Climate Change Adaptation and Maternal Health Consultant

ABOUT CARE INTERNATIONAL AND PREMIERE URGENCE INTERNATIONALE (PUI):

CARE International in Iraq resumed its activities in 2014, focusing then on humanitarian response efforts and providing development assistance to vulnerable populations across multiple Governorates in Iraq—including Dohuk, Ninewa, Salah Al-Din, Al-Anbar, and Diyala. With the end of the humanitarian cluster system announced by the UN in 2022, the country is now transitioning towards development initiatives. As part of this transition, CARE International in Iraq is expanding its activities into the southern regions of Dhi Qar and Basra, while continuing to maintain operations in the northern areas. This shift signifies a strategic expansion of our programming to address broader development needs in the country, aligning with our commitment to supporting communities across Iraq.

Première Urgence Internationale (PUI) has been active in Iraq since 1983, focusing on humanitarian responses to population displacement. PUI strengthens health systems, provides Mental Health and Psychosocial Support (MHPSS), and enhances access to shelter, drinking water, hygiene, and sanitation (WASH). PUI’s multi-sectoral support includes health, education, WASH, and shelter services for displaced populations in Dohuk, Sulaymaniyah, Ninewa, Anbar, and Baghdad. In recent years, PUI has focused on the link between climate change and health, particularly in Maternal, Child, and Newborn Health (MCNH).

CARE International and Première Urgence Internationale (PUI) have partnered to conduct this study on the consequences of climate change on maternal health in Iraq.

BACKGROUND:

Iraq has endured numerous challenges in recent decades, characterized by economic instability and conflicts, which have deeply impacted its social and healthcare landscape. Amidst these adversities, Iraq grapples with a rapidly growing population (2.24% per year), with maternal health emerging as a pressing concern. In 2018, only 53.7% of women had their need for family planning met with modern methods, reflecting ongoing challenges faced by women. Moreover, Iraq continues to struggle with maternal health indicators, with a maternal mortality ratio of 79 deaths per 100,000 live births and an adolescent birth rate of 70 births per 1,000 women aged 15-19 years. It is also estimated that one in five women experience a perinatal mental health condition in Low- and Middle-Income Countries such as Iraq, which does not only affect their quality of life but also increases risks for adverse obstetric and pregnancy outcomes, including preterm birth, fetal growth impairments, or death.

In addition to these socio-economic challenges, Iraq’s climate further exacerbates its vulnerabilities, creating the perfect storm for a systemic crisis. With a climate ranging from Mediterranean to warm desert patterns, Iraq is highly susceptible to the impacts of climate change due to its arid and semi-arid conditions. The country has been identified as the 5th most vulnerable nation to climate change, according to the Global Environment Outlook 6 (UN), positioning itself on the frontline of an escalating climate crisis. Rising temperatures, changing precipitation patterns, recurrent droughts, desertification, and more frequent sandstorms are among the environmental hazards exacerbated by climate change in Iraq.

In light of these challenges, addressing the nexus of maternal health, women’s rights, and climate change is imperative for promoting holistic well-being and resilience in Iraqi communities. By understanding the complex interplay between these issues and implementing targeted interventions, initiatives improve maternal health outcomes, advance women’s rights, and enhance adaptive capacities to climate change, ultimately fostering sustainable development and resilience in Iraq.

Climate change is an important determinant of health, threatening to undermine global health gains—such as the reduced maternal and child mortality achieved in the last few decades worldwide. Indeed, numerous diseases are affected by changing climate patterns. Factors like temperature, UV rays, humidity, precipitation, and dust impacts the health of communities, especially those with limited physiological ability or socioeconomic means to respond or adapt to temperature rises¹. Understanding how these elements are connected is crucial to ensure communities’ well-being. This will set the groundwork to handle health risks caused by the climate crisis.

Pregnant women, new mothers and young children are increasingly identified as one of the most vulnerable groups to the health impacts of climate change due to a host of physiological, clinical, social, and behavioral factors, and it will take time for that recognition to translate into action. Climate hazards bring a set of additional vulnerabilities on women and girls, such as poor nutrition, water, hygiene and sanitation, limited access to quality health services, but also mental health issues and intergenerational trauma, during extreme climate events and in their aftermath. They are vulnerable to hot temperatures and heat waves as it compromises their ability to thermoregulate effectively. Pregnant women are susceptible to several types of complications at all stages of the pregnancy. The main risks associated with extreme heat for pregnant women are premature birth, pre-eclampsia and stillbirth². However, many other diseases and physiological changes associated with heat, such as cardiovascular, respiratory or kidney diseases, gestation hypertension, gestational diabetes and miscarriage— which can contribute to lifelong health complications or even death.

