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Ref.
2023/CG/9501

Job offer type
Experts

Type of contract
Service contract

Activity sectors
Non communicable diseases ; Health policy ; Health systems

Sub-theme
Cancer

Deadline date
2023/06/05 23:59

Duration of the assignment
Short term

Contract
Freelancer

Duration
3 mois

Mission description

Objectives of the consultancy:

 Job Description:

The SUCCESS project will be engaging a consultant to conduct a data collection exercise to work with other team members to collect the data needed for the cost study. 

The consultant will be responsible for the following:

  • Technical meetings with project counterparts to share with the consultant the adapted C4P tool and the data needs to be collected.
  • Preparation of a work plan with a detailed schedule of activities.
  • Validate the source of the female population, according to age groups included in the C4P-SUCCESS tool, considering the reference year and the annual growth rate.
  • Validate the annual targets for the five years of the projection with the designated MPSAS and project counterparts.
  • Compilation of activities and units required for the costing of the following screening tests, triage methods and treatment including the categories of human resources, supplies and materials, as well as other direct costs that take place in different levels of facilities:
    • Screening tests: HPV DNA by provider and self-testing modality; visual inspection with acetic acid (VIA) and Cytology (Pap smear).
    • Triage methods: Visual inspection with dilute acetic acid and colposcopy.
    • Treatment methods: Cryotherapy, thermoablation; Loop electrosurgical excision (LEEP), including biopsy and histopathology.
    • Cost: Loop electrosurgical excision procedure (LEEP), including biopsy and histopathology.
  • Validate with MSPAS and SUCCESS project counterparts, the health facilities by type of care package and the estimated number of health facilities to be financed per year according to the following categories:
    • Facilities that perform any procedure requiring basic gynecological equipment
    • Health facilities that perform primary HPV DNA screening by provider sample collection modality with the capacity to follow up on positive cases.
    • Health facilities that perform primary HPV DNA screening by the self-collection modality with the capacity to follow up positive cases.
    • Laboratories with HPV DNA test processing capability
    • Health facilities with VIA capabilities
    • Health facilities with the capacity to perform Pap smears
    • Health facilities with capacity to perform Colposcopy
    • Health facilities with the capacity to perform Cryotherapy
    • Health facilities with capacity to perform Thermoablation
    • Health facilities capable of performing Loop Electrosurgical Excision Procedure (LEEP), including biopsy and histopathology.
  • Collect data on additional equipment required, according to the type of health facility and care package.
  • Compile data for estimation of Service Unit capacity and staffing requirements
  • Validate with MSPAS and SUCCESS project counterparts the type of activities (planning, coordination, training, etc.), and the amount to be carried out in each year of the projection.
  • Validate and update the costs of the following categories, included in the database: type of personnel, supplies and materials, other direct costs, equipment costs, included in the C4P tool.
  • Compilation of other primary and secondary costs identified by consulting counterparts.
  • Report weekly to the study team on the progress of data collection.
  • 3-5 cost validation meetings to validate collected costs with MSPAS counterparts.
  • Attend weekly team meetings
  • Requests for support from the study team

 Products

Final consulting report including:

  • Validated reference population
  • Type of services per screening and treatment services portfolio and number to include per projection year
  • Validation of costing units and quantity by type of screening, triage and treatment.
  • Country-adjusted cost categories, validated with counterparties.

Confidentiality of information and intellectual property

The contracted company and its personnel undertake to carry out the assigned tasks in accordance with the highest standards of ethical competence and professional integrity. All data collected and databases are confidential, and therefore may not be shared or used in other media by the consulting team.

The ownership, title and industrial and intellectual property rights of the results of the consultancy, as well as of the reports and other documents produced, are the property of the SUCCESS Project.

At the beginning of the process, the team must sign a confidentiality and intellectual property agreement.

Expected execution period:

  • From June 2023 to October 2023

Project or context description

Introduction:

Cervical cancer is one of the most common preventable forms of cancer, but it is the fourth most common cancer among women globally and the leading cause of death among HIV-infected women. [1],[2],[3] An estimated 604,127 new cases of cervical cancer were diagnosed worldwide and 341,831 women died from the disease in 2020. An overwhelming majority (90%) of these cervical cancer deaths occur in low- and middle-income countries (LMICs), which often have poor health infrastructure.[4] Nearly all cases of cervical cancer (99%) are related to infection with high-risk human papillomavirus (HPV), an extremely common virus transmitted through sexual contact.[5],[6]  

To address this situation, the World Health Organization (WHO) has launched a strategy to accelerate the elimination of cervical cancer worldwide. This strategy aims to ensure that, by 2030, 90% of girls are vaccinated against HPV, 90% of adult women have access to screening services with a highly effective test, and 70% of women with cancer or precancerous lesions receive the treatment they need.

In Guatemala, cervical cancer continues to be the second most frequent cancer among women, and the leading cause of cancer deaths in women. It is estimated that 872 women die each year, and 1,555 new cases are detected.4 For this reason, the State of Guatemala, through the Ministry of Health and Social Assistance, has joined this initiative and updated its Comprehensive Care Guide for the prevention, detection and treatment of cervical cancer precursor lesions, which includes guidelines for vaccination against HPV, the offer of screening tests including Pap smears, Visual Inspection with Acetic Acid and HPV DNA tests, and finally guidance on methods of precursor or precancerous lesions.

