Consultancy services: (KAP) Survey

Background/Summary

Médecins du Monde (MdM France) has been working in the occupied Palestinian territory (oPt) since 1996. Nowadays MdM France is present in the country through its three offices located in East Jerusalem, Nablus and Gaza.  MdM France works, in collaboration and coordination with the government and both international and national organizations, to reinforce the access to quality medical, mental and psychosocial services, through both responding to emergencies and crisis and strengthening local capacities to ensure that health and protection systems provide sustainable aid to population in need.

Within this approach, MdM is starting a new project in both West Bank and Gaza, funded by German Federal Ministry for Economic Cooperation and Development, and in coordination with Ministry of Health (MOH), to achieve an efficient and sustainable integration of Mental Health (MH) services within Primary Health Care Centres (PHCCs). 

The three main outcomes the project aims to attain are:

1. Ensure mainstreaming of quality MH public services into the basic primary health care package delivered by the Ministry of Health in two governorates: Middle Area in Gaza and Qalqilya in West Bank (WB).
2. Ensure proper case management for MH patients by improving protocols and procedures as well as reinforcing the referral pathway between different levels of care in the public health system of Middle Area Governorate in Gaza and Qalqilya Governorate in WB.
3. Strengthen accessibility and acceptability for MH public services by fighting against stigma and misconceptions on MH among community members of Middle Area Governorate in Gaza and Qalqilya Governorate in WB.

In order to assess, evaluate and understand knowledge, attitudes and practices among PHC staff, managers and MoH policy makers in regard to MH conditions and case management, MdM France will conduct a KAP Survey in the targeted areas (23 clinics in Qalqilya Governorate in WB and 15 clinics in Middle Area in Gaza Strip) both at the beginning of the intervention and at the end.  The results of the initial survey will serve to tailor the intervention guiding MDM and MOH in the final design of training material, behavioural change strategies and the identification of challenges and opportunities in order to achieve the expected impact on the availability, accessibility and quality of services provided and the improvement and resilience of Palestinian individuals and communities. At the same time it will set a baseline in order to monitor and evaluate the progress and the impact. MoH and MH directorate focal points will be involved in the designing and implementation of the KAP survey, and results will be shared and discussed with them and with all the PHC staff targeted. This will facilitate the implementation and capacitation, together with the acceptance of the intervention among clinical staff.

Objective of the consultancy and scope of work

The study will aim, but not limited:

• Measure the level of knowledge of PHCCs clinical staff (Doctors and Nurses) in most common MH conditions (identification, treatment, management, referral…)
  • Do they have proper technical knowledge on most common MH conditions?
  • Is the knowledge homogeneous among staff (geographical areas, clinics, categories, individuals…)? 
  • Is any tool in place to keep them updated about clinical changes and advances (regular refreshment trainings, learning platforms…)?
  • What are the main sources of the clinical knowledge? Did they receive any training or capacitation in the past?
  • What are the main gaps and needs in regard to knowledge?

• Identify positive and negative attitudes among PHCCs staff, managers and policy makes toward MH conditions, MH patients and the integration of MH services within Primary Health Care.
  • How is the integration of MH services at PHC perceived by staff?
  • What are the factors impacting perceptions and attitudes (positive and negative)?
  • What is the will of health authorities and policy makers in regard to a real and efficient integration of MH services into the primary health system?
  • Are main public stakeholders willing to allocate resources on this integration?
  • How are services perceived in terms of quality by the staff? By the users? By policy makers?

• Determine the current practices on MH within the targeted PHCCs (availability, accessibility and quality of services)
  • Are quality services available? (if not, what are the barriers to availability)
  • Are services accessible? (what are the barriers/factors preventing accessibility? economic, social, cultural, gender, physical (PWD))
  • Are services having objective quality? (international and national standards)
  • What are tools in place to assure availability, accessibility and quality? (procedures, SOPs…for identification, management, referral…) if some, are there, who is in charge of making its use come true?

The KAP survey will generate a strategy that will help to design training material, to improve and strengthen proper theoretical and technical knowledge among PHCC staff, promote positive behaviours and attitudes towards MH patients’ needs and integration of services that are appropriate to the targeted settings.

The KAP Survey result must also include appropriate methodology for the upcoming implementation of the capacitation, pointing out the most appropriate practices identified as in need of being adopted in order to achieve the aimed impact of the intervention.

