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Job Title:Consultancy - Domestication of National Task Shifting and Task Sharing (TSTS) Policy in Lagos State
Lagos State boasts of 15, 000 health workers in its public service providing care at different levels and approximately 15,000 in the private sector. The State health worker ratio to the population continues to show a decline with increasing vacancy levels, attrition, pressure on fiscal space for Human Resources for Health (HRH) and challenges based on embargo on recruitment of health workers, thereby increasing shortages at most levels and maldistribution within the urban/local locations of health systems. This has affected the availability, accessibility and quality of care delivered at various points of services especially essential services. The Lagos State Government has proactively strengthened its HRH has implemented various strategies to address the impending challenges as documented in its HRH policy (2011- 2016) and the HRH strategic plan (2011- 2016). These strategies include redeployment of personnel, introduction of new cadres such as that of carers, and deepening its relationship with the private health sector.
With the introduction of Task Shifting Task Sharing (TSTS) at the Federal level, the Lagos State Government participated actively in the consultation and understanding of the arrangement of this national policy. The development of the National Task Shifting and Task Sharing Policy in 2014 is a major progress made in improving and scaling up access to effective and evidence- based health care packages for the Nigerian population, especially the vulnerable within communities in an effort to significantly reduce Nigeria’s unacceptably high mortality ratio and to achieve set Sustainable Development Goals’ (SDGs) targets and other national development goals. The pursuit of the TSTS initiative in Lagos State enables the preparedness of the State staffing for the achievement of Universal Health Coverage (UHC) goals with its drive for the implementation of social health insurance scheme.
The Lagos state Government has since 2012 commenced the facilitation of engagement processes on the need to implement the TSTS initiative in the state. This engagement has presented task shifting and task sharing as a short- term strategic move to bridge, extensively, the gap in shortages, move and create more time for highly qualified personnel, and empower those with less training to handle less and easier tasks. Consultations and sensitizations have commenced with the various health workers associations and the HRH Technical Working Group (TWG) engaged on the issue. Making progress, a committee on TSTS has been constituted with terms of reference to guide the work.
Rationale of this Assignment
The rationale for the development of the TSTS policy is based on the following needs:
- To review efforts made on task shifting and task sharing in the health sector in Lagos State.
- To understand the peculiarities of task shifting and task sharing in Lagos state.
- To agree on its scope for essential health services such as child health, maternal health, HIV, malaria and TB.
- To articulate policies to guide the implementation and standards of task shifting and task sharing in both the public and private sectors.
- The purpose of this consultancy is to support the Lagos State Ministry of Health (LSMOH) in strengthening its HRH planning and management capabilities through the development of its Task Shifting Task Sharing policy. This will support the standardization of HRH utilization, promote compliance to ethical guidance on tasks shared or transferred.
Scope of Work:
- The Consultant will conduct rapid assessment of TSTS situation in Lagos state, facilitate the development of a TSTS policy for the state’s health sector, in line with the National TSTS policy. This assignment will provide evidence on the current situation and practice, and articulate policy to guide the standardization of the use of HRH, shifting and sharing of tasks and quality of care. Critical organizations to be involved include the State Ministry of Health (SMOH) and its agencies, private medical and nursing associations and other allied health workers associations.
The Consultant will:
- Adopt participatory and collaborative techniques to facilitate stakeholder leadership, engagement and ownership in the planning process and its outcomes.
- Conduct rapid assessment of the task shifting task sharing situation in Lagos State. This will entails administering questionnaire to selected facilities in the state and work with selected Lagos State Ministry of Health personnel and Primary Health care development board
- Develop a state TSTS Policy , the process will involve facilitation of a participatory workshop with the State Ministry of Health and its agency, HRH critical stakeholders in the state , relevant medical associations and the State HRH Technical Working Group (TWG)
- Facilitate a validation meeting with larger HRH stakeholders in the state and key policy makers to secure ownership and acceptance.
- Document the process and support the collation and submission of the following validated documents: rapid assessment findings; the TSTS policy, and the process report of the assignment.
- For this piece of work, the consultant will provide technical support to the SMOH in Lagos State on the development of a TSTS Policy. Based on the nature of this assignment, the following specific tasks are required:
- Facilitate planning meetings with the SMOH and Save the Children International (SCI) and other stakeholders as identified throughout the assignment.
- Conduct desk review and rapid assessment of task shifting task sharing situation in Lagos state. This will through deployment of questionnaire, key informant interviews and meetings with stakeholders.
- Facilitate a 3-day policy drafting workshop with stakeholders.
- Facilitate a validation meeting for the TSTS policy
- Document the final TSTS policy and report on the rapid assessment.
- Debrief on the outcome of the assignment.