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Palliative Care Transformational Project Public Health Specialist

Consultancy terms of reference


Médecins Sans Frontières/Doctors Without Borders (MSF) provides life-saving emergency relief and longer-term medical care to some of the most vulnerable and excluded communities around the world. As an independent medical humanitarian organisation, we deliver care based only on need, regardless of ethnic origin, gender, religion or political affiliation.

Around 40,000 patients die in MSF’s Projects every year.

Despite the valuable efforts of Palliative Care clinicians working with MSF, we have not yet been able to address quality of death and dying for most of these.

Medical managers in charge of MSF projects need a simplified tool (algorithm / decisional tree) allowing them to identify specific service needs and integrate Palliative Care tools and resources appropriately from a programmatic / operational perspective.

Gap analysis/Assessment of current need

In previous years, MSF developed extensive guidelines, toolkits, and training materials for our medical managers. Despite these efforts, and a few successful pilot projects, palliative care needs remain unmet in most projects.

Pilot projects to date, required high intensity specialist input and produced poorly adaptable tools which are non-user friendly. We need high-standard tools to support our medical staff to prioritise quality of death services.

MSF wishes to integrate palliative care services in more structural and sustainable ways in all its projects to improve quality of death and dying.

Expected results/outcomes

· Strategic leadership and management, in collaboration with a Nurse Consultant, provided to the Palliative Care Transformational project.

· Gathering and cross-analysis of MSF mortality data. Development of simplified toolkits accessible to MSF medical project leaders.

· Development of models to clarify and decentralise Palliative Care in crisis contexts, focusing on nursing staff and locally hired staff.

· Partnerships created within and external to MSF ensuring the availability of specialised support for projects.


The consultancy will:

  • Provide strategic leadership and management of the Palliative Care Transformational Project aimed at designing, prototyping, implementing, and evaluating adapted and customisable solutions to integrate Palliative Care in all MSF Projects.
  • Connect with all existing MSF capacities useful for the development of the project: Health Information System teams, Palliative Care working group, Health Advisors, Social Scientists, etc.
  • Represent MSF with associations and institutions specialised in Palliative Care, particularly those located near MSF projects.
  • Ensure specialised clinical support for all existing projects providing palliative care.

Assumptions made / areas of uncertainty

MSF is a complex and ever-changing organisation, composed of a variety of medical and operational structures. The consultant will be required to navigate this complexity while creating generalised buy-in for the project implementation.

The consultant will be required to provide recommendations on priorities using existing data analysis which may be incomplete, of poor quality and have inconsistent use of definitions.

It is presently unclear what percentage of time will be required in the support of existing projects.

In / out of scope

The initial focus of the project concerns patients who are dying and their families. Broader aspects of palliative care, although very important, are out of scope at this stage.

Deliverables and deadlines

The deadline for the project is 12 months from its conception, with six key outcomes:

Evaluation of the outcome of a Minimum Viable Product (MVP) consisting of:

  • support to selected projects identified for their simple mortality patterns
  • development of tools, trainings, and networking support to MSF Projects
  • development of a Monitoring, Evaluation, Accountability, and Learning (MEAL) framework for implementation and integration, to be piloted in MSF Projects

Deadline: 5 months

Together with a Nurse Consultant, production of an initial map of external Palliative Care partners who could support MSF’s patients.

Deadline: 6 months

Collaboration with a Palliative Care Nurse Consultant in the development of a user-friendly repository of all documents and tools in a central location with clear versions, dates, and responsibilities for document owners.

Deadline: 7 months

Creation of a simplified decision-making algorithm accessible for Project Coordinators to indicate what type of Palliative Care offer is adapted to each existing type, size, and urgency of medical services.

Deadline: 9 months

Creation of a mechanism for continued review of processes and tools both routinely and in response to monitoring and evaluation findings, with clearly defined roles and responsibilities.

Deadline: 10 months

Dissemination of processes, documents, and tools to all relevant colleagues with clear direction on use, adaptation, and feedback to ensure that documents remain relevant, up-to-date and available where they are most needed.

Deadline: 12 months

Profile required:

  • Medical qualification.
  • Prior work experience leading public health Palliative Care projects / activities.
  • Clinical or managerial experience in a variety of Palliative Care settings (hospice, ambulatory, home-based, etc).
  • Excellent strategic planning and management skills of big teams / diverse activities.
  • Prior experience working and collaborating with partners within cross cultural settings and humanitarian settings.
  • Proven strategic and analytical thinking skills.
  • Good understanding and knowledge of epidemiological analysis of public health data.
  • Ability to develop and maintain relationships with high profile stakeholders in professional manner and in accordance with MSF principles.
  • Strong communication and interpersonal skills with the ability to motivate and influence change.
  • Ability to lead a project through teaming approach.
  • Ability to complete work within specific timescales.
  • Proven networking and representation skills
  • Fluent English language abilities
  • Research experience is advantageous.
  • Commitment to the aims and values of MSF.

How to apply

Please submit to admin.mu@london.msf.org a brief proposal, including:

1. Proposed approach to achieve the deliverables including:

  • Commentary on Death and Dying presentation – which are the relevant aspects to work on – max. two pages.
  • Project GANTT
    - how can the roadmap and timeline be improved?
    - are there important aspects that should be added?

2. What you see as being in / out of scope.

3. CV(s) of those involved including examples of previous similar work.

4. Total fee proposal.

Deadline for applications

21 May 2023

For questions, further background information please contact: admin.mu@london.msf.org