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1 Recruitment of individual consultant for the Analysis of the Situation of Elderly health in Member Countries of the Economic Community of West African States (ECOWAS) TERMS OF REFERENCE October 2017 TDR_SITAN_SPA_CEDEAO Page 1 sur 5

2 I. Background and Rationale According to current projections, between 2000 and 2050, the proportion of the world's population aged 60 and over will double from about 11% to 22%. The absolute number of people aged 60 and over is expected to increase by 901 million in 2015, 1.4 billion by 2030 and 2.1 billion by 2050, and could reach 3.2 billion by By 2050, about 34% of Europe s population will be over 60; Latin America, the Caribbean and Asia, about 25%; although Africa has the youngest age pyramid in the whole area, aging is expected to be rapid: its population aged 60 years or more will increase from 5% today to 9% by Africa will have more than 200 million people over the age of 60, much of whom in sub-saharan Africa, particularly in ECOWAS member countries where this target is a vulnerable population, too often neglected by public policies and where increased efforts are needed to ensure that everyone has the right to age in good health. '' Healthy aging '' is defined as the process of developing and maintaining functional skills that enable elderly people to enjoy a state of well-being. The overall goal is wellness, which is holistic and encompasses all aspects and components of life and lifestyle that people value. Since 2013, WHO's most recent estimates show that the average life expectancy of a 60-yearold person is 20 years, which is a substantial increase by 2 years compared to the year Unfortunately, although it is often assumed that increase in longevity should come along with a longer period of good health, there is little evidence that today's elderly people are healthier than their parents at the same age, or that all elderly people have equal opportunities in the matter. WHO's Global Statistics reveal significant inequalities among countries in terms of life expectancy or the likelihood of a healthy old age. For example, between the least performing and the best performing countries, there is a difference of 38 years for life expectancy at birth, 37 years for healthy life expectancy at birth and 13 years for life expectancy at 60. In addition, over the past two decades, the gap in life expectancy at 60 between high-income and low- and middle-income countries has widened (WHO s Global Health Observatory Data, 2015). It should be pointed out that the West African Health Organisation (WAHO) has identified among the priority programmes of its Strategic Plan, the Programme for improving maternal, newborn, child, adolescent, youth and elderly health. In addition, the Assembly of Health Ministers of ECOWAS which was held in June 2017 in Abuja, instructed WAHO to assist countries to develop further actions for elderly people. Against this background, WAHO intends, in collaboration with all key stakeholders, to analyze Elderly s Health situation in the ECOWAS region. The Objectives of the situation analysis are defined as below: II. Objectives 2.1. Overall Objective To analyze Elderly s health situation in ECOWAS Member States with a view to contributing to the improvement of their social and health care in the region. TDR_SITAN_SPA_CEDEAO Page 2 sur 5

3 2.2. Specific Objectives 1. Describe the epidemiological profile, including the most common pathologies, the causes of elderly people s death in the region, and the country mechanisms and systems in place for their social and health care. 2. Determine factors that hamper healthy aging in the countries of the region. 3. Identify factors that promote healthy aging in all ECOWAS member countries, including those related to the health care systems and environment, and those of long duration (in homes, in the community and institution) 4. Propose strategies and interventions to be undertaken, taking into account factors that hamper healthy aging in the countries of the region, as well as care systems adapted to the elderly people s needs. 5. Develop a costed ECOWAS five-year Strategic Plan for the Promotion of Elderly people s Health and Well-being (healthy ageing) with solutions that promote adaptation, recovery, dignity and taking into account the different challenges related to the healthy aging process while optimizing all individuals functional capacities, regardless of their social situation or economic means. 6. Propose a framework for the implementation and monitoring and evaluation of the Regional Strategic Plan III. Duties and Responsibilities of the Consultant Under the technical co-ordination of the Professional Officer for Child, Adolescent and Elderly Health and the supervision of the Director of the Department of Primary Health Care of WAHO, the Consultant has, inter alia, the following main tasks and responsibilities: 1. Make a technical and financial Proposal 2. Conduct a desk review on the issue of elderly health in general and particularly in the ECOWAS region. 3. Develop and validate the appropriate tools to carry out the analysis of the Elderly health situation. 4. Conduct a field visit to 5 selected countries for an in-depth analysis of elderly health in the ECOWAS region. 5. Draft the preliminary report of the situation analysis of elderly health in the ECOWAS region. 6. Validate the report on the analysis of elderly health situation in the ECOWAS region, taking into account WAHO and key stakeholders contributions and inputs. 7. Present the final report on the situation analysis of elderly health in the ECOWAS region. 8. Propose a costed five year ECOWAS Strategic Plan for promoting healthy ageing. IV. Methodology The proposed methodology for the situation analysis is as follows: 1. Conduct a situational analysis based on a preliminary desk review of national health strategies for Elderly Health in general and particularly in the ECOWAS region, supplemented by in-depth situational analysis through a field visit to five target TDR_SITAN_SPA_CEDEAO Page 3 sur 5

