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Background and Justification

The HIV prevalence in Kenya is estimated at 6% with 1.5 million people living with HIV of which approximately 98,170 are children aged 0-14 years.1 HIV acquisition amongst children mostly occurs through mother to child transmission (MTCT), but despite increased access to antiretroviral therapy by pregnant and lactating mothers, the national MTCT rate stands at 8.3% with approximately 6,600 new infections occurring in 2015 according to the national HIV estimates report 2016. Of those who required essential early infant diagnostic services, 76% of HIV-exposed infants received a PCR test with only about half of them receiving a timely PCR test before the age of 2 months in 2016. In Kenya, only eight central laboratories provide EID services across the country. This prolongs the lead time for sample transportation and turnaround time for receipt of EID results. The eight national laboratories are equally mandated to offer viral load testing services, to support the national programmes recommendation on routine viral load monitoring for those on ART. However, due to bottlenecks or gaps in the system, there are considerable delays in timely sample transportation, processing and results relay. This further contributes to delayed confirmation of HIV infection in infants, late recognition of treatment failure, and therefore postponement of comprehensive care and treatment.

The MOH through the National AIDS & STI Control Program (NASCOP) developed a new Country Framework for eMTCT for HIV and Syphilis for 2016-2021, in which innovative approaches have been recognized as game changers in strengthening diagnostics for HIV and syphilis. Also, guidelines and policies are in existence that are geared towards enabling the health sector to optimize pediatric HIV care and treatment and the eMTCT agenda.

It is against this background that UNICEF seeks to support the National HIV Reference Laboratories (NHRL) and National AIDS & STI Control Program (NASCOP) to create an enabling environment for HIV programmes for the diagnostics of infant, children, adolescents and pregnant and breastfeeding women, and linking them to appropriate MNCH/HIV related care, through accelerating access to innovative POC HIV diagnostics, linkage to appropriate care and optimization of HIV care and treatment among children, adolescents and pregnant and breastfeeding women.

Scope of Work

Goal

To accelerate access to quality Paediatric HIV and PMTCT services.

Objectives

To increase access to innovative POC HIV diagnostics for early infant diagnosis
To increase access to innovative POC HIV diagnostics and/or syphilis
To increase access to innovative POC HIV diagnostics for viral load among target populations (women, children, adolescents at risk)
To increase access to linkage to care among children, adolescents and pregnant and breastfeeding women
To increase access to optimized HIV treatment for children, adolescents and pregnant and breastfeeding women
References to the UNICEF Regional Work Plan (RWP) areas and UNDAF outputs

The role of the incumbent will be to contribute to outcome 5, output 5.4 of the RWP that aims to improve access and quality of pediatric HIV care and treatment, and PMTCT services.

This role additionally ensures that UNICEF’s contribution to the HIV response is met under commitments made to:

UNDAF Outcome 2.3: Multisectoral HIV and AIDS Response. By 2019, Kenya has reduced the socio-economic impact of HIV through a well-coordinated fast-tracked and adequately resourced multi-sectoral response towards an AIDS-free population.
UNJP HIV Outcome 1: By 2019, all those in need have equitable access to and utilization of quality HIV prevention at national and county level
KASF Strategic Area Directions: 1, 3 and 4 i.e. Reducing new HIV Infections; Using a Human Rights Based Approach to Facilitate Access to Services; Strengthening Integration of Community and Health Systems.

Activities and Tasks:

The incumbent will work in close collaboration with focal persons from NASCOP and the NHRL and under the supervision of the Chief HIV and AIDS, UNICEF. She/he will be based in Nairobi with 30-40% travel to 6 priority counties as identified by NASCOP and NHRL and will be responsible for the following:

Providing technical assistance to the leadership of Ministry of Health to leverage and maximize eMTCT and POC investments as part of system strengthening of integrated and effective eMTCT and Paediatric HIV programming.
Providing policy and strategy support to the Kenyan Ministry of Health NASCOP and NHRL on eMTCT and POC implementation.
Providing technical support to accelerate the introduction of POC testing and providing targeted support for conventional testing systems. This will entail implementation of HIV diagnostics (EID and viral load) through the development of an analytical framework to determine the performance of the POC implementation for viral load and EID testing.
Providing technical support for the dissemination of the national policies strategic frameworks and guidelines on POC and necessary resources that link diagnostics to care
Supporting County Health Management Teams to strengthen planning, evidence generation and monitoring of results for women and children living with HIV and for HIV diagnostics.
Providing technical support and leadership within the UNICEF country office and the UN Joint team for a harmonized eMTCT and Paediatric HIV care and treatment response.
Identifying best practices in eMTCT and POC implementation for potential scale up
Identifying opportunities to support shared learning to build awareness of, and knowledge about POC diagnostic technologies, in order to create demand for POC uptake

Outputs/Deliverables

National and selected sub-national HIV, sectoral and development plans, strategies and investment cases comprehensively address HIV and children, pregnant and lactating women
Access and quality of maternal and child HIV diagnostics, care and treatment services improved.
County engagement for planning and implementation of POC diagnostics for viral load and early infant diagnosis, eMTCT and Paediatric HIV Care and Treatment optimization strategies.
Counties adopt and scale-up targeted evidence-based population and location-based prevention interventions to reduce new HIV infections
Project goals are routinely monitored through field visits, exchange of information with partners/stakeholders to assess progress, identify bottlenecks and potential problems are resolved in a timely manner
Identification of scalable best practices to build the capacity of partners and stakeholders and to support the implementation and delivery of concrete and sustainable programme results for POC diagnostics in the context of pediatric HIV care and treatment and PMTCT

Required qualifications, desired competencies, technical background and experience

Advanced university degree in public health, pediatric health, family health, laboratory diagnostics and technologies, health research, global/international health, health policy and/or management, or other health-related sciences is required.

A minimum of 5 years professional experience in public pediatric and/or PMTCT, HIV/AIDS, public laboratories service management and/or in relevant areas of health care, health emergency/humanitarian preparedness, preferably in a developing country.

Oral and written proficiency in English is a requirement.

UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization