Mobile Implementation officer – TIC children’s tuberculosis M/F

Médecins Sans Frontières, an international medical humanitarian association created in 1971, provides medical assistance to populations whose lives are threatened: mainly in the event of armed conflicts, but also of epidemics, pandemics, natural disasters or exclusion from care. The French section of MSF is present in about thirty countries.

In the context of a project opening, we are looking for a:

Mobile Implementation officer (MIO) – TIC children’s tuberculosis

The project:

Children with tuberculosis (TB) are underdiagnosed and undertreated, leading to high mortality and morbidity. Almost all MSF projects, in almost all contexts see patients with TB and struggle with the challenges of diagnosing TB, especially amongst children. In March 2022, the World Health Organization (WHO) Global Tuberculosis Program published new recommendations for children with TB including integrated treatment decision algorithms to diagnose pulmonary TB, a shorter 4-month treatment for non-severe TB and shorter treatments for TB prevention. These recent WHO recommendations present a unique window of opportunity that cannot be missed to transform the way that children are diagnosed and treated with TB across MSF projects, and to have a truly meaningful impact on mortality and morbidity from TB in this population. In order to achieve this, MSF has built a project to support MSF teams and their partners with scaling up the use of the above-mentioned recommendations, as well as providing evidence to improve their further use: TACTiC – Test, Avoid, Cure TB in Children.

All MSF operational sections are involved in this multidisciplinary, inter-working groups, transversal and integrated project which will roll out along 3 main axes of work:

1. Implementation: training and the development of training and support pediatric patient-centered tools for wide dissemination, increased access to diagnostic tools, development of tools for record keeping and data collection, local and national advocacy for implementation of new recommendations.
2. Operational research (OR): in some contexts, MSF projects will conduct operational research (OR) on the feasibility, acceptability and validation of new recommendations.
3. International advocacy: with the Access Campaign, advocacy for the development of better tools (diagnostics, treatments) adapted to children.

The project will have a special focus on change management, user and patient experience, and will ensure that inclusive dialogue with external partners and populations is anticipated at every stage.

The project has 2 phases. The first phase, funded and supported through the Transformational Investment Capacity (TIC) initiative – and internal funding mechanism of the MSF movement -, will run from October 2023 to September 2025 and will target non-TB specialized projects across 12 countries where MSF is active.

MAIN RESPONSIBILITIES

The Implementation officer supports the kick-starting of implementation of WHO recommendations as per priorities set by the hosting MSF Mission/Project. He/she is accountable to the MSF Mission/Project Management team on the field (hierarchical management) and to MSF HQ advisor for TB or pediatrics (functional management). He/she works in close collaboration with TACTiC’s Project Management team at central level and with research assistants where operational research is carried out at field level, and is responsible for the following:

1. Preparation phase

• A brief assessment, including:
  • a mapping of current practices (i.e. diagnosis, treatment and prevention of TB in children) in the MSF project and in the wider context of the country relevant to the project for MSF (all sections), MoH/NTP and other key implementation partners,
  • the identification of barriers to implementation of the WHO recommendations both at MSF and MoH/NTP levels, the identification of solutions to overcome those barriers.

• A plan of action for the implementation of the WHO recommendations, including:
  • a projected timeline and evaluation of what resources and tools would be needed,
  • in collaboration with the MSF HQ pediatric advisor, MSF Mission’s Medical Coordinator and/or Project’s Medical Referent, and MoH/NTP relevant representatives, a proposition of where the TB diagnostic algorithms articulate with the current paediatric algorithms, and how to integrate the two,
  • a plan for advocacy at local level.

• In coordination with the MSF HQ TB, pediatrics and diagnostic advisors, the MSF Mission/Project medical management team and the MoH/NTP focal point and other relevant key stakeholders (MSFeCARE, etc.), the development of user-centered training and support tools, or the adjustment of existing ones, to facilitate the implementation in the targeted project as well as in other MSF/MoH projects in the country.

2. Implementation phase

• Active support to MSF Coordination/Project for dialogue with MoH/NTP and other key external stakeholders on the introduction of the WHO recommendations, including, where relevant, participation to the organization and animation of inclusive design workshops.
• Organization, animation, follow-up and potential adjustment of inclusive (MSF, MoH) training sessions for targeted health and other staff, including the measurement and analysis of training outcome, e.g. (projected) effect on practice.
• Feedback on training and first days/weeks of implementation outcomes (staff practice, patient’s adherence, etc.) and impact (link to programmatic indicators: number of patients diagnosed, treated, followed-up, etc.). Lessons learned and identification of adjusting measures if/where relevant.
• In coordination with MSF sections active in the country, identification of and support to additional MSF implementing sites in country through:
• Transposition of training and support tools for tailored use in additional sites
• Where possible, direct on-site training and/or training of trainers
• Identification of peer-to-peer support possibilities from “pilot” site to subsequent sites in country

The time estimated for supporting kick-start of implementation in one project is 2 months.

DELIVERABLES

• Brief “baseline” assessment report including mapping of practices, identification of barriers to implementation and propositions to overcome them.
• Training and support kit of tools usable/transposable for implementation of WHO recommendations in multiple sites.
• A final report including outcome and impact analysis and propositions/recommendations for scaling-up in country and, in general, in non-TB specialised projects or facilities, both at regional and periphery levels.

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