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Background / Purpose of the Assignment
The hostilities of 1992–1993, along with the subsequent prolonged isolation, have had enduring negative impacts on the economic and social well‑being of people living in Abkhazia, Georgia. Over the past three decades, the protracted nature of the conflict has hindered development and continues to affect human rights and the living conditions of conflict‑affected communities, including their access to essential social services, human security, and opportunities for sustainable peace.
The healthcare system in Abkhazia remains rooted in an outdated, inpatient‑oriented model. Services are delivered across central, district/urban, and rural levels; however, primary healthcare (PHC) facilities - including antenatal care clinics - are often under‑equipped and face shortages of qualified personnel. These gaps lead to frequent referrals to higher levels of care. Significant disparities in the distribution of healthcare workers further constrain service availability, with urban areas comparatively better staffed than rural and remote regions. Only around 19 percent of doctors work in PHC, and opportunities for continuing professional development are extremely limited. Many health workers were trained outside Abkhazia region and lack access to ongoing medical education. At the same time, nurses’ skills remain underutilized, contributing to low public confidence in nursing services. Additional systemic challenges including limited supplies of essential medicines, outdated medical equipment, deteriorated WASH infrastructure, and high out‑of‑pocket costs - further undermine the quality and accessibility of healthcare and discourage timely care‑seeking.
Despite the sustained efforts of UNICEF and other international development partners, notable gaps persist across the health sector. Limited availability of essential medicines, shortages of trained personnel, inadequate health data, and constrained capacities for planning and managing health interventions continue to affect access to essential services.
These challenges are especially evident in maternal and child health - an essential pillar of public health. In Abkhazia region perinatal services are delivered through one republican maternity hospital in Sukhumi and maternity wards within seven district hospitals (Gagra, Gudauta, Gulrypshi, Gali, Tkuarcheli, and Ochamchyre). However, several facilities operate at reduced capacity due to low delivery numbers and resource constraints. Seven women’s consultation (antenatal) clinics operate in the same locations, but coordination between primary and secondary levels of care (antenatal clinic – maternity – PHC) remains limited, with many services following vertical structures and not sufficiently integrated.
UNICEF, as a leading advocate for children’s rights under the Convention on the Rights of the Child and guided by the Core Commitments for Children in Humanitarian Action, implements strategic interventions across health, education, and child protection in Abkhazia, Georgia. UNICEF Georgia has maintained a Field Office in Abkhazia since October 2005. Since 2011, UNICEF has supported the Extended Programme on Immunization (EPI) and has worked with health workers to adopt internationally recognized maternal and child health (MCH) and Integrated Management of Childhood Illness (IMCI) standards. UNICEF has further contributed to the development of clinical guidelines and the provision of specialized equipment for safe neonatal transport across the administrative boundary line (ABL). A network of health professionals has also been established to support guideline development, trainings, and supportive supervision, particularly within PHC and MCH services.
Addressing maternal and child health challenges in low‑resource settings requires a comprehensive, lifecycle‑based approach. In Abkhazia region, the shortage of trained personnel, limited use or absence of evidence‑based clinical standards, and lack of targeted public health interventions pose significant risks to maternal, newborn, and child health. Health workers require strengthened knowledge and skills, supportive supervision - which to date has been implemented only on a pilot basis - and availability of/access to reliable health data.
To address these challenges, and within the EU‑funded UNICEF/WHO joint initiative “Support provision of basic health services for conflict‑affected people living in Abkhazia, Georgia,” UNICEF will support the strengthening of risk‑appropriate maternal and neonatal care in the region. The planned interventions will be informed by a comprehensive assessment of the quality of neonatal and obstetric care in Abkhazia, using a methodology that includes analysis of medical documentation, facility inspections, and interviews with medical staff. The assessment will be conducted with ‘Integrated quality of hospital care assessment and improvement tool for maternal and neonatal health’ World Health Organization (2024): https://iris.who.int/handle/10665/379487.
The assessment will place particular emphasis on the organization of care for sick newborns, including the availability of effective referral and transport pathways and the functionality of intensive care units and availability of structured handover and continuity of care with primary health care settings upon neonatal discharge. It will also focus on the development and integration of priority clinical care protocols, as well as the continued analysis of quality of care to inform a plan of action at both maternity/local and regional levels.
Scope of Work:
To address the critical needs in peri- and neonatal care in Abkhazia region, UNICEF is recruiting international consultants: 1) Obstetrician/Gynaecologist (Team Leader), Neonatologist and Midwife to work as a team to plan and carry out Assessment of the quality of neonatal and obstetric care in Abkhazia, Georgia using the ‘Integrated quality of hospital care assessment and improvement tool for maternal and neonatal health’, World Health Organization (2024): https://iris.who.int/handle/10665/379487.
