Consultancy for Medical Health Services Management at International Rescue Committee

The health and nutrition teams are composed of program managers (2 Health managers, 2 RH/CHP Managers, 2 Nutrition Managers), 2 medical officers in charge of hospital, 7 medical officers, 2 Clinical officers in charge of Clinics, 20 Clinical officers, 2 Nursing officers in charge, 70 nurses, 4 pharmacists, 8 Lab technologists, 1 radiologist, 12 nutrition officers, and 11 Community Health officers). IRC engages 370 refugee incentive staff to support the qualified staff in various health facility departments and at the community level (271 CHWs, 99 Nutrition assistants).

The Field operations is led by the Senior Field Coordinator and the programs are supported by the administration/logistics team comprising of HR and Supply Chain team.IRC Kakuma program is grappling with a pediatric surge with an increase in pediatric admissions and mortality at IRC Ammusait Hospital (Level 4 facility), both at Pediatric and Stabilization Centre Wards. This is worsened by the drought, reduction in food rations, gaps in WASH and seasonal flu transmission. Most of the deaths reported occurred within 48 hours of admission with some cases being too critical/very ill before by the time of admission. A total of 585 children have been admitted and managed for the month of May, with 24 mortalities reported in both wards. The surge in admission has caused a strain to the existing health facilities especially in the main hospital inpatient unit. In Dadaab, the Stabilization center and pediatric wards have also seen an upsurge in admissions in the month of May. A total of 263 children have been admitted into the Pediatrics and SC during the month of May. The total number of deaths is 7.

Objective of the consultancy

• Assess the IRC capacity to respond to the current surge crisis of increase in number of patients, both at the IRC operated health facilities and the community level.
• Review the program management, skills, and competencies for the field management team in relation to crisis response and routine program management.
• Support the IRC Kakuma team in the development and implementation of surge preparedness and response plan, based on comprehensive data review and needs including required resources.
• Facilitate management capacity and good governance at the field and Nairobi levels to lead health development, strengthen the different pillars of the health.

Expected outcome

• Submit a report to IRC SMT on Medical Services Management at Kakuma and Dadaab highlighting the staff capacity/competencies, key management strengths/challenges and recommendations
• Improved Management of Health services at IRC Kakuma and Dadaab field operations.

Tasks to be performed

Acting independently but with full consent to access of resources from the Kakuma and Dadaab team, the consultant shall review the IRC Health and Nutrition program regarding the current surge crisis and health services preparedness and planning. He/ She will:

• A ssess the clinical services management at OPD and inpatient departments of the hospital with respect to capacities and gaps in operational sufficiency to provide timely and accurate clinical care for patients,
• Determine and execute immediate interventions to address the current gaps particularly to mitigate mortality trends and improve the quality of care at OPD and IP for the current surge.
• Monitor the functioning of the OPD and IPD providing advice on the organization of the clinics and wards including consultations, admissions, transfer, and discharge.
• Provide advice on the procedure for referrals and support in the timely referrals as required.
• Contribute to data analysis, monitoring and reporting aiming at improving the quality of care.
• Provide a report on the status of IRC medical services surge response outlining the actions undertaken and key recommendations for IRC SMT to provide immediate support.

Health services preparedness planning

• Conduct a Services Availability and Readiness Assessment of IRC medical/ clinical and community health services to respond to morbidity surge crisis and provide recommendations.
• Assess the Health Workforce (HW) profile and proficiency for outbreak/ surge preparedness and response and recommend HW learning and development activities that are relevant to clinical care.
• Assess the Risk Communication and Community Engagement (RCCE) needs for the current seasonal morbidity trends and provide recommendations for RCCE interventions.
• Develop a health facilities readiness/ preparedness action plan outlining all relevant actions to be taken at all stages pre, during and post emergency crisis.
• Develop an implementation plan for rolling out the preparedness plan at IRC health facilities.