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Background and Purpose

Development of the Urban Health Strategy Globally, urbanization is a dominant ecological change in the twenty-first century. Cities and urban places play a central role in global development, significantly shaping social and political relations, and population health at all levels. This has led to increasing interest in sustainable urbanization.

In 2020, the Ugandan government designated new cities, municipal councils, town councils, and town boards to promote urbanization. Currently, Uganda has 11 cities, including the capital city with 25 divisions, 31 municipalities with 89 divisions, and 580 town councils. Approximately 25% (11.6 million) of Ugandans live in urban areas, and 15% to 20% of non-residents engage in transactions within cities and municipalities. With the government’s commitment to sustainable urbanization, the high annual urbanization rate (5.2%) and exponential population growth (3% per year), it is projected that by 2040, around 25 million people (33% of the population) will be living in urban areas.

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Unplanned urbanization can have detrimental effects on population health and development, particularly when policies and infrastructure fail to address the needs of the rapidly growing population. In such situations, urban communities become densely populated, leading to issues like poor housing, overcrowding, and inadequate hygiene, and sanitation facilities in informal settlements. Open sewers and drainage channels, along with a lack of clean water supply, further compound the challenges. Additionally, heavy fumes from motor vehicles and industries, as well as poorly designed roads, expose a majority of urban dwellers to disease outbreaks, accidents, injuries, and air pollution. These factors, combined with unhealthy lifestyle changes, contribute to an increased risk of non-communicable disease.

Problem

Urban areas in the country are major contributors to the burden of tuberculosis (TB), HIV, other sexually transmitted infections (STIs), and diarrheal diseases. For instance, in Kampala metropolitan city alone, about 29% of new HIV infections and 15% of national TB cases are reported. Despite implementing various interventions, disease prevention and health promotion in the urban context remain inadequately addressed. The health facilities in urban areas face challenges of overcrowding due to serving both urban and rural clients, which strains infrastructure, medicines, and human resources. This congestion leads to high out-of-pocket expenses for patients and contributes to delays in receiving healthcare. Consequently, preventable morbidity, mortality, and low client satisfaction become prevalent issues.

Additionally, there is a paradox where some health facilities are underutilized, while others unnecessarily refer patients to higher-volume centres. This is attributed to poor performance management and disparities in human resource capacity, skills mix, and infrastructure within urban areas. For example, a significant percentage of maternal deaths occur in large private non-profit facilities and regional referral centres, while general hospitals in municipalities contribute to institutional mortality, mainly due to late referrals from lower-level health facilities in urban or peri-urban areas. Therefore, there is a need for health institutions and resource distribution reform, including primary health care grants and human resources, to align service delivery with the demands in urban settings. This reform should take into account the lessons learned from health service delivery in Kampala City Council Authority, municipalities, and recently launched cities.

Purpose of Assignment and Scope:

The Urban Health strategy aims to offer guidance to both the Ministry of Health and Urban health authorities, enabling them to provide health services that cater to the specific needs of the Urban population.

Justification

Urban areas contribute greatly to the country's TB, HIV and other STIs, and diarrheal disease burden. For example, Kampala metropolitan city alone contributes about 18% of new HIV infections and 15% of the national TB case notification.

While several interventions have been implemented, they have not adequately addressed disease prevention and health promotion in the urban context. Following a consultative meeting held on 8th May 2023, stakeholders recommended the development of a comprehensive Urban Health Strategy to address infrastructure, Human resources, Health financing, Governance and leadership challenges within the urban areas.

The development of the Urban Health Strategy in Uganda is to support a comprehensive situation analysis of the urban health policy landscape, disease burden and service delivery in urban areas in Uganda.

Objectives:

1. Undertake a comprehensive Situation analysis of the Urban Health Policy landscape, Disease burden as well as Service delivery in Uganda

2. Develop an Urban Health Strategy to consolidate the healthcare gains and well as address the identified gaps in health service delivery.

Methodology:

This will utilize a human-centred design approach to engage with stakeholders involved in disease prevention, health promotion as well as curative health service delivery in Urban settings. Such consultations will explore the opportunities, bottlenecks and gaps in the existing plans, data systems, structural organization, equity and efficiency in health service delivery.

Further, a comprehensive review of secondary data such as existing policies, strategies, and legislations with a multisectoral lens to contextualize Urban Health issues will be conducted.

