- International Organisation for Migration (IOM)Please note: this opportunity closing date has passed and may not be available any more.Opportunity closing date:Sunday, September 15, 2013Opportunity type:Employment
IOM South Africa Migration Health Unit seeks to recruit a Consultant to do a systematic review of published peer reviewed articles on migration and malaria in eight countries of southern Africa, four of which are high malaria transmission and four low malaria transmission countries. In addition, the consultant will conduct mapping of institutions that provide malaria control services (such as treatment, distribution of long lasting insecticidal nets, vector control and education programmes and training of community health workers in migration affected communities)to migrants and mobile populations within countries and at the borders of the eight malaria-elimination countries.
Under the direct supervision of the Migration Health Research Officer and with support from IOM research team, the consultant is expected to do a systematic review of published peer reviewed articles on population migration patterns in relation to malaria risk in the region as well as categories of migrants in need of malaria control services in the eight countries. The review should, in addition, document existing government policies in health and non-health sector (environment, transportation, social welfare etc.), programmes and legislature on malaria, especially as they affect migrants and mobile populations in the eight malaria elimination countries (E8) of SADC. Furthermore, the assignment would involve mapping of institutions that provide malaria control services highlighted above, to migrants and mobile populations within the countries and at the borders of the E8 countries. This mapping would document who the different players are in provision of malaria control services to migrants and mobile populations, specific services offered, and where the services are being offered.
The Consultant will work from IOM’s Pretoria Offices. S/he will work with the Regional Migration and Health Unit.
This is a three-month contract from date of signing contract.
Starting date: As soon as possible.
IOM’s Migration Health vision is “to ensure that migrants and mobile populations benefit from an improved standard of physical, mental and social well-being, which enables them to substantially contribute towards the social and economic development of their communities, in their countries of origin and destination. Guided by the World Health Assembly Resolution (WHA61.17) on the Health of Migrants adopted in May 2008, IOM supports its governments and partners to “promote migrant-sensitive health policies” and “to promote equitable access to health promotion and care for migrants”. IOM’s Migration Health programmes in East and Southern Africa address the health needs of individual migrants as well as the public health needs of migration affected communities by assisting governmental, non-governmental and civil society partners in the development and implementation of relevant policies and programmes.
Since 2003 IOM started its regional programme, “Partnership on HIV and Mobility in Southern Africa”. As from July 2010 the programme entered its third phase and includes East Africa and is known as the “Partnership on Health and Mobility in East and Southern Africa” (PHAMESA).
Partnership on Health and Mobility in East and Southern Africa (PHAMESA)
The overall objective of PHAMESA is to contribute to the “improved standards of physical, mental and social well-being of migrants by responding to their health needs throughout all phases of the migration process, as well as the public health needs of host communities”, using IOM’s network of regional and country missions, and partnerships with Regional Economic Communities, National AIDS Councils, Ministries of Health, Ministries of sectors dealing with mobile and migrant workers, Private Sector Companies, Unions, UN Partners, and International and local NGOs.
Introduction and Background
Malaria is one of the most severe public health problems worldwide. It is a leading cause of death and disease in many developing countries where young children and pregnant women are the groups most affected. Malaria mortality constitutes a great percentage of deaths in Africa. In 2010 more than 219 million of malaria cases were reported, with more than 650000 deaths due to this epidemic, of which approximately 81%; 174 million cases were in Africa. These deaths occur mainly among pregnant women and children under the age of five. In the SADC region the total number of reported malaria cases in 2011 were 34,978,680; with Zimbabwe at 247,379 cases, Mozambique at 1,522,577, Namibia at 556, Botswana at 1046, Zambia at 13,500,000 and South Africa at 3875 cases1. In southern Africa, Malawi, Mozambique and Zambia are among the high transmission areas, while Botswana, Namibia, South Africa, Zimbabwe and Swaziland are considered low transmission areas. Seasonal migration of workers has been associated with malaria epidemics in Kenya (Bloland & Williams, 2003). Meade and Earickson (2000) reported the effect of population movement on the extent of malaria drug resistance as migrants that move from areas where resistance strains of the parasite have been identified introduced the strain into areas where resistance had not been acquired yet. Most recently migration is believed to have initiated malaria transmission in African highlands where there were no malaria parasites previously (Castro, 2002). Pindolia et al (2012)reviewed human movement data for malaria control and elimination. The review documented human population movement in relation to malaria transmission to be both internal (rural to rural or rural to urban) and international. The authors suggested that “neglecting human population movement from high to low transmission areas can lead to re-emergence in areas where low transmission had been previously achieved but receptivity to infection remained high”5.
The transmission of malaria is strongly influenced by population movements and by the process of urbanisation. Whether malaria risk increases depends on the social, economic and behavioural characteristics of migrants, the type of ecological setting, availability of malaria vectors in the area and the changes people impose on the environment (Castro, 2002)4. Increase in malaria infection has been documented in all newly opened frontiers for economic development in agriculture and mining, in those areas affected by war, lawlessness and open conflicts and in locations that are a focal point for refugee migrations (Knudsen & Slooff, 1992). A good picture is the case of Dar es Salaam, which is characterised with endemic and perennial malaria resulting in transmission occurring through the year4.
The most common malaria parasite is plasmodium falciparum with 90% of all cases, and Anopheles mosquito is the vector of Plasmodium falciparum. Other malaria vectors include Anopheles gambiae and Anopheles funestus. These vectors breed in permanent water, especially near inland marshes , presence of creeks, areas where agricultural actives are undertaken, raised planting beds, salt pans, paddy fields, sand pits, seepage, swamps, mangrove swamps, pits for house construction, roadside rubbles to mention a few. These factors describe some of the characteristics of urban informal settlements in sub-Saharan Africa where many migrants live due to high cost of living in more developed urban areas. Urban informal settlements therefore create a conductive environment for high larval breeding of malaria vectors and increase the risk of malaria infections among migrants and mobile population within urban settings with malaria vectors.
Justification of Assignment
Migrants and mobile populations travelling to, from and within different parts of Southern Africa face various social, climatic, economic as well as political determinants of health. As case fatality due to malaria is high among the general population in Africa, especially pregnant women and children under 5 years of age, in countries of high malaria transmission in southern Africa (WHO, 2012), one would equally expect the case fatality due to malaria to be high among migrants and mobile populations of similar demographics, especially, those from areas of high malaria transmission. Available evidence on the case fatality and morbidity due to malaria among migrants and mobile populations in southern Africa is scarce, neither is there a policy that clearly articulates malaria prophylaxis or regimen for migrants and mobile populations in transit or in destination countries. Migrants and mobile populations as well as their families from a country of high malaria transmission to a country of low malaria transmission could be faced with obstacles in accessing malaria control services and/or essential health care services either in transit or in their countries of destination; whilst migrants from countries of low transmission moving into or through countries of high transmission may face similar challenge. With escalating human mobility; large numbers of people are travelling from malaria endemic to non-endemic areas, and malaria non-endemic areas to malaria endemic area more regularly. Undocumented migrants face many obstacles in accessing essential health care including malaria prevention, screening as well as treatment.
African Ministers of Health declared malaria elimination a priority in 2007. In 2009, SADC Ministers of Health approved the SADC Malaria Strategic Framework and a subsequent Malaria Elimination Framework, which urged member states to identify potential areas for elimination and to develop national malaria elimination strategic plans. In order to implement the framework, SADC supported the development of malaria elimination 8 countries, subsequently called “SADC E8”, a coordinated, multi-country programme that seeks to work in the 8 countries most affected by malaria in the region. This initiative seeks to support the elimination of malaria in four low transmission countries at the fore-front of malaria elimination (Botswana, Namibia, South Africa, and Swaziland); and the other four (second-line) high transmission countries (Angola, Mozambique, Zambia and Zimbabwe). A SADC malaria elimination resolution (SADC 2009) with action points on elimination of malaria in the eight countries was agreed upon. One of the action points agreed upon was the need to strengthen existing cross-border collaboration and establishment of additional initiatives between front-line and second-line countries. IOM believes that this goal cannot be achieved without policies that are cognisant of mobility and migration dynamics, which also support the treatment and prevention of malaria among migrants and mobile populations, especially in high and low transmission SADC countries.
In the same vein, strategies and policies to prevent and treat malaria among mobile populations and migrants could reduce the introduction of resistant strains of Plasmodium falciparum from mobile populations with resistant strains. Pindolia et al (2012) suggested the implementation of cross-border initiatives between countries linked by significant human population mobility from high to low transmission areas are more likely to succeed in both achieving and maintaining elimination than single country strategies, which would face challenges through imported infections5.
In order to advocate for increased funding for malaria control for migrants and mobile populations in the E8 countries, there is need for coordinated effort by government, international organizations, non-governmental organizations and regional bodies working with migrants and mobility affected populations. Information that provides a better understanding of malaria transmission as well as the adverse effect of malaria on migrants, mobile populations and affected communities becomes vital. In addition, mapping available institutions or organisations currently providing malaria services to migrants and mobile populations within the E8 countries and at the borders will show existing gaps in malaria control service provision in the E8 countries.
Objectives of Assignment
The main objective of this assignment is to provide information and better understanding of the link between malaria and human mobility in order to improve access to malaria prevention and treatment for migrants, mobile and trans-border populations, and migration affected communities through a comprehensive review of published literature on migration and malaria in the E8 countries. The assignment will show population mobility pattern in relation to migrants risk for malaria in the region, review existing policies, programmes and legislature on malaria treatment provision to migrants and mobile populations, as well as map existing malaria control services available to migrants, mobile and cross border populations within and at the borders of the E8 countries.
Scope of work
The assignment will be divided into two stages:
Stage 1: Desk review
This review will:
- Document population mobility patterns in relation to malaria risk in the region. This will include available literature on mobility pattern of migrants and mobile populations (rural/urban, rural/rural, international migration), from areas of high malaria density to areas of low malaria density and vice versa;
- Document different categories of migrants and mobile populations in southern Africa in need of malaria services;
- Document malaria morbidity and mortality related evidence among mobile populations;
- Document existing government policies, programmes and legislature on malaria, especially as they affect migrants and mobile populations in the E8 countries.
This mapping exercise should document the different stakeholders involved in the provision of malaria control services to migrants and mobile populations in the E8 countries. It should include details of the type of malaria control services that are being offered, who can access these services and where the services are being offered to migrants and mobile populations within countries or at the borders. This should include those currently offering malaria initiatives at the borders in the E8 countries are the Lubombo spatial development, Trans-Zambezi, Zam-Zim and Trans-Kunene malaria initiatives as well as all others.
Successful completion of this assignment will involve answers to the following research questions:
- How do mobility patterns within and across international borders contribute to risk of malaria transmission in the E8 countries?
- What categories of migrants in southern Africa are in need of malaria services?
- What are the existing policies and programmes on malaria control especially for migrants and mobile populations in the E8 countries?
- Which institutions are providing malaria control services to migrants and mobile populations within and at the borders in the E8? What specific services are provided, where and who are the beneficiaries?
The research will be in two stages. The first stage of the research will be a desk review of existing literature, on migration and malaria; followed by a mapping exercise in the E8 countries, which will involve focus group discussions as well as structured interviews with key informants from institutions providing malaria control services to migrants and mobile populations. This will elucidate the type of malaria control services provided, who is providing the services, where the services are being provided (within countries or at the borders) and whom the beneficiaries are.
Stage 1 Comprehensive Review:
The literature review is expected to investigate:
- Population mobility patterns in relation to malaria risk
- Categories of migrants and mobile populations in the E8 countries in need of malaria services
- Review of existing health and non-health sector policies, programmes and legislature on malaria in the E8 countries
This will involve mapping of, and gathering information from institutions providing malaria control services to migrants and mobile populations within countries and at the borders of the E8 countries. These will include institutions already providing cross border malaria initiatives such as the Lubombo spatial development, Trans-Zambezi, Zam-Zim and Trans-Kunene malaria initiatives; as well as other institutions, international organizations, NGOs, FBOs etc. providing malaria control services within the countries. The information gathered will detail the type of malaria control services provided, by who, where and the beneficiaries.
Focus group discussions will be held with key informants from institutions providing malaria control services to migrants and migration affected communities within countries and at the borders of the E8 countries and with migrants and mobile populations.
Analysis and report writing
All the data collected during the focus group discussions will be analysed in order to produce a comprehensive report that answers all research questions above, including key policy and programmatic recommendations at a regional and country level.
Consultants are expected to provide a brief response to this Terms of Reference (not more than 2 pages). This response should include brief description of the scope as well as a detailed work plan, itemised budget and curriculum vitae.
The key expected deliverables from the selected service provider are:
- A draft review of stage 1 of the assignment and focus group discussion guides
- A draft report of mapping exercise
- Presentation of report
- Final report consisting of the desk review and mapping, incorporating comments from stakeholders.
Payments will be based on submission of deliverables
5% on signature of contract and submission of a work plan
30% on submission of draft review
30% on submission of interview tools
35% on submission of consolidated report including review and mapping
- Advance degree in social sciences, public health or related field;
- Understanding of and experience in migration and malaria dynamics of the region;
- Demonstrated skill in and qualitative field research and related report writing;
- Experience in migration health research;
- Experience in formal report writing;
- Language skills- excellent command of English (spoken and written);
- Ability to deliver under tight time frames.
To apply, submit a CV, brief response describing how you intends to undertake the assignment and budget to firstname.lastname@example.org.
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