Consultancy For Assessing The Impact Of Reproductive Health Trainings At The Primary Health Care Level

  Consultancy for Individuals Background Since 1994, the Ministry of Public Health (MOPH) and UNFPA, have been working together to reinforce the quality of Reproductive Health (RH) services in the public sector that necessitated the development and adoption of RH Service Delivery Guidelines (SDG). While these guidelines were primarily intended to reflect and translate the need to integrate RH services within primary health care (PHC) services, they also came at a time where clinical algorithms and standards of practice at PHC level were somehow dispersed and inconsistent. In 2014, and in line with progress made in medical and public health understanding of RH, and based on clinical experience of the RH SDG practice and providers’ feedback, the ministry – through continued partnership with UNFPA - ventured into a process for further revising, expanding and updating the RH SDGs taking into consideration emerging and changing priorities within the national health system.  More so, the overwhelming spillover of the Syrian crisis on Lebanon and the presence of more than 1 million Syrian refugees across the Lebanese territory resulted in a highly complex public health situation, and thus the evolving concept of RH necessitated a newer version of the SDG. Accordingly, the MOPH/UNFPA partnership expanded to comprise the Lebanese Society of Obstetrics and Gynecology (LSOG) - a leading scientific organization that aims to promote women's health care and well-being - to further provide technical input on the existing RH SDGs that has been in practice at the levels of primary health care since 2009.  As a result, and in addition to the existing topics ranging from safe motherhood and family planning among others, this revised version of the RH SDG captures additional essential RH dimensions namely emergency obstetric care, RH minimum initial service package, adolescents and youth health, HIV/AIDS prevention and management, clinical management of rape survivors, prevention and management of sexually transmitted infections, post-abortion care, and ethics.  Those RH SDG are supposed to provide one of several criteria adopted by MOPH and necessary to realize standardized quality assurance on the RH services provided by the PHCs. The revised RH SDGs were officially adopted by the Ministry in 2015 and the capacity development roll out was kicked off during the same year and through 2016 targeting a total of 475 and covering all regions in Lebanon (please see Annex 1 for details on the all RH SDG training).  In 2017 and also under the partnership between MOPH, UNFPA and LSOG, additional number of health care providers at PHC level will be targeted to be trained on the RH SDG to ensure that comprehensive RH services are fully integrated and accessible at primary health care level.    To assess the impact of the RH training through SDGs on the health care providers at the PHC level, the proposed assessment will accordingly look at the usefulness, relevance, content, effectiveness, etc. of the training and identify successes, challenges and will pave way forward for future recommendations for ensuring universal access to RH at the PHC level based on the revised RH SDGs.   Purpose   The purpose of this consultancy is to carry out an assessment on the impact of the RH SDG trainings carried out between 2015 and 2016 with the aim to ensure universal access to RH at the PHC level. As such, the assessment is expected to provide an overview of participants’ and trainers’ perception about the RH SDGs training as well as linkage to practice by exploring its effectiveness, relevance, quality and usefulness as well as to identify additional needs and explore ways to fill critical gaps related to capacity building and RH services through more focused interventions.   The specific objectives of this assessment are:   To assess the RH SDG training workshops in terms of usefulness, relevance, effectiveness, quality, content, and methodology; To assess the participants’ perception on how the RH SDG training impacted their knowledge and attitudes and enhanced their skills for improved provision of SRH services according to RH SDGs ; To assess the participants’ needs for additional training and/or on-the-job coaching on reproductive health; To assess how the RH SDGs are being utilized (or not) by the participants; To assess the participants’ views for developing a mobile application (as well as other visuals/tools) that reflect key aspects of the RH SDG; To assess the participants’ perception about challenges and gaps pertaining to the provision of standard RH package at the service delivery level based on the RH SDGs; To assess trainers’ views about the RH training and use of SDG as a main reference; and To come up with a series of recommendations for improving the quality of RH care        Description of Tasks   Under the guidance by UNFPA and MOPH, a consultant will be identified to carry out the following tasks: Meet with UNFPA to understand the scope of the consultancy and draw a plan of action including proposed methodology Meet with MoPH and other involved stake holders to seek support, facilitation and advise for the purpose of consultancy.  Conduct a desk review of global, regional and local literature on the subject matter and review relevant resources such as RH SDGs, training reports, ministry’s annual and related reports, other relevant material (including online) to identify evidence based approaches to carrying out such assessments. Develop a comprehensive assessment tool and finalize based on input from UNFPA and MoPH. Select the sample size of respondents based on database to be made available by MOPH and develop an interview plan with a timeline. Initiate interview process that will target the trainers, the PHC service providers trained previously on the RH SDGs and a sample of service providers never trained in the past. The format/structure of these meetings will be based on the agreed upon methodology of the assessment (self-administered or semi-structured interviews). Consolidate the data collected and provide detailed analysis as part of final draft report. Ensure timely delivery of a comprehensive final report + executive summary based on UNFPA’s feedback. Deliver a power point presentation with infographics (20-22 slides) summarizing key results of the assessment Take part in a technical meeting to present the findings as advised by UNFPA   Proposed Methodology   The following methodology is proposed to conduct the assessment: Literature and documentation review (Refer to task #3 under Description of tasks) 4 key informant interviews with central stakeholders (UNFPA, LSOG, MOPH and LOM); Interviews with 3-4 trainers 45-50 interviews (self-administered or semi structured to be agreed upon) with service providers previously trained on the RH SDG.  Selection criteria include the following: Geographical coverage based on attached Annex 1 Male and female service providers based on attached Annex 1 Service providers with different specialties (i.e. Ob/Gyn, General Practitioner, midwives, nurses) Respondents working at MOPH/MOSA/medical universities based on attached Annex 1 30-35 interviews with service providers not trained on the RH SDG Expected Outcomes   The consultant shall deliver a comprehensive report in English based on the objectives and requirements set forth in the Terms of Reference. The report will constitute the final outcome of this consultancy and consisting mainly of the following sections: Overview and background of the assessment; Methodology, data collection procedures, and data analysis plan; Findings and discussion including challenges and lessons learned; Conclusion and recommendations; List of annexes; and References   Duration of Assignment Two months from the signing of the contract.   Support to be provided by UNFPA   Review and provide technical input on the assessment tool. Provide consultant with necessary and relevant reports and documents Facilitate contact with the main stakeholders namely MOPH, LSOG, LOM Participate in the field level meetings/interviews/FGDs where feasible. Provide input on the draft final report   Support to be provided by MOPH/LSOG   Provide access to related reports  Provide consultant/researcher with database of trained personnel in RH as well as trainers on RH Facilitate access to PHC and respondents   Qualification and/or specialized knowledge/experience   Advanced University degree in social/development sciences/public health/epidemiology/biostatistics or other related areas with knowledge and understanding of sexual and reproductive health. At least 7-8 years’ experience in research methodology including data collection and analysis in the health sector Good knowledge and familiarity with human rights principles and approaches. Good knowledge with the health system in Lebanon Excellent interpersonal skills and ability to establish effective and working relations with various stakeholders Considerable knowledge in statistical package Excellent written and spoken communication skills in Arabic and English.  ANNEX 1    HOW TO APPLY Interested candidates may apply online by providing: (1)   a most updated CV, and (2)   a cover letter mentioning the relevance of past/current experience with the requirements of the consultancy.   The above documents must be sent to the following email address: info-lebanon@unfpa.org by no later than August 14, 2017 Candidates who fail to submit the required documents above will not be considered for review. UNFPA Lebanon will only be responsible to respond to those applicants submitting the required documents above and in which there is further interest. ONLY individual consultants, not companies, are eligible to apply.