Despite the urgency of the needs, the effects of heat on maternal & child health have been underreported and neglected worldwide. Much of the research on climate & health in low- and middle-income countries has centered on infectious diseases such as malaria, and in high income countries, the focus has been on heat-related mortality among groups such as elderly people or those with chronic conditions⁴. Iraq has not been the subject of previous studies, underscoring the necessity for both further assessments and action on these matters.

OBJECTIVE:

• The objective of this consultancy service is to conduct study on the consequences of climate change on maternal health in Iraq. The study aims to assess how current environmental stressors, particularly heat, impact maternal health (including perinatal health) outcomes in the selected areas of the country:
• Gather evidence-based data at the intersection of climate change adaptation and maternal health in Iraq, using a community-based approach :
• Conduct an assessment of the links between climate change impacts and maternal health outcomes, considering socio-economic factors, healthcare infrastructure, and community resilience.
• Identify key climate change-related hazards affecting maternal health, focusing on extreme heat and droughts–and potentially other environmental stressors if relevant.
• Identify best practices and adaptation strategies to address the adverse effects of climate change on maternal health–these recommendations will provide insights to engage in future project development and advocacy.

Location: Iraq (Ninewa, Basra and Baghdad)

METHODOLOGY:

The consultant will employ mixed methods, integrating quantitative and qualitative data analysis, such as:

• Desk review of existing literature and studies on climate-induced impacts on health overall and maternal health in Iraq and globally.
• Gathering available quantitative data and existing analysis on maternal health indicators and relevant climate data in Iraq.
• Conduct qualitative analysis in country and online (with key informants i.e. pregnant women, young mothers, hospital management, midwives, medical doctors,  community members).

DELIVERABLES:

• Detailed methodology and planning of the research.
• Draft Research Report: Comprehensive document presenting the research findings, (including the raw data), analysis, and recommendations.
• Final Research Report: Revised and finalized version of the research report incorporating feedback from reviewers (CARE International and PUI).
• Presentation: Oral presentation of the research findings, highlighting key insights and implications for practice.

SUGGESTED TIMEFRAME:

Up to 60 days

Detailed methodology and planning of the research.: Within 1 week from the start date.

Data Collection: Within 4 weeks

Draft Research Report: Within 5 weeks from the start date.

Final Research Report: Within 11/12 weeks from the start date.

Presentation: Scheduled upon completion of the final report.

TERMS AND CONDITIONS:

The selected consultant will be required to sign a consultancy agreement outlining the terms and conditions of the engagement.

SELECTION PROCESS:

Proposals will be reviewed by a selection committee comprising representatives from CARE Iraq and PUI. The committee will evaluate proposals based on the specified criteria and select the most qualified consultant for the assignment to interview.

CONFIDENTIALITY:

The consultant shall maintain confidentiality regarding all data, documents, and discussions related to the research project. Any sensitive information obtained during the course of the consultancy must be handled with discretion and not disclosed to third parties without prior authorization.

ADDITIONAL INFORMATION:

• This position will require meeting with key stakeholders in Baghdad, Basra, Ninewa.
• The budget for this consultancy will cover consultant fees, travel costs and any other relevant costs associated with the study.
• The consultant will provide his own computer, materials, and supplies.
• CARE International in Iraq will not be responsible for providing accommodation, transportation, or any other logistical support outside the consultant’s fee. The consultant is expected to manage and cover these aspects independently. The consultant will provide his own computer, materials, and supplies.

QUALIFICATIONS, EXPERIENCE AND SKILLS

• An advanced degree in public health, maternal health, climate change adaptation, epidemiology, sustainable development, environmental studies, anthropology of health, political science or other relevant area.
• Previous experience in drafting studies, policy/advocacy-oriented reports or similar documents.
• Experience in designing data collection tools, collecting qualitative data, and conducting quantitative and qualitative data analysis
• Excellent writing and organizational skills, and ability to successfully manage research project and meet deadlines.
• Experience working in Iraq on similar context.
• Previous experiences on topics related to climate change and health desired.
• Excellent oral and written communication skills in English and Arabic required, Kurdish optional.

Interested consultants should submit their proposals, including a CV, proposed budget, and preliminary workplan/methodology to

hr-iraq@care.de  by 20th October 2024.

CARE has zero tolerance for sexual exploitation, sexual abuse and child abuse. CARE takes all concerns and complaints about sexual harassment, exploitation and sexual abuse as well as child abuse by CARE staff and related personnel very seriously. CARE International has therefore drawn up the CARE International Safeguarding Policy on Protection from Sexual Harassment, Exploitation and Abuse, and Child Abuse CARE staff and its related personnel must adhere to CARE’s core values which are Transformation, Integrity, Diversity, Equality, and Excellence.

-For any inquiries regarding this position, please contact CARE Iraq HR Manager through nmirza@care.de”