4 countries in the ECOWAS region (2 Francophone countries, 2 Anglophone countries and 1 Lusophone country). The selection criteria for countries to be visited shall be mutually agreed upon. During this field visit, Consultant will have to meet all various key national stakeholders and structures involved in elderly health, including those involved in social and health care. 2. Draft the preliminary analysis report and submit it to WAHO for input. 3. Based on the findings of the situation analysis, develop a costed five year ECOWAS Strategic Plan for promoting elderly health. 4. Finalize the Situation Analysis Report and the Plan 5. Submit the Final Report and the Revised Plan to WAHO for validation. 6. Finalize and send back to WAHO the Situation Analysis Report and the validated Plan. The Total duration of the consultancy period shall be for 60 days. The situation analysis is expected to start early November The proposed number of working days is broken down as follows: Table: Estimated Duration of Consultant s key Tasks Activity Situation Analysis Preliminary desk review and drafting of Analysis tools and the plan Duration Proposed Dates Venue 6 days November- Country of December Presentation of tools to WAHO for validation 2 days 2017 Bobo Incorporation of observations for finalization of tools 2 days Bobo Conduct of in-depth situation analysis in the 5 25 days 5 target target countries (3 working days per country countries and two day round trip) Synthesis, analysis of collected data and drafting 5 days Country of of the preliminary report Total for the Situation Analysis 40 days Development of a Draft of the costed five year ECOWAS Strategic Plan for the promotion of healthy ageing Preparation of a draft plan 7 days January Country of 2018 Collection of WAHO and key stakeholders inputs to the Plan. February 2018 Finalization of the Draft Plan 3 days March 2018 Total for draft plan development 10 days Validation Workshop of the Situation Analysis Report and the Plan Preparation of the Validation Workshop of the Situation Analysis Report and the Plan Country Country 2 days April 2018 The Gambia (2018 Budget) of of TDR_SITAN_SPA_CEDEAO Page 4 sur 5

5 Activity Duration Proposed Dates Venue Validation Workshop of the Situation Analysis 3 days The Gambia Report and the Plan April 2018 (2018 Budget) Finalization of the validated Situation Analysis 5 days Country of Report and the Plan April/May Submission of Final report and validated Plan 2018 Country of Total number of days for validation 10 days Total number of days on 2018 Budget 20 days 2018 Budget Total number of Days of Consultation 60 days V. Deliverables 1. Validated Final Report of the Situation Analysis. 2. Tools for Situational Analysis. 3. List of countries targeted for field visits (with justification for selection). 4. List of national key actors and structures involved in elderly health in targeted countries visited. 5. Mission Report (for each of the 5 countries visited). 6. ECOWAS Costed five-year Strategic Plan for the promotion of healthy ageing. NB : All work produced as part of this activity remains the sole property of WAHO. VI. Qualifications and Experience 1. Be a physician with at least a Master s Degree in public health or any other similar field or related specialty. 2. Have at least 8 years of working experience in the field of reproductive health including at least 5 years in the field of Elderly Health in West African countries. 3. Have a good experience in the development of regional health documents (plans, programmes, strategies,...) in the field of RH including Elderly Health. 4. Have a good understanding of the economic, political and cultural environment and of the role of regional institutions and Member States, private and public sectors when developing health objectives and priorities, including Elderly Health. 5. Must be fluent in French and English (writing and speaking). 6. Ability to communicate in both languages. 7. Knowledge of Portuguese would be an asset. 8. Be able to work in Bobo-Dioulasso and travel across West Africa at least 60% of the time during the mission. TDR_SITAN_SPA_CEDEAO Page 5 sur 5