Outputs:

1. A Comprehensive Situation Report on Urban Health

2. The National Urban Health Strategy.

Major Tasks:

The consultant will need to accomplish the following tasks during the period:

1. Inception report
2. Consultative meeting (KI/ID)
3. National Stakeholders Consultative workshop including civil society, private sector and the academia
4. Consolidation of the first draft
5. Validation workshop of the 1st Draft and Presentation of the first draft
6. Adopting recommendations, incorporating changes to the document
7. Validation of the strategic plan
8. Submission of the Fair copy
9. Approval of the plan

1) IMT

2) Strategic Committee

3) HPAC

4) Top Management

10. Launch the endorsed plan (at the 29th JRM)

To qualify as an advocate for every child you will have… 

• Education

An advanced university degree (master's or higher) in Public Health, Health and Social Policy social sciences, social work, or related qualifications.

• Work Experience

1. Over 10 years of experience working in the public health sector in Africa is required
2. Core knowledge of government public health programs, strategies, methods, and processes used to plan, develop, implement, and evaluate results of health programs is required
3. Intimate knowledge of best practices for implementing community health programmes

a. globally with experience in developing guidance for implementation of community health

b. programmes

4. Previous experience working with the government of Uganda’s Ministry of Health is an

a. added advantage working knowledge of the objectives and operations of the MOH, or the public health activities of other East African communities, or international donor organizations, is required

5. Should have a good understanding of the power-related dynamics at district and community levels
6. Should have a good understanding of the national community health strategy and other community health programs like iCCM, CAPA, among others
7. Should have demonstrated negotiation and convening skills to bring together powerful actors in the Community Health area
8. Worked in data analysis and generated data-driven insights
9. Experienced stringent reporting demands and can write professional project plans and reports
10.  Has experience working with both Government and international NGOs (Non-Governmental Organizations)
11. Engaged diverse stakeholders among public and private sectors as well as development agencies
12. Excellent written and verbal communication in English

• Technical knowledge

• Community health systems in Uganda & Region
• Human Resources for Health
• Public Health
• Health System Strengthening

• Language skills:

• Excellent written and verbal communication in English is required. Knowledge of the local language is considered as an asset.

Other desired attributes:

1. Communication: expresses opinions, speaks clearly has a sense of diplomacy while interacting with external stakeholders

2. Drive for results: passionate about action and helping to get things moving

3. Team spirit: enjoys working as part of a group with members of diverse backgrounds

4. Learning agility rapidly learns new tasks and demonstrates an understanding of newly acquired information

5. Independence: can take initiative and work with limited supervision to deliver results

6. Coping with pressure maintains a positive outlook at work and works productively in a pressurized environment and in a crisis while keeping emotions under control.

For every Child, you demonstrate... 

UNICEF’s Core Values of Care, Respect, Integrity, Trust and Accountability and Sustainability (CRITAS) underpin everything we do and how we do it. Get acquainted with Our Values Charter: UNICEF Values 

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 (8) Nurtures, leads and manages people.  

During the recruitment process, we test candidates following the competency framework. Familiarize yourself with our competency framework and its different levels: competency framework here. 

UNICEF is here to serve the world’s most disadvantaged children and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, age, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, or any other personal characteristic. 

We offer a wide range of benefits to our staff, including paid parental leave, breastfeeding breaks and reasonable accommodation for persons with disabilities. UNICEF strongly encourages the use of flexible working arrangements. 

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF is committed to promote the protection and safeguarding of all children. All selected candidates will, therefore, undergo rigorous reference and background checks, and will be expected to adhere to these standards and principles. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check. 

UNICEF’s active commitment towards diversity and inclusion is critical to deliver the best results for children. For this position, eligible and suitable are encouraged to apply. 

UNICEF appointments are subject to medical clearance.  Issuance of a visa by the host country of the duty station, which will be facilitated by UNICEF, is required for IP positions. Appointments are also subject to inoculation (vaccination) requirements, including against SARS-CoV-2 (Covid). Government employees that are considered for employment with UNICEF are normally required to resign from their government before taking up an assignment with UNICEF. UNICEF reserves the right to withdraw an offer of appointment, without compensation, if a visa or medical clearance is not obtained, or necessary inoculation requirements are not met, within a reasonable period for any reason. 

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.