BACKGROUND AND CONTEXT
Various studies and assessments have shown that a large number of health facilities either lack the basic equipment needed for maternal, new-born and child health (MNCH) service delivery, or items are present but not functional. An assessment of health facilities in Kenya indicates that none of the 40 facilities (i.e., dispensaries, clinics, health centres, hospitals, maternities, and nursing homes) reviewed in Nairobi had all essential equipment available. A large majority of medical supplies in Kenya are imported (over 90%) from abroad and very little equipment is locally procured and this is generally limited to non-complex equipment such as beds and trolleys. Heavy overreliance on international procurement, time-consuming bureaucracy, and lengthy international transport delays combined with limited funding in procurement and maintenance of medical devices has resulted in a chronic lack of medical equipment in health facilities. In these same facilities, faulty equipment is also not being replaced or repaired, leading to reduced quality of care and increased maternal and newborn mortality. To compound these challenges, policies and guidelines supporting local research, development and manufacture of medical devices are insufficient.
Whereas skilled delivery improved from 46% in 2009 to 61% in 2014 (KDHS 2014), maternal mortality has not improved and modelled estimates by the World Bank estimate it at 510/100,000 in 2014 up from 488/100,000 in 2009(KDHS 2008/2009). A hospital specific study identified sepsis, haemorrhage, and hypertension as the leading causes of maternal death. Neonatal mortality rate has also stagnated over the same period i.e. from 25/1000 in 2011 to 22/1000 in 2015. Prematurity, birth asphyxia and neonatal sepsis are the leading causes of neonatal mortality in Kenya (CHERG 2014). Interventions to prevent these maternal and neonatal deaths require access to equipment and/or medical devices. This equipment is often unavailable or unsuitable in low resource settings owing to challenges with cost or imported or donated equipment that is not tailored to local conditions. Full use of equipment is further limited by human resource and heath infrastructure capacity constraints and lack of standardized regulatory protocols.
This project aims to address key health system gaps by increasing access to essential lifesaving medical equipment for mothers and new-borns by locally manufacturing the devices; harnesses key opportunities of a large network of biomedical engineers and the growth of Kenya as an economic and technological hub in Africa; and aligning directly with national government priorities to find local solutions for local problems and promote innovations as a foundation for social, economic and political development. This project has the potential to both save lives and create jobs and opportunities for the next generation. Young entrepreneurs and students are empowered to become agents of change and to foster the Maker culture of the future. A key piece of this program is to work intentionally with government to improve policies for local prototyping and manufacturing of medical devices for the nations maternity and labour wards at all levels. Concern Worldwide will incorporate its vast expertise in working with the poorest of the poor to ensure that the medical devices that will be selected and fabricated within the project do not only improve maternal and new-born health but do so in among the most vulnerable in the low resource settings of Kenya. These areas include the Urban Slums and Marsabit County The needs and experiences of health workers in these marginalized areas will be captured during the selection, design and validation of the medical devices.

CONSULTANCY OBJECTIVES
The consultant will support the health and nutrition team to conduct a desk review, identify key stakeholders, carry out expert consultations and conduct a capacity assessment of Maker space with the key outcomes of determining the MNCH equipment ecosystem and gap analysis of MNCH equipment

METHODOLOGY AND TECHNICAL APPROACH
Activity 1: Conduct a published and grey literature review of the status of MNCH Medical device access in Kenya. The Consultant will;
a) Identify policies, strategies and budgetary allocation trends for research and development, production of MNCH medical devices in Kenya
b) Determine the MNCH Medical devices supply and distribution processes at National and county levels;
c) Conduct a demand analysis of key MNCH medical devices i.e. Trends in MNCH medical device gaps at various levels of the supply chain;
d) Using a health systems approach identify linkages between medical device shortages to key maternal and new-born mortality drivers especially in the urban slums and ASAL areas.
e) Provide recommendations on local production of MNCH medical devices(Globally and Nationally)
Activity 2: Stakeholder Validation
a) Conduct county and sub-county consultations (should include government, private and not for profit stakeholders) to validate findings from the Desk review
b) Jointly identify facilities and facility based health workers to provide facility based user feedback.
c) Conduct facility based user feedback exercise.

Activity 3: Conduct facility based usability inputs and/or gaps (User cantered design)
Activity 4: Determine organizational, staff and infrastructural capacity gaps in the Maker space
Any other value-add that the consultant can provide beyond the basic requirements is an added advantage and should be included in the technical proposal.

DELIVERABLES/OUTPUTS
1) Inception report from the desk review and bibliography
2) Presentation of draft report for input by Concern from the workshops and the MNCH opportunity areas and gap assessment
3) Final report with findings and recommendations

TIMELINES AND LOCATION
The assignment will be undertaken in Nairobi, Kenya and is scheduled to commence in October 2016 for a maximum of twenty (20) days as follows;
Activities and Duration (No. of Days)
Desk review report and bibliography 6 Days
Expert validation workshops at various levels of governance 5 Days
Two user centred design workshops i.e. Urban Slums and ASAL (Marsabit) 5 Days
MNCH opportunity areas and gap assessment 4 Days
Total 20 Days

RENUMERATION
Agreed rates will be based on prevailing market competitive rates and value for money. Payment will be upon satisfactory completion of the assignment.

WORKING CONDITIONS
The consultant will liaise with the Senior Manager – Health and Nutrition and overall with the Health and Nutrition Coordinator based in Nairobi. Concern will cover transport costs while visiting partners and field. The consultant will work independently using his/her own laptop and office space.

CONSULTANT’S PROFILE
a) Masters degree in social and human sciences, development studies or relevant degree. Knowledge and skills on innovative technology, design thinking or equipment manufacture and production would be an added advantage. Extensive knowledge of mixed method applied research (qualitative and quantitative) are required.
b) At least five (5) years’ experience in relevant field
c) Demonstrated ability to develop institutional partnerships and build networks
d) Be an excellent communicator, team player and willingness to work in a multi – sectorial setting
e) Excellent analytical, problem solving, planning, organizational, interpersonal, capacity building, report writing and editorial skills.
f) Proficient in the use of computers and relevant applications or software(s)

HOW TO APPLY:
Interested applicants who meet the above requirements must submit the following;
• A technical proposal including proposed methodologies, work schedule and earliest date of availability to undertake assignment (maximum 6 pages)
• A financial proposal quoted in Kenya Shillings (Kes) for the whole assignment
• Cover letter and CV (Demonstration of Capability) If quoting for an organization attach the CV of the Lead Consultant and any other personnel to be involved in the assignment
• A list of previous work done (Work Completion Certificates can be attached) including telephone and email contacts of three (3) referees who can validate technical expertise
All submissions must be addressed to the HR Coordinator, Concern Worldwide, Nairobi to the following email addresses: nairobi.hr@concern.net and quotes.kenya@concern.net with the subject of the email as ‘MNCH Medical Device Gap Assessment’.
The closing date for submission of Expressions of Interest is Sunday, 9th October 2016.
Concern has a Code of Conduct and a Programme Participant Protection Policy to ensure the maximum protection of programme participants from abuse and exploitation.
CONCERN WORLDWIDE IS AN EQUAL OPPORTUNITY EMPLOYER