WHO estimates that a total of USD 10.5 billion is required to finance cervical cancer eradication in low- and low-to-middle-income countries by 2030, where a large portion of this amount (equivalent to USD 1.8 per capita) should be frontloaded to rapidly establish and scale up services; 6.2 USD of this figure is needed for vaccination programs; 2.1 USD for facility utilization; 1.3 USD for consumables, 0.5 USD for human resources and 0.4 USD for equipment; by 2019 TogetHER for Health, reported that only one-seventh of this amount was invested in these countries[7] .

In this context, the SUCCESS (Scale up cervical cancer elimination with secondary prevention strategy) project is supporting four countries (Guatemala, Burkina Faso, Côte d'Ivoire and the Philippines) to expand their screening programs with an emphasis on HPV DNA testing and ablative treatment of precancerous cervical lesions as part of their interventions, the project plans to estimate the costs of implementing cervical cancer prevention interventions over a 5-year period in each of the implementing countries and, in the case of Guatemala, involves an exercise to estimate the costs of integrating secondary prevention (screening) and tertiary prevention (early treatment of precancerous lesions) into the continuum of care through services  integrated into MSPAS health facilities; this also includes a comparative analysis of costs in different potential scenarios. This is part of a transition plan that will allow MSPAS, to optimize national funds and other sources of funding in the financing of screening and ablative treatment services, through a phased implementation in its network of services.

This exercise will be conducted using an adapted version of the Costing Tool for Cervical Cancer Prevention and Control (C4P), developed for WHO. This tool is intended for use by LMIC program managers to plan cervical cancer control strategies and make multi-year cost projections. It uses a bottom-up, input-based approach (i.e., unit cost X quantity of good or service). The C4P-SUCCESS tool will reflect the country's screening and treatment algorithm.

These costs will include two broad categories:

  • Provision of services (e.g., personnel salaries, equipment, supplies, laboratory fees), and
  • Program support activities (e.g., training, IEC development and deployment, supervision, M&E).

[1]World Health Organization. Global strategy for accelerating the elimination of cervical cancer as a public health problem and its associated goals and targets for the period 2020-2030. Vol 2.; 2020.

[2] World Health Organization. Analysis and use of data from health facilities: guidance for HIV program managers.; 2018. https://www.who.int/healthinfo/FacilityAnalysisGuide_HIV.pdf

[3] Kelly HA, Sawadogo B, Chikandiwa A, et al. Epidemiology of high-risk human papillomavirus and cervical lesions in African women living with HIV/AIDS: effect of antiretroviral therapy. AIDS. 2017;31(2):273-285.

[4] UICC. GLOBOCAN 2020: New Global Cancer Data.; 2020. https://www.uicc.org/news/globocan-2020-new-global-cancer-data.

[5] UICC. GLOBOCAN 2020: New Global Cancer Data; 2020. https://www.uicc.org/news/globocan-2020-new-global-cancer-data. https://www.uicc.org/news/globocan-2020-new-global-cancer-data.

[6]Castle PE, Glass AG, Rush BB, et al. Clinical detection of human papillomavirus predicts cervical cancer risk in women over 18 years of follow-up. J Clin Oncol. 2012;30(25):3044-3050. doi:10.1200/JCO.2011.38.8389.

[7] WHO and Together for Health, 2020 (The Economist Intelligence Unit Limited 2021. UICC, Expertise France, Unitaid).

Required profile

Required qualifications:

  • Bachelor's degree in Economics, majoring in Health Economics or other similar field
  • Experience working with the Ministry of Public Health and Social Assistance in Guatemala
  • Experience working with national and local government stakeholders and international organizations.
  • Experience in data collection and development of costing tools
  • Excellent communication and written expression skills
  • Proficiency in MS Office applications (Word, PowerPoint and Excel).
  • Experience working in programs or projects related to cervical cancer prevention or reproductive health, desirable
  • Working knowledge of cost analysis
  • Residency in Guatemala preferred


Professional skills:

  • Good organization, communication and personnel management skills
  • Good verbal skills
  • Proficiency in Spanish and English
  • Strong analytical, problem solving and decision making skills.
  • Strong business ethics, including the protection of confidential and proprietary information.
  • Proven experience working with multi-disciplinary teams

 

Additional information

Liaison:

  • The consultant will liaise with a designated member of Jhpiego's Guatemala office staff to ensure that the consultant's activities are in line with Jhpiego's activities and operations.

 Employed by:

  • Expertise France will hire the consultant.
    • If the candidate is not currently based in Guatemala, relocation costs will not be covered by the contract.
    • References will be requested if candidates proceed to interview

 Reporting to:

  • The consultant will report directly to the health economist at Levin & Morgan, LLC.

We invite qualified candidates to please submit a CV and a cover letter., both in English and Spanish.

Selection criteria for applications

The selection process for candidates will be based on the following criteria :

  • Candidate’s training/skills/experience
  • Candidate’s experiences linked with the expert mission
  • Candidate’s expected linguistic understanding
  • Assessment of the candidate's skills in the sought-after domain
  • Candidate's knowledges related to local context (country or region intervention)
  • Candidate’s understanding of the mission’s role in the cooperation project

Deadline for application : 2023/06/05 23:59

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