Roster Consultant PHC Physician

1.Purpose of consultancy

The purpose of the consultancy is to provide technical expertise to strengthen the quality of care within Primary Health Care (PHC) settings, particularly in vulnerable contexts, and to support the scale-up and implementation of PHC projects in line with people-centred primary health care (PCPC) approach.

2.Background

Country context

Lebanon has been impacted by multiple crises; these include a major economic crisis followed by a historic devaluation of the Lebanese pound, the COVID-19 pandemic and recovery from it, a cholera outbreak, the Beirut port explosion, and continuous civil unrest. Currently, Lebanon has also been heavily impacted by the political and military situation in the region and is dealing with frequent bombardments and displacement in the southern areas, while facing a potential war threat that may expand to its entire geography.

Lebanon was reclassified by the World Bank as a lower middle-income country. In 2021, a report from ESCWA, utilizing household data sources, revealed that 82% of the population experiences multidimensional poverty, with 40% facing extreme levels of such poverty[1].

The multi-layered crises have been significantly impacting the determinants of health and affordability of health care. Communities have become increasingly vulnerable to poor health outcomes. With increasing poverty and unemployment rates, vulnerabilities among people are increasing, leading to more reliance on the public health system for accessing health care. Many people have turned to the public sector relying on MOPH support to access even basic care. Data from Primary Health Care (PHC) shows an increase in consultations and requests for medications.

Primary health care

There are around 310 PHC centres that are part of the MOPH network and that are bound by a contractual agreement with the MOPH whereby they benefit from in-kind support such as essential medications for acute and chronic diseases, vaccines and training, amongst others. Following the Beirut Port explosions in 2020, the MOPH has worked on unifying basic benefit packages, to be subsidized at PHC level – the Long-term Primary health care Subsidization Protocols (LPSP), covering noncommunicable diseases, reproductive health, other common diseases, and coupled with a M&E framework and a communication and outreach strategic plan (focusing on health promotion and community engagement).

In 2023, the MOPH launched the basic clinical algorithms of care for the most common adult conditions encountered PHC, with the aim to ensure standardization in the delivery of care. Capacity building of physicians on the clinical algorithms also complemented the efforts of the LPSP and further quality of care.

WHO has been working on strengthening the health system to ensure continued access to essential services including at primary health care level; several initiatives have been taking place, addressing quality of care, provision of essential medications including chronic and mental health medications, health information system, capacity building, among others. In order to monitor the quality of care at PHC, WHO conducted a chart audit in 2019-2020, which indicated the need to conduct and coaching for physicians on most common conditions to improve management and documentation.

In addition, WHO implemented a project in Lebanon’s largest central prison where inmates with noncommunicable diseases received comprehensive care based on the LPSP that were adapted to prison context. At the same time, WHO is adapting the LPSP to the context of long-term residential facilities, mainly mental health residential facilities and elderly homes. This effort aims to harmonize and strengthen the quality of primary healthcare in the different types of facilities.

In terms of health quality services at the PHC, WHO piloted the integration of the people-centred primary health care approach in 4 PHC centres in addition to the PHC at Roumieh Central Prison. This project aimed at reprofiling the core care team (physician, nurse, social worker) and providing training and on-the-job coaching, as well as establishing people participation groups.

In the context of the support to Roumieh Central Prison, a project has been implemented by WHO since 2019, which aims at improving access to health and mental health services, in line with the national essential packages of care used at the PHC level.

The MOPH is planning on building on the efforts done especially in NCDs, PCPC and other PHC interventions. In addition, the MOPH is prioritizing the review of the basic benefit packages (LPSP), in line with WHO guidelines and ongoing interventions.

To support the ongoing initiatives, we propose to recruit a senior physician with family medicine speciality preferably in order to provide technical expertise in the implementation of priority interventions including development of materials, capacity building, coaching, chart audit, to improve quality at PHC level including in vulnerable contexts such as prison.

3.Work to be performed

Output 1: Support the improvement of the quality of care at PHC in line with the essential benefit packages, PCPC, and with a focus on vulnerable contexts.

–Deliverable 1.1: Provide technical advice to review the health protocols and packages of care in PHC with focus on vulnerable contexts such as prison and support their implementation. This includes conducting training sessions for PHC staff on the new protocols and monitoring their application to ensure they meet the specific needs of these populations.

–Deliverable 1.2: Conduct a comprehensive review/update of the essential benefit packages in consultation with MOPH, WHO and relevant stakeholders and prepare a report of the review process and findings.

–Deliverable 1.3: Provide technical support for the integration of the people-centred primary care approach, including for facilitating training workshops, prioritization of key indicators, data collection and evaluation processes.

–Deliverable 1.4: Draft reports and recommendations for improvement of quality and continuum of care highlighting key findings and best practices and specific aeras for improvement

Output 2: Support in training and coaching to PHC staff, with focus on algorithms of care, PCPC, health benefit packages, etc.

–Deliverable 2.1: Develop training materials and finalize based on review by WHO and MOPH.

–Deliverable 2.2: Prepare needed supporting material such as job aids, case studies, brochures, etc.

–Deliverable 2.3: Conduct training and coaching sessions, using different interactive training methodologies in line with adult learning theory.

–Deliverable 2.4: Draft training reports and presentations for dissemination as needed.

Output 3: Provide technical support for the monitoring of quality of care at PHC level including automation efforts.

–Deliverable 3.1: Review key performance indicators used at PHC level.

–Deliverable 3.2: Provide technical advice on the dashboards and the automation of medical files at PHC.

–Deliverable 3.3: Monitor the quality of care through medical chart audits in a sample of PHC centres as well as other tools as needed.

–Deliverable 3.4: Prepare report with recommendations.

4.Qualifications, experience, skills and languages

Educational Qualifications:

– Essential: University degree in Medical Sciences with specialty in Family Medicine.

–Desirable: Master’s degree in Public Health.

Experience:

Essential:

–5 years relevant work experience in medical practice.

–Experience working in public health settings.

–Experience in providing training and coaching.

Desirable:

–Previous working experience in vulnerable contexts including prison settings.

Skills/Technical skills and knowledge:

–Knowledge of national health system, primary health care and packages of health services.

–Strong communication, interpersonal and organizational skills.

–Research and analytical skills (qualitative and quantitative)

–Computer Skills: Good knowledge of the Microsoft Office including Word.

Languages and level required:

–Arabic, English (read, write, speak)

–French is desirable

5.Location

Beirut, Lebanon; with frequent visits to the field as needed

6.Planned timelines

To be determined later.

7.Medical clearance

The selected Consultant will be expected to provide a medical certificate of fitness for work.

8.Travel

Not applicable

Additional Information

·This vacancy notice may be used to identify candidates for other similar consultancies at the same level.

• Only candidates under serious consideration will be contacted.
• A written test may be used as a form of screening.
• If your candidature is retained for interview, you will be required to provide, in advance, a scanned copy of the degree(s)/diploma(s)/certificate(s) required for this position. WHO only considers higher educational qualifications obtained from an institution accredited/recognized in the World Higher Education Database (WHED), a list updated by the International Association of Universities (IAU)/United Nations Educational, Scientific and Cultural Organization (UNESCO). The list can be accessed through the link: http://www.whed.net/. Some professional certificates may not appear in the WHED and will require individual review.
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The WHO is committed to achieving gender parity and geographical diversity in its workforce. Women, persons with disabilities, and nationals of unrepresented and underrepresented Member States (https://www.who.int/careers/diversity-equity-and-inclusion) are strongly encouraged to apply for WHO jobs.

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