1. BACKGROUND Over the past three decades, maternal and newborn survival rates have improved globally. However, in Eastern and Southern Africa (ESA), newborn mortality rates remain among the highest in the world. In Lesotho, neonatal mortality stands at 26 deaths per 1,000 live births, with no significant improvement over the past decade. Additionally, the maternal mortality rate is alarmingly high at 566 deaths per 100,000 live births, while the stillbirth rate in 2021 was 27 deaths per 1,000 total births. Many of these deaths could have been prevented with improved quality care during childbirth, including better monitoring and timely access to emergency obstetric care when needed. Like many other countries in the region, Lesotho faces high institutional mortality rates and stillbirths, as high-quality Maternal and Neonatal Health (MNH) services are not accessible to every mother and child. Historically, health care providers in Lesotho had limited opportunities for pre-service learning and lacked formal in-service training programs, with only sporadic initiatives supported by various partners. Post-training follow-up, mentoring, and continuous supportive supervision have also been inadequate and unstructured. To address these challenges, UNICEF, in partnership with the Church of Jesus Christ of Latter-day Saints, began supporting Lesotho#s health system strengthening efforts through the capacity building of the health workers to improve the quality of maternal neonatal and child health services.  UNICEF works closely with the Ministry of Health (MOH) to enhance the availability of high-quality MNH care, focusing on increasing in-service training for health personnel and improving care within catchment-area-based programs. One of the key initiatives is the transformation of referral hospitals into learning hubs. This initiative aims to equip health care providers with the skills and knowledge necessary to meet the immediate and long-term needs of Basotho women and children. This includes establishing training hubs, setting up simulation centers, and implementing mentorship programs for health care providers in catchment areas. The Ministry of Health has already established one learning hub and a simulation center at the Queen Mamohato Memorial Hospital (QMMH), the only tertiary institution in the country. Additionally, six simulation centers have been set up in two regional referral hospitals, as well as four other hospitals within their catchment areas. Simulation-Based Education (SBE) is a key component of this initiative. It allows clinical procedures to be practiced in a safer environment to enhance the confidence of learners before performing these procedures in real-life situations. The Ministry of Health has collaborated with seven nursing training institutions to onboard this initiative. To date, learning hub guidelines, a training curriculum, and checklists have been developed. A total of 35 simulation center facilitators (8 doctors and 27 nurses) have been trained to manage all aspects of simulation. These facilitators play a critical role in ensuring the success of the training and must be well-equipped with the necessary skills and knowledge to teach healthcare workers effectively. Despite these advancements, there is still a need to further capacitate the simulation facilitators with knowledge and skills in Emergency Obstetric and Newborn Care (EmONC) and Emergency Triage Treatment (ETAT), as well as in the treatment and management of hospitalized sick children. This training is essential to ensure that facilitators can effectively train other healthcare workers, ensuring the sustainability of the program even after the contract period ends. Considering this, UNICEF seeks the services of a consulting company with the requisite technical capacity to support the Ministry of Health#s Maternal and Child Health program. The consulting company will provide training for simulation center facilitators and midwifery clinical supervisors in EmONC and ETAT, focusing on a #train-the-trainer# approach. This will ensure that the training capacity remains within the country even after the contract ended. The company will also be responsible for monitoring the implementation of the training and providing ongoing mentorship and supportive supervision. 2. SCOPE OF WORK The main objective of this consultancy is to enhance skills and competencies in Emergency Obstetric and Neonatal Care (EmONC) among healthcare providers in Lesotho. This includes the introduction of standardized care protocols across all maternity facilities. The consultancy aims to ensure that the Ministry of Health (MoH) implements evidence-based clinical practice guidelines for common illnesses that significantly contribute to mortality in resource-limited countries, in alignment with WHO recommendations. In addition, the program will provide in-service training for healthcare workers in emergency care and the initial management of critically ill neonates, infants, and children, with a focus on Newborn and Paediatric Life Support skills. Healthcare providers will also be supported in auditing their facilities' preparedness to deliver essential care, in line with WHO guidelines for the management of sick children, addressing physical infrastructure, staffing, and patient data.