Professional Documents
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CVKBA
CVKBA
Medical training:
Date : October 1969 - October 1977
Institution : Faculté de médecine de Tunis
Diploma : Docteur en médecine (Medical doctor)
Short courses:
Result based approach for programming:
- Date: one week, February 2007
- Institution: UNDP, Tunis
Human rights based approach to programming:
- Date: one week on January 2005 and one week on February 2006
- Institution: UNICEF; facilitator: Urban Jonsson
Cours sur la Recherche opérationnelle en santé primaire :
- Date : 6-12 mai 1984
- Institution : Pricor, Canada
Cours International de formation des responsables nationaux de lutte anti-diarrheique
- Date : 2 weeks, February 1983
- Institution : WHO
March 2005-todate: Chief Section Young Child Survival and Development, UNICEF Sana’a
From March 2005 to December 2006, I was responsible for the Health and Nutrition Program. The
current Country Program integrated the Water and Sanitation Program in one Young Child
Survival and Development Program. The YCSD Program is running four projects: Child Health
(EPI, IMCI and District Health Strengthening), Nutrition (Child malnutrition, Infant and Young
Child Feeding, Management of Acute Moderate and Severe Malnutrition and Micronutrients
control), Maternal and New born health (with a focus on Home Based Maternal and New Born
Care) and Water& sanitation. When I joined Sana’a UNICEF CO, the H&N section counted two
NOB, one GS4 and one GS6. Currently our section is composed, beside myself, one L4, 9 NOBs
(five of them are working in UNICEF sub-offices), one NOA, two GS6, one GS4 and two UNVs.
During the last three years, I contributed to strengthen the collaboration and harmonisation
between UN agencies and the main development partners involved in Yemen health programs. I
collaborated closely with WHO, CO and GAVI focal point to support MOH’s efforts in
controlling the Yemen 2005 Polio outbreak. Beside the organization of nein Polio NIDs, I have
been fully involved in the planning and organization of a National Measles campaign targeting 9
months-15 years old children. The coverage achieved by all these campaigns was above 95%. This
led to end the circulation of the wild Polio virus as no new Polio cases were reported since
February 2006 and to control Measles as after being endemic through over all Yemen, only 17
Measles cases were reported since the organization of the campaign.
To sustain these achievements, and as around half of Yemeni population has no access to health
facilities, we developed and supported the Outreach Integrated Package of Services strategy
(immunization, IMCI, Reproductive health, Nutrition,…).
With the main donors involved in Reproductive Health, mainly UNFPA and WHO, I participated
in setting up the “Reproductive Health Technical Group” and the “RH Steering Committee”.
These two mechanisms are contributing to the donor’s inputs harmonization and alignment with
national policies and procedures.
Furthermore, I coordinated a Joint UNICEF/UNFPA Maternal and New Born Health project of
US$ 12 Million. During the second semester 2006, I coordinated the organization of an EmONC
Needs Assessment in five governorates and the development of a new “Home Based Maternal and
New Born Care strategy” addressing the 82% of deliveries taking place at home. This HBMNC
strategy is adopted by MOH as National strategy and is being piloted in 11 districts.
Furthermore, I succeeded in advocating with national counterparts to put child and women
malnutrition on the top of MOH priorities. Currently a National strategy document is being
developed with the participation of MOH and Development partners (WFP, WHO, WB, JAICA,
University…). In parallel and as Acute malnutrition is highly prevalent in Yemen (above 15%),
three therapeutic feeding Centers (TFCs) for the management of complicated moderate and severe
acute malnutrition were set up in three teaching hospitals. Three new TFCs are being implemented
in new governorate hospitals. In the Catchment’s areas of these TFCs a Community Therapeutic
Care strategy is initiated with its community (community health workers) and health facilities
(OTPs) components. In parallel, Flour and Oil are successfully fortified. Salt iodization is not yet
universal due to the presence of many hard to reach small producers.
