Thinking of a Career in Emergency Management?
- BY Nicole Pelette
For every child, a hero
Tonga is a Polynesian Kingdom comprised of over 170 islands, 36 of which are inhabited. The total area of the islands amounts to 747km2, spread over an area of around 700,000 km2 in the Pacific Ocean. Tonga is made up of four main island groups: Tongatapu, Vava’u, Ha’apai, and Niuatoputapu and Niuafo’ou. The capital is Nuku’alofa. The total population is estimated at 107,000. Most of Tonga’s population live in rural areas compared to urban areas. The government is the main provider of health services in Tonga and 90% of health services are delivered from four hospitals in the country. The government is the main financer of the health system (47%), with considerable funding also from donors (38%). The immunization service is delivered as a public service, with no services being provided in the private sector. It is estimated that 70% of immunization services are delivered through by fixed site services, 20% by outreach and 10% home to home services. Reported immunization coverage rates varies between 78% to 96% (DTP3), and 80%-91% (BCG).
Disease burden of pneumonia, diarrhea and cervical cancer: A Tongan study in 2017 found an incidence of invasive pneumococcal disease (pneumococcal meningitis and sepsis) of 113 per 100,000 in children under the age of two, with a case fatality rate of 25%. Diarrhea is estimated to cause 2% of child deaths under the age of five and it is estimated that RV kills 1.5 per 100,000 children. Unpublished data from Vaiola Hospital shows an incidence of cervical cancer of 11.2 cases per 100,000 women, recorded in 2017. Mortality rate from cervical cancer is approximately 3.9 per 100,000 women, and there are approximately 5 new advanced cervical cancer cases seen each year. Similar to data for other diseases, this data is likely to be underrepresented due to lack of a nation-wide screening program, e.g. pap smear, and awareness amongst women to identify early danger signs for diagnosis, particularly at the sub-national levels.
To reduce disease burden of pneumonia, diarrhoea and cervical cancer the Governments of Tonga recognizes the importance of expanding their immunization programs with the addition of three new vaccines: human papillomavirus (HPV) vaccine, pneumococcal conjugate vaccine (PCV) and rotavirus (RV) vaccine and using the introduction of these vaccines to strengthen immunization programs, health systems and regional cooperation. The Asian Development Bank (“ADB”) and UNICEF will provide financial support to the Government of Tonga to reduce the disease burden of three vaccine preventable diseases, cervical cancer, rotavirus and pneumococcal disease, and to strengthen immunization programs through Systems Strengthening for Effective Coverage of New Vaccines.
UNICEF will provide technical assistance to Tonga government to procure vaccines (HPV, PCV, RV and COVID 19) through the Existing VII Agreement. UNICEF will procure and install WHO Performance, Quality and Safety (PQS) pre-qualified cold chain equipment.
UNICEF will build the capacity of the MOH to establish and strengthen the reaching every child approach as part of the introduction of new vaccines and strengthen new vaccine integration into routine immunization services. This will entail microplanning, outreach services, supportive supervision, strengthening production, quality and use of data for decision making, and linking services with communities. As part of this approach effective catch-up campaigns will also be prioritized including the planning of HPV school-based campaigns. UNICEF will provide advisory services upon request to the Government in leveraging existing community structures through partnerships with Ministry of Health and other Ministries, non-government and civil society organizations, community and church leaders and other local community groups on vaccine awareness and in developing vaccine communication material to address vaccine hesitancy concerns improve public health knowledge, attitude and practice for better overall health seeking behavior and vaccine acceptance.
How can you make a difference?
UNICEF Pacific is seeking a qualified and skilled international consultant for Tonga to provide technical guidance and expertise for strengthening routine Immunization, human resource capacity building, vaccine management, immunization supply chain, and embedding the reaching every child approach into the system as the main approach to the introduction of three new vaccines.
UNICEF recently signed an output agreement with the Ministry of Health in Tonga for procurement and installation of cold chain equipment and the provision of technical services for new vaccines introduction, cold chain maintenance, and immunization programme strengthening. The output agreement follows funding from the ADB to the Government of Tonga to reduce the disease burden of three vaccine preventable diseases, cervical cancer, rotavirus infection and pneumococcal diseases, and to strengthen their immunization programmes through system strengthening for effective coverage of new vaccines.
The deliverables and results from this consultancy will be used by the MoH for the introduction of three new vaccines, to strengthen the routine immunization and to increase the immunization coverage.
The Consultant will guide the MoH on the readiness of the country to introduce new vaccines (PCV, Rota, HPV and COVID-19) and will provide the government with the requisite policy, guideline and job aids following the global standard, and provide overall coordination for UNICEF’s work on new vaccine introduction activities in the two countries. As a result, the MoH will be able to close the gaps for all components of the routine immunization including vaccine management, planning, monitoring, data management.
Scope of Work
The Child Health Consultant will work in close collaboration with the Ministry of Health in Tonga and other partners including integrated project management team (IPM), to plan and coordinate the implementation of the introduction of three new vaccines. The Consultant will build the capacity/collaborate and oversee with the Government in the lead the following work assignment: