Adolescent Maternal and Newborn Health (MNH) Consultant

Period of Engagement

We anticipate the consultancy will take approximately fifteen days starting in early October and completing the work by end of December 2022.

Background

Each year, an estimated 12 million adolescent girls give birth and nearly one third of all women in low- and middle-income countries begin childbearing in adolescence (i.e., at age 19 years and younger). A body of evidence exists demonstrating that adolescent mothers have an increased risk of adverse pregnancy and birth outcomes compared to women in older age groups. The poorer outcomes for adolescent mothers are well described and are driven by biological, social, and developmental vulnerabilities; as well as health systems factors that impact how these young mothers seek, use, and experience maternal and newborn health (MNH) services. MNH services should be tailored to respond to these vulnerabilities, with sustainable approaches that strengthen existing health systems rather than introducing parallel or siloed approaches for adolescent mothers. Isolated projects and programs have recently been emerging to address adolescent mothers’ special needs yet global and country MNH efforts largely do not consider the needs of adolescent mothers.

Save the Children has prioritized advancing global and country attention to adolescent MNH. Integral to this process is the mapping of available evidence (published and gray literature) for approaches to increase healthful behaviors, evidence-based practices, and use of key interventions to improve pregnancy, birth, and postnatal outcomes among adolescent mothers. We aim to understand the evidence regarding how to facilitate the way adolescents are reached or targeted in MNH programs most effectively and efficiently, the approaches that have been demonstrated to influence adolescent women/girl’s behaviors and practices, and any evidence showing impact on adolescent MNH outcomes.

Description of services

While Save the Children has made progress in documenting the need for increased attention to the needs of adolescents in MNH efforts, the way forward in terms of specific recommendations for government, programmers, researchers, and donors, as well as insights into existing efforts in low- and middle-income countries (LMICs) remain a key gap.

The consultant will

1. Review Save the Children’s existing description of the data around adolescent MNH and the specific vulnerabilities and factors that contribute to poor adolescent MNH outcomes. As part of this review, the consultant will be asked to add additional pieces of data or sources based on their understanding of the literature and can provide additional inputs to validate or revise the framing.
2. Conduct a scoping to identify interventions, and any evidence of impact of those interventions, that are addressing the specific needs of adolescents in MNH at the health system, facility, and community level in LMICs. Interventions could include those that improve care seeking, appropriate use of health services, and the quality of care (including respectful care) for pregnant adolescents, adolescent mothers, and the newborns of adolescents, among others. The scoping should include a thorough review of both published and grey literature as well as approximately 5-6 key informant interviews.
3. Propose an intervention framework for adolescent MNH. This framework should respond to the unique needs and vulnerabilities of adolescents as it relates to MNH and include recommended interventions at community, facility, and health systems level. Interventions will likely include those that have been tried and have evidence, those that are being tried where no evidence has yet been generated, and those that are proposed and hypothesized to improve adolescent MNH but for which piloting and implementation learning will be needed.
4. Based on the first three activities above, identify priority areas for future research and implementation learning on adolescent MNH, including as it relates to modifying existing MNH programs/interventions/services, content and delivery of MNH care to become more adolescent-responsive.

Deliverables

• Final report, following an agreed-upon outline, identifying:
  • Methodology used by the consultant
  • Updates to the background that Save the Children has developed on the needs and vulnerabilities of adolescents as it relates to MNH.
  • Findings from the scoping of interventions/approaches for adolescent MNH. Intervention framework and recommendations for potential adolescent MNH interventions
  • Recommendations for future areas of learning/research within programmatic settings and/or clinical evidence gaps.
• PowerPoint presentation, and debrief with Save the Children RMNAH technical team

Deliverables and timeline

• Onboarding and inception: Briefing meeting with SCUS, review webinar recordings and key documents provided by Save the Children, prepare brief inception report outlining proposed scope and process for the scoping as well as tools for the key informant interviews. # of days: 1
• Conduct review of background provided by Save the Children and add any additional information/references. # of days: 1
• Conduct scoping review, including of published and grey literature and key informant interviews. # of days: 6
• Draft report for SCUS review. # of days: 5
• Finalize report based on SCUS feedback, and present findings to RMNAH technical team via PowerPoint. # of days: 2

Total # of days: 15

Consultant qualifications

• Professional proficiency in spoken and written English
• Experience with advancing global thought leadership in an area of maternal and newborn health
• Proven proficiency in design, implementation, and monitoring of FP and MNH programs, particularly for adolescents and youth, in low- and middle-income countries
• Demonstrated experience working within health systems in low- and middle-income countries
• Experience with developing technical products (briefs, reports and manuscripts)