To ensure sustainability of the supported health programs and projects, we developed close
collaboration with Pediatric and Gyne-Obstetric Departments of Faculties of Medicine and High
Institutes for Health Sciences. Integration of IMCI and Home Based Maternal and New Born Care
are in process to be integrated in pre-service curricula. Furthermore, this year, we are supporting a
one year Neonatal Care diploma in collaboration of the Yemeni high council of medical
specialties.
A promising new development in UNICEF cooperation is the new partnership with private sector
to produce locally Plumpy Nut and to initiate WASH Programs in Child Friendly schools.
February 1991- March 2005: Health officer, UNICEF Tunis Country Office:
The UNICEF, Tunis health program of cooperation was mainly providing intensive technical
assistance to our partners in MOH. Despite a small budget and a reduced team we achieved a
long-list of success stories.
During the nineties, the program of cooperation UNICEF/MOH focused on Mid Decade Goals
and Decade Goals. In close collaboration with my partners in MOH, I contributed to develop the
appropriate strategies and supported there implementation. During this period, I was the only
representative of international development organization being accepted as member in all National
committees (Comité National de périnatalité, Comité National pour la certification des cas de
Polio, Comité National de Développement des Circonscriptions sanitaires…). The main domains
where I was particularly active are:
- Polio eradication, NN Tetanus and measles’ elimination: organisation of NIDs then
Maghrebian Immunisation days; SIAs; AFP surveillance and the NIDs for measles’
elimination. These three diseases were controlled/eliminated from Tunisia.
- Universal salt iodization: situation analysis; adoption of legislation; set up of quality control
system of iodised salt; organization of pre-post iodization surveys on Goiter prevalence and
iodine urinary elimination. In 2002, close to 96% of Tunisian households were consuming
appropriately iodised salt and goiter prevalence, mainly seriousness declined significantly.
- Child malnutrition : I constantly advocated to a mixed approach (promotion of adequate
nutrition + control of recurrent child diseases) rather than an exclusive nutritional approach to
address child malnutrition. To achieve this, IMCI/CIMCI was our main strategy.
- In 1994, after a freeze of more than ten years, I re-started the negotiation about the
Decentralisation of PHC system and facilitated the signature of a long term MOU with the
Institute of Tropical Medicine of Antwerp, Belgium which provided TA in adapting the
concepts of decentralisation to the Tunisian context and accompanied us during the
implementation phase. The reform was tested in six starting districts. We involved Universities
in supporting the PHC Department in the implementation, monitoring and evaluation of the
pilot phase. The legislation on the “Circonscriptions sanitaires” was adopted on the year 2000.
- Quality assurance of PHC services and the adoption of criteria and norms to be used during
self assessment and quality control process were parts of the Decentralization Program’s
components. An accreditation system was developed to be used by health authorities.
- Promotion of women health and reduction of maternal mortality: during 1993-94, I
contributed to the maternal mortality survey (MMR: 69p100.000). The survey results
contributed to the development and implementation of a National strategy for the acceleration
of MMR reduction. Launched in 1999, the strategy achieved encouraging results as maternal
deaths occurring in hospitals were reduced by half within five years.
- To contribute to the reduction of neonatal mortality, and in collaboration with all neonatal
care country teams (4 Faculties’ Departments), I contributed to the update of the training
module on neonatal care and neonatal resuscitation in delivery room, organized a competency
based training (using dummies and in neonatal units) for all pediatricians operating in
immediate neonate and midwives working in public maternities (90% of deliveries).
- Anemia remains the main public health problem among both children and women.. We
developed a national strategy with three components: iron supplementation, flour fortification
and promotion of adequate diet. De-worming was excluded as a research conducted in 2001
showed that parasites are not a cause of anemia among Tunisian children. A socio-
mobilisation strategy was designed to address primary and secondary prevention of anemia.
- Promotion and protection of breastfeeding through the implementation of BFHI: a huge
capacity building effort was conducted by training health staff in all maternities. Exclusive
breastfeeding increased from 11% to 48% within four years. The BFHI contributed also to the
enforcement of the milk substitutes National Code.
