Local Consultant: Midwifery Specialist, Freetown, Sierra Leone

The Position:

Despite notable progress in maternal and neonatal health, Sierra Leone continues to face challenges in ensuring equitable access to quality midwifery services, particularly in rural and underserved areas. Recognizing midwifery's critical role in reducing maternal and neonatal mortality and achieving health-related Sustainable Development Goal 3 (SDG3), UNFPA, in partnership with key stakeholders, is committed to strengthening these vital services across the country. This commitment aligns with global initiatives such as the Midwifery Accelerator.

The Midwifery Accelerator, launched globally in April 2025 by a coalition including WHO, UNICEF, ICM, and Jhpiego, offers a unified, evidence-driven approach to catalyzing collective efforts for maternal and newborn health and well-being. This initiative aims to expand access to care provided by midwives, aligning with the \"Transitioning to Midwifery Models of Care: Global Position Paper.\" It is worth noting that Sierra Leone is one of the six champion countries selected to champion the Midwifery Accelerator initiative. In a programme funded by FCDO, UNFPA supported the training of midwives, which has resulted in a nearly 20-fold increase in the number of midwives to about 2000. Therefore, this consultancy will draw lessons from the investment made in midwifery so far to contribute to the impressive reduction of maternal mortality by 79% between 2000 and 2023 i.e., from 1682 to 354 deaths per 100,000. 

Midwifery models of care are a proven, cost-effective, and sustainable solution. This approach directly addresses the root causes of adverse maternal and newborn health outcomes, strengthens health systems, advances public health, supports healthier future generations, and accelerates progress towards SDG 3 (health and well-being) and SDG 5 (gender equality). 

Building on this momentum, UNFPA will develop a Sierra Leone-specific Midwifery Investment Case. This case will guide strategic investments, policy
formulation, and resource mobilization, with the ultimate goal of improving maternal and neonatal health outcomes in the country. This approach will involve the consideration and adaptation of high-impact interventions, drawing insights from established frameworks such as the Minimal Initial Service Package (MISP) and the Lives Saved Tool (LiST), for reproductive health, which prioritizes lifesaving interventions to address reproductive health emergencies. 

The Objective of the consultancy:

The primary objectives of this consultancy are: 

● Lead the technical analysis required for the development of Sierra Leone’s Midwifery Investment Case. 

● To conduct a comprehensive situational analysis of the maternal and neonatal health landscape, including the current midwifery workforce and services. 

● Define and tailor high-impact interventions, drawing insights from frameworks like the Minimum Initial Service Package (MISP) for reproductive health, to Sierra Leone’s context. 

● Conduct health impact modeling to project outcomes such as maternal and neonatal lives saved, stillbirths averted, and morbidity reductions under different scale-up scenarios. 

● To develop evidence-based workforce strategies and policies to support the scale-up of midwifery services. 

● Develop a policy brief based on the final version of the National Midwifery Investment case 

● To facilitate stakeholder engagement, validation workshops, and disseminate findings to inform policy and resource allocation. 

● To work alongside a Health Economist to formulate a health impact model to predict outcomes.

The scope of work and responsibilities:

In addition to working in collaboration with a consultant health economist, the consultancy will be under the guidance of UNFPA's global technical team, who will be providing virtual technical support.

The consultant will be responsible for the following tasks: 

1.  Inception and Stakeholder Engagement:

● Organize and facilitate an inception workshop with government officials, UN agencies, midwifery associations, NGOs, academia, and development partners. 

● Develop a stakeholder engagement plan to ensure broad participation and buy-in. 

● Work in close collaboration with the Health Economist consultant to ensure health analyses and workforce strategies inform the economic modeling, and vice versa. 

2.  Situation Analysis:

● Conduct a detailed review of Sierra Leone’s maternal and neonatal health indicators, causes of preventable deaths, health system characteristics, policies, and current midwifery services and workforce. 

● Identify gaps in coverage, financing, training, and workforce distribution. 

