Background:
In 2018, the Ministry of Health conducted the first of its countrywide assessment of EmONC (Emergency Obstetric and Newborn Care) services using the AMDD (Averting Maternal death and disability) tool. The cross-sectional facility-based survey used 12 modules as data collection instruments from 3 referral hospitals, 21 hospitals and 23 Basic Health Units (BHU) I.
In 2018, the Ministry of Health conducted the first of its countrywide assessment of EmONC (Emergency Obstetric and Newborn Care) services using the AMDD (Averting Maternal death and disability) tool. The cross-sectional facility-based survey used 12 modules as data collection instruments from 3 referral hospitals, 21 hospitals and 23 Basic Health Units (BHU) I.
The assessment provided critical findings related to the health facility performances based on the critical clinical interventions (EmONC signal functions). Since then, there have been changes in the maternal and newborn landscape in Bhutan. Quality improvement, a human rights-based approach to respectful maternity care, health system strengthening and implementation science have come together to create new norms. Quality of care can no longer be seen as simply a side issue of improving technical delivery of clinical interventions in the facility, but also the experience of care.
Globally, there is focus on keeping the mother-newborn dyad together as much as possible during their stay in a facility, even in the event of obstetric or newborn complications. Therefore, there is a need to incorporate geographic modeling to map the travel time for EmONC accessibility into assessments of EmONC functionality, ensuring that a strategically selected network of referral maternal cares can be realistically reached within 1 and 2 hours of an emergency and be able to provide quality EmONC care. With the launch of third child incentive in Bhutan (2026), every pregnancy is counted and the risks associated with advanced age pregnancy are expected to become more frequent.
Monitoring the availability, readiness, and functionality of EmONC services remains a key priority for Ministries of Health and development partners. However, routinely collecting and using reliable EmONC data to guide decision-making remains a major challenge and comprehensive EmONC assessments are resource-intensive and infrequent, limiting their application to real-time program management. Therefore, to address these challenges, UNFPA introduced the EmONC Light Assessment Tool (LAT), a simplified approach designed to streamline data collection on essential EmONC readiness and service provision. This light assessment evaluates the availability, readiness, utilization, and quality of signal functions in selected health facilities to guide immediate policy and program decisions.
Globally, there is focus on keeping the mother-newborn dyad together as much as possible during their stay in a facility, even in the event of obstetric or newborn complications. Therefore, there is a need to incorporate geographic modeling to map the travel time for EmONC accessibility into assessments of EmONC functionality, ensuring that a strategically selected network of referral maternal cares can be realistically reached within 1 and 2 hours of an emergency and be able to provide quality EmONC care. With the launch of third child incentive in Bhutan (2026), every pregnancy is counted and the risks associated with advanced age pregnancy are expected to become more frequent.
Monitoring the availability, readiness, and functionality of EmONC services remains a key priority for Ministries of Health and development partners. However, routinely collecting and using reliable EmONC data to guide decision-making remains a major challenge and comprehensive EmONC assessments are resource-intensive and infrequent, limiting their application to real-time program management. Therefore, to address these challenges, UNFPA introduced the EmONC Light Assessment Tool (LAT), a simplified approach designed to streamline data collection on essential EmONC readiness and service provision. This light assessment evaluates the availability, readiness, utilization, and quality of signal functions in selected health facilities to guide immediate policy and program decisions.
The overall purpose of this consultancy is to support the Ministry of Health to conduct an EmONC light assessment using the EmONC Light Assessment Tool (LAT), a simplified approach designed to streamline data collection on essential EmONC readiness and service provision. The LAT focuses on a minimum set of tracer indicators that assess the presence of skilled personnel, key drugs and supplies, functional equipment, and the performance of critical signal functions at health facility level. It enables Ministries of Health and partners to systematically assess and track the availability, readiness, and performance of EmONC services as part of ongoing efforts to reduce maternal and newborn morbidity and mortality, specifically capturing information on key inputs and functions for quality EmONC service delivery including:
- Availability of essential drugs, supplies, and equipment,
- Human resource capacity and presence of skilled providers,
- Functionality of signal functions for obstetric and newborn care,
- Service utilization and outcomes, including deliveries, complications, and referrals, and
- Readiness of the infrastructure and referral system supporting EmONC service delivery.
Scope of Work (Description of services, activities, or outputs): The overall EmONC Light Assessment programme in Bhutan will focus on:
Service Availability: Measure the presence and geographic distribution of Basic EmONC (BEmONC) and Comprehensive EmONC (CEmONC) facilities [FM1]
Signal Functions: Assess whether facilities perform vital signal functions over a retrospective 3-month period
Readiness & Inputs: Verify tracer indicators including essential medicines, consumable medical supplies, functioning equipment, and skilled human resources
Bottleneck Analysis: Combine facility data with travel-time mapping or GIS tools to locate coverage gaps and referral blockages
The local consultant will work closely with MOH, UNFPA and UNICEF to undertake the following tasks:
- Develop a study design and sampling methodology based on total facilities as a sampling frame in the selected districts.