- The launch of the “IMCI plus strategy” in close collaboration with EMRO: in addition to
WHO-UNICEF guidelines, I contributed to the development of additional modules: young
child psycho-motor development, early detection and care of sensorial disorders,
neonatal care (0-7days) and audiovisual material on better parenting to support the
C-IMCI aiming to promote key family practices. I also contributed to develop a training
package on early detection of child abuse, neglect and maltreatment. This training
package was developed in collaboration with the protection section. The Tunisian law
established the obligation of reporting “Obligation de signalement” the health staff is
mandated to report any suspicion of child abuse or maltreatment to the « Délégué à la
protection de l’enfance » and should collaborate with other stakeholders such as police, social
workers, and psychologists for the best interest of the child…
- Development of the “Evaluation and micro-planning tool” which helps local teams to
conduct regular self assessments of qualitative and quantitative aspects of their programs. This
tool was developed and used for EPI, Antenatal care and management of chronic diseases
(hypertension and diabetes). This tool helps the identification of ‘bottle necks’ and the
identification and implementation of appropriate solutions.
- In the area of HIV/AIDS prevention, we helped MOH in strengthening the HIV surveillance
system, in setting up VCT centers and to support IEC intervention mainly among youth and
high risk groups.
- As unique manager of the UNICEF health program, the assessment of my contribution to the
achievements in health is very positive: I contributed to the reduction of IMR and maternal
deaths occurring in hospitals by more then half; to USI since 1996; to NN Tetanus, Polio and
measles control/elimination; children’s deaths by Diarrhea diseases are currently negligible;
Decentralization of PHC system adopted by law on 2000; no more acute malnutrition…
- Beside the health program, I was closely involved in the Protection Program. In 2000, I
started the project on abandoned children: prevention of unwanted pregnancies occurring out
of wedlock, prevention of abandon of children born out of wedlock, and promotion of
alternatives to orphanages: social and financial support to the unmarried mothers, Kafela
(Islamic adoption), civil adoption, foster family, temporary placement in small life units
“Unités de Vie”. Our work contributed to the adoption of a law establishing the right for the
unmarried mother to request DNA for confirmation of the paternity of her child, the
establishment of a data base for foster families, twofold increase in the allowance given to
foster families to benefit in priority the biological mother to prevent child abandonment…
- The Inclusive school project: During the last two years in Tunis UNICEF CO, I have been
member of the interdepartmental committee having the mandate to develop a National strategy
for the promotion of Inclusive education that aims to integrate children with handicaps in
regular schools. The strategy we developed was adopted by Tunisian Government and
launched during the academic school year 2004/05.
- In 1996, after a study tour to Mali and Senegal, I introduced the « Monitoring tool » in the
Tunisian health system with substantial improvements as I integrated indicators for assessing
quality of care.
- During Afghani war in 2002, I performed three months assignment to coordinate the
emergency interventions in refugees’ camps in Quetta, Peshawar and Islamabad. My duty
was the daily coordination between Pakistani authorities, UN organisations, NGOs, UNICEF
Islamabad and the two UNICEF sub-offices in Quetta and Peshawer. Three weeks after the
starting of the war, all commodities were in place to receive one Million of refugees.
- In April-May 2002, I performed a three week mission to UNICEF Dakar CO to help in
developing a micro-plan for the acceleration of child survival Program in three regions. In
addition, I have been asked to analyze two studies on the improvement of Quality of care in
Dakar and to enrich thoughts on the «Contrat de performances ».
September 1982- June 83 : Master in Public Health, Institute of Tropical Medicine Antwerp
(Belgium):
The MPH training gave me a broader approach of public health problems and the ability to
challenging myself on daily bases.
July 1981-September 1982 : Médecin Chef de Service Régional des Soins de Santé de Base
du Gouvernorat de Nabeul :
Before the end of the “Projet Tuniso-Belge de Médecine Intégrée”, I have been assigned to the
Regional Department for Basic Health Care in Nabeul Governorate to relief the Belgium medical
team. Leading a National team of around 20 physicians and 15 public health technicians, I
succeeded in maintaining the dynamic established by the Tuniso-Belgium project and in ensuring
the management and supervision of the 80 basic health centers of the governorate.