesses, and recommendations for improving the immunization supply chain. The report should include a clear action plan for implementation and recommend the lead & dependencies for each action. The report must mention risks and blockages that may impact the success of any intervention.Presentation: A presentation summarizing the assessment findings, recommendations, and action plan, to be delivered to key stakeholders.Dissemination: Disseminate the finding to key stakeholders across the four countries.Capacity building plan: A detailed plan outlining the training and capacity building needs identified during the assessment, with recommendations for implementation.Final report: A final report incorporating feedback received during the presentation and including any additional information or adjustments deemed necessary.

 

Key Aspects of the Assessment:

1) Effective Vaccine Management

In addition to the main objectives and responsibilities outlined above, the consultant will also explore relevant aspects of effective vaccine management during the assessment (at national, relevant Regional/ subnational, and REACH locations). This will ensure a comprehensive understanding of the entire supply chain and focus on achieving last mile delivery of vaccine products, from the national level to the REACH locations. The consultant will specifically address the following areas:

Vaccine storage and handling: Assess the storage facilities at health facilities and warehouses, including temperature monitoring, stock rotation, and adherence to recommended storage conditions. Identify any gaps or challenges in vaccine storage and handling practices.Cold chain equipment: Evaluate the functionality, maintenance, and availability of cold chain equipment such as refrigerators, freezers, and temperature monitoring devices. Identify any issues related to equipment performance, maintenance protocols, reliable sources of power and availability of spare parts.Vaccine transportation: Assess the transportation methods used for vaccine distribution, including cold chain requirements during transit. Identify any challenges related to transportation logistics, including capacity, reliability, and temperature control.Data management: Review the systems and processes for vaccine data management, including stock management, consumption tracking, and reporting mechanisms. Assess the availability and accuracy of data for informed decision-making and accountability.Vaccine wastage: Analyze vaccine wastage rates related to the GAVI-REACH program and identify factors contributing to wastage at various levels of the supply chain. Provide recommendations for reducing vaccine wastage and improving efficiency in vaccine utilization.

2) Remote or Hard-to-Reach Areas

In the context of remote or hard-to-reach areas (REACH locations), the assessment should consider the unique challenges and considerations associated with supply chain management in such locations. The consultant should incorporate the following aspects into the assessment:

Accessibility and Transportation: Evaluate transportation infrastructure and modes available for delivering vaccines and supplies to remote areas. Assess logistical challenges related to limited access, adverse weather conditions, or seasonal restrictions.Cold Chain Capacity: Assess availability, functionality, and maintenance of cold chain equipment in remote areas. Evaluate the capacity to maintain temperature requirements during transportation and storage.Stock Management and Resupply: Assess stock management practices, including inventory control and resupply mechanisms in remote areas. Identify challenges related to monitoring, order placement, and timely resupply.Communication and Information Systems: Evaluate communication systems and information exchange between remote areas and central supply chain entities. Assess data visibility and communication challenges.Local Capacity Building: Assess the capacity and skill level of local healthcare workers involved in the supply chain. Identify training and capacity building needs specific to remote settings.

Duration of the assessment

The assessment will take place from September to November 2023, and the final report will be submitted in December 2023. The assessment will take place from September to November 2023, and the final report will be submitted in December 2023.

Budget:

The estimated budget for this assignment is $XX. This amount is expected to cover the costs of a lead consultant, and field-level data collection activities. The daily rates for the lead consultant will be for a fixed number of days.