● Define Midwifery Intervention Package: In line with the investment case framework and national priorities, define and select a package of evidence-based interventions that can be delivered by midwives in the Sierra Leone context. 

3.  Define and Adapt the Intervention Package

● Collaborate with the national Health Economist Consultant and stakeholders to identify and adapt high-impact interventions, including those aligned with emergency obstetric care, family planning, HIV prevention, and post-abortion care. 

4.  Modeling Health Impacts and Scenario Planning: 

● Support the use of impact modeling tools to project health outcomes, including maternal and neonatal lives saved, stillbirths averted, and reductions in morbidity. 

● Develop multiple investment scenarios reflecting different levels of intervention coverage and resource allocation. 

5.  Workforce Analysis and Policy Development:

● Estimate the required midwifery workforce to implement the scaled-up interventions. 

● Conduct a gap analysis of existing workforce capacity, skills, and distribution. 

● Develop strategies for workforce strengthening, including training, task-shifting, and retention.

6.  Enabling Environment and Policy Analysis 

● Assess systemic, regulatory, and policy factors affecting midwifery services. 

● Provide recommendations for improving the enabling environment, including professional recognition, regulation, and integration into health systems.

7.  Validation and Dissemination 

● Prepare and facilitate validation workshops and stakeholder consultations. 

● Incorporate feedback into the final investment case document. 

● Support the dissemination of findings through policy briefs, advocacy materials, and high-level events.

Duration:

25 working days within a timeframe of 3 months. 

Monitoring and progress control, including reporting requirements, periodicity format, and deadline:

A clear milestone-based payment is outlined for this consultancy, with each payment tranche released upon the successful submission and approval of specific deliverables. The payment is made upon receiving a confirmation email for the final approval from UNFPA (and MOH) if needed), on the deliverables. The payment schedule is a lump sum value for each deliverable, which will be paid to the consultant upon successful submission and approval from the UNFPA Sierra Leone CO side, based on the breakdown in the TOR.

Key Deliverables:

The following key deliverables against which payments will be made are as below:

Supervisory arrangements: 

The consultant will report to the UNFPA Sierra Leone Country Office, in collaboration with the Ministry of Health and Sanitation. Technical guidance will be provided by designated UNFPA technical team members and regional experts. Regular review meetings will be held to assess progress and resolve challenges.

Required expertise, qualifications, and competencies, including language requirements: 

The Consultant will meet the following criteria: 

● Advanced degree in Public Health, Midwifery, Medicine, Nursing, or related health sciences. 

● At least 7 years of experience in Sexual, Reproductive, Maternal, Newborn, Child, and Adolescent Health (SRMNCAH), health systems strengthening, or health workforce planning. 

● Demonstrated experience with impact modeling tools relevant to reproductive health service packages. 

● Knowledge of Sierra Leone’s health system, policies, and sociocultural context. 

● Proven experience in developing investment cases and policy advocacy in low-resource settings. 

● Excellent analytical, facilitation, and communication skills in English.

Other relevant information or special conditions, if any:

All interested applicants should submit the following: 

Required Competencies:

Values:

Core Competencies:

Functional Competencies:

UNFPA Work Environment:

UNFPA provides a work environment that reflects the values of gender equality, diversity, integrity, and healthy work-life balance. We are committed to ensuring gender parity in the organization and therefore encourage women to apply. Individuals from the LGBTQIA+ community, minority ethnic groups, indigenous populations, persons with disabilities, and other underrepresented groups are highly encouraged to apply. UNFPA promotes equal opportunities in terms of appointment, training, compensation, and selection for all regardless of personal characteristics and dimensions of diversity. Diversity, Equity, and Inclusion is at the heart of UNFPA's workforce - click here to learn more.

Disclaimer:

Selection and appointment may be subject to background and reference checks, and other administrative requirements. 

UNFPA does not charge any application, processing, training, interviewing, testing, or other fee in connection with the application or recruitment process, and does not concern itself with information on applicants' bank accounts.