Guided by the team leader, consultants will complete all modules of the tool on-site at the Republican Maternity Hospital in Sukhumi, as well as in the maternity wards of seven district hospitals (Gagra, Gudauta, Gulrypshi, Gali, Tkvarcheli, and Ochamchyre) and in seven women’s consultation (antenatal) clinics in the same locations.
The completion of modules and their respective chapters - each addressing specific parameters, will be allocated among team members according to their professional expertise.
More specifically, the following dimensions for peri‑ and neonatal care in the region will be assessed:
1. Hospital Resources - availability of essential resources for maternal and newborn care, including:
2. Hospital-level Policies and Organization of Services covering:
3. Provision of Health Care
Evaluation of case management for common maternal and newborn conditions according to WHO standards:
(a) Maternal health: pregnancy, intrapartum, and postpartum care
(b) Newborn health: readiness to manage newborns at birth; care for healthy and sick newborns; facility preparedness for advanced newborn care
Additional areas to be assessed:
4. Experience of Care
Collecting perspectives from mothers and caretakers through structured face-to-face interviews, focusing on:
5. Motivation and Perspectives of Human Resources
Assessment of factors influencing health providers’ ability to deliver quality care, through structured face-to-face staff interviews including:
6. Feedback and Action Planning
Supporting a standards‑based audit process to:
Develop action plans for improvement at both maternity/local and regional levels including:
Interested experts should apply for the Neonatologist role of the assignment indicating lumpsum fee in the Cover Letter.
Work modality
Hybrid with international trips to the duty station anticipated.
Work Assignment Overview: The consultation envisages both online and hybrid modalities (to come as a part of the offer)
Tasks/Milestone for Neonatologist
Task
Provide technical expertise for neonatal components of the assessment by supporting tool adaptation, conducting neonatal-related evaluations across facilities, contributing to draft and final reports, developing neonatal clinical protocols and training materials, and participating in workshops under the guidance of the Team Leader.
Deliverables/Outputs
Written technical inputs for the neonatal components of the assessment plan.
Proposed neonatal-specific additions/adaptations to the assessment tool/modules.
Timeline
June 2026
14 in-country days (Tbilisi)
Task
Technical participation in a stakeholder workshop (introductory presentation of the assessment plan and tools to local stakeholders in the Abkhazia region, including the management and staff of all targeted facilities), supporting neonatal-related topics and clarifications.
Deliverables/Outputs
Contribution materials (slides/notes) provided for neonatal topics.
Technical input documented through a workshop report.
Timeline
June 2026
7 in-country days (Sukhumi)
Task
Complete the assigned modules (in neonatology) of the assessment tool at the Republican Maternity Hospital in Sukhumi and maternity wards of seven district hospitals (Gagra, Gudauta, Gulrypshi, Gali, Tkuarcheli, Ochamchyre), with specific focus on:
Deliverables/Outputs
Finalized list of neonatal clinical protocols required for adaptation/development.
Completed modules with neonatal-specific inputs, findings, and recommendations.
Timeline
June 2026
Task
Support the Team Leader and contribute to the development of the draft assessment report. Draft neonatal clinical protocols with evidence references and neonatal-specific training materials.
Deliverables/Outputs
Inputs to the draft assessment report provided/shared with the Team Leader.
Draft versions of neonatal clinical protocols submitted (with evidence sources, references, and required equipment lists).
Neonatal training materials (slides, job aids, checklists) submitted.
Timeline
July 2026
15 online days
Task
Co-facilitate protocol development workshops with peri-neonatal health personnel, providing neonatal expertise and facilitating relevant sections.
Deliverables/Outputs
Technical contributions delivered during the five protocol development workshops (documented in workshop reports).
Timeline
October 2026
7 in-country days (Sukhumi)
Task
Finalize neonatal components of the clinical protocols.
Deliverables/Outputs
Fully elaborated neonatal components of the clinical protocols submitted.
Timeline
October 2026
7 online days
Task
Provide technical inputs to the final assessment report and validation from the perspective of a neonatologist.
Deliverables/Outputs
All neonatal-related corrections, clarifications, and technical contributions for the final assessment report submitted.
Timeline
October 2026
Task
Support the preparation of the final presentation, ensuring accuracy of neonatal findings.
Deliverables/Outputs
Verified and finalized neonatal input for the final presentation delivered.
Timeline
October 2026
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Minimum requirements:
Knowledge / Expertise / Skills Required
For every Child, you demonstrate...
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The UNICEF competencies required for this post are…
(1) Builds and maintains partnerships
(2) Demonstrates self-awareness and ethical awareness
(3) Drive to achieve results for impact
(4) Innovates and embraces change
(5) Manages ambiguity and complexity
(6) Thinks and acts strategically
(7) Works collaboratively with others
[add the 8th competency (Nurtures, leads and manages people) for a supervisory role].
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Remarks:
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