- Develop and finalize the study protocol in collaboration with technical working group.
- Adapt the EmONC light assessment tool (LAT) to Bhutan’s context for rapid data collection, including updating to reflect new changes in EmONC signal function and levels of care definitions.
- Lead the development of an assessment plan/agenda with timeline and adapted LAT; target audiences to be engaged; orientation of responders on self-assessment format and other needed elements.
- Liaising with the district health teams to plan and implement the exercise in collaboration with the Technical Working Group.
- Ensuring that clearance for data collection has been obtained from the appropriate authorities, before the data collection process.
- Train and orient service providers on the data collection tool and to facilitate rapid EmONC assessment prioritizing CEmONC and BEmONC facilities across the country
- Coordination and close monitoring of data collectors in the field; ensuring adequate supervision of the data collectors to ensure that quality data is collected.
- Liaise with UNICEF to use and link the health facilities GIS data, capitalizing on existing travel time analyses and accessibility analyses available for the country [FM1]
- Produce the EmONC needs assessment report and conduct a national dissemination of the findings and the report.
Duration and working schedule: The contract for the consultancy will be for a period of forty-five (45) working days; from September to November 2026.
- Phase I: Initial Preparation (Before data collection): 10 days. Adaptation of the EmONC tools, data collection tools, training, meetings with TWGs.
- Phase II: Data Collection (Field work for monitoring): 15 days.
- Phase III: Data cleaning and analysis and report writing: 20 days.
Place where services are to be delivered: Thimphu, Bhutan. The Consultant is expected to work from her/his own location, with periodic visit to the Ministry of Health, UNFPA and UNICEF as needed to undertake this assignment.
Payment Schedule: Payment will be based on deliverables, made upon the satisfactory completion of tasks as per the following schedule:
- 30% upon the submission and acceptance of inception report
- 30% upon the submission of draft report
- 40% upon the submission and acceptance of final report
Delivery dates and how work will be delivered: The Consultant is expected to submit all deliverables, in both hard and soft copies, to UNFPA, coordinating review and acceptance of deliverables with MoH and UNICEF. The consultant/team will deliver the following:
- Inception report outlining the proposed methodology and work plan.
- Adapted EmONC light assessment tool for Bhutan’s context
- Draft assessment report for review and feedback.
- Assessment findings presentation
- A final assessment report
The Consultant will be expected to interact both in-person and virtually, as needed, with key stakeholders, including the MoH staff, UNFPA and UNICEF staff, other relevant UN Agencies and development partners supporting the health sector, and selected hospitals. The Consultant will be expected to interact both physically and virtually, as needed, with key stakeholders, including the MoH officials, UNFPA and UNICEF staff, other relevant UN Agencies and development partners supporting the health sector, and selected hospitals.
Supervisory arrangements: The Consultant will work under the direct supervision of the Programme Focal at the UNFPA Country Office, who will liaise closely with the RMNH Program at the Ministry of Health in overseeing the Consultant and his/her deliverables.
Monitoring and progress control, including reporting requirements, periodicity format and deadline: The consultant will work closely with the RMNH program at the Ministry of Health, with technical guidance from both UNFPA and UNICEF and their respective technical advisors, technical working group, and other technical staff/program advisors of the Ministry of Health and EmoNC focal/specialist from the health facilities. The consultant is expected to maintain fluid communication and in person and virtual meetings will take place throughout the consultancy, particularly to coordinate with the UNFPA and UNICEF Regional Offices as needed.
Expected travel: Travel to selected districts within Bhutan may be required for this assignment. Such travel will be authorized by UNFPA in consultation with the Ministry of Health (MoH) and UNICEF. Travel costs will be covered by the coordinating agencies (either MoH/UNFPA/UNICEF) in accordance with their respective rules and regulations.
Required expertise, qualifications and competencies, including language requirements
Medical doctor or Gynecologist with master’s degree in public health or advanced/postgraduate degree in Public Health or reproductive health or relevant field of studies with 10 years of experience;
- Demonstrated experience in conducting complex assessments, reviews, and training in the field of SRH;
- Familiarity with UNFPA/UNICEF mandate and activities;
- Experience and understanding of development issues in the country, especially related to maternal and neonatal health; familiarity with the UNFPA, UNICEF agenda and 13FYP of MoH;
- A strong experience in qualitative and quantitative data analysis, analytical, research and writing skills in the areas of maternal and neonatal health issues
- Strong policy analysis and writing skills are essential;
- Previous experience of EmONC assessment or work on maternal and newborn health is an asset;
- Be able to coordinate and meet with line ministries, health facilities and other agencies for gathering information related to the assignment;
- Be able to facilitate and provide high-level presentations at meetings/workshops with technical and high levels of government officials; and
- Fluency in English- both written and oral required.
Application Requirements: Interested applicant are required to submit the following as part of their application:
- A technical proposal, including a brief description of the proposed approach to the assignment
- A financial proposal, submitted separately from the technical proposal
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. Reasonable accommodation may be provided to applicants with disabilities upon request, to support their participation in the recruitment process. 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 official source link 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.