The result of the KAP survey will be used as baseline to measure the progress and the impact of the intervention.

To evaluate Knowledge, Attitudes and Practices among PHCCs staff, the survey will also address the perception from PHCCs users as a key source of information.

The assessment must cover all the targeted clinics: 23 clinics in Qalqilya Governorate in WB and 15 clinics in Middle Area in Gaza Strip, as well as MoH relevant managers in charge of current or any potential upcoming integration of MH services.

Methodology

In consultation with key program and technical staff, the consultant/firm will be responsible for defining the parameters of the assessment, including the finalization of an assessment plan to be shared with MdM France coordination team. 

The assessment will look at the Knowledge, Attitude, and Practices regarding MH services within the targeted PHCCs and identify barriers to these services and include health facility Exit Interviews (EI) and Focus Group Discussions (FGD) both with PHCCs staff and PHCCs users. FGD with personnel will be conducted in a participatory manner that will enable the government counterparts from the Ministry of Health (MoH) to participate when pertinent and relevant.

Key activities include, but not limited:

• Desk review: Review existing materials to identify areas in need of further information or clarification. MdM France will provide consultant/firm with all the relevant proposal documents (narrative, framework and target groups).
• Construction and validation of Survey Protocol:
• Identification of population target group and key informants, including but not limited to MoH personnel (PHCCs users).
• Preparing questionnaires, focus group discussions (FGD) and key informant interviews (KII) guides: Guides and questionnaires should be developed in consultation with MdM France program staff. In addition, a clear description of the quality control mechanism that will ensure a quality assessment will also be developed.
• Coding questionnaires.
• Deciding and constructing data entry and analysis tools.
• Developing schedule and team deployment plan.

Implementation of the survey.

• Analysis of findings and presentation of the report: The consultant/firm will be responsible for the analysis of findings and drafting of the final report. The report must provide a clear picture of the current knowledge, attitudes and practices around MH including Psychosocial Support as well as the barriers to optimal MH practices and care, and recommendations on the priority needs, gaps and behaviours to address and how to fill those gaps and needs and address the barriers to those behaviours.

Expected Deliverables by the end of the consultancy:

1. Assessment plan: The consultant/firm is expected to submit a detailed plan of how the assessment will be carried out including the survey protocol. The plan will outline the tools and detailed work plan for the entire exercise.
2. Questionnaires, KII and FGD guides: Draft tools will be shared with MdM France for technical review, inputs, and comments. The consultant/firm will incorporate MdM France comments into the final version and field test tools before carrying out the assessment.
3. Final Report: In addition to covering Knowledge and Beliefs surrounding integration of MH services at Primary Health Care, the report should clearly identify the positive attitudes and best practices that need to be enhanced and the negative attitudes and poor practices that need to be addressed to integrate and/or strengthen accessible, quality and sustainable MH services. This report should incorporate specific realistic and achievable recommendations. A draft of the report will be shared with key MdM France staff for review and before the end of the consultancy to allow time for review before the release of the final report. 

Handover notes and electronic versions of collected data to be shared with MdM France. All data must be provided electronically, and all field assessment remains the property of MdM France.

Minimum criteria for consideration of the proposal BID

The consultant/firm is expected to demonstrate that it has a track record of not less than three (3) years of experience executing similar surveys in similar set-up with diverse geographic and group compositions. The consultant/firm should also list the scale of similar projects worked on in the past.

The consultant/firm is expected to display:

• High sensitivity to conflict-affected settings and diversity issues;
• Good interpersonal, administrative and management skills;
• All Bidders are required to meet the following minimum requirements in order to qualify to consider their proposal:
• Previous experience in similar assessments.
• Capability of the assessment team: Team member(s) shall have health background, with special focus on MHPSS, along with relevant experience.
• Attachment of all supportive documents with the technical proposal is required.
• Knowledge of the project area and knowledge of the local language (s) will be considered a plus.

Preparation of Technical Proposal

If you qualify to consider your technical proposal, your proposal should include the following at minimum:

• A brief introduction of bidding consultant/firm or person attaching relevant CVs. The proposed survey team members must, at minimum, have qualifications and experience indicated above.
• Similar projects worked in the past. The technical proposal shall provide a description of the consultant/firm including an outline of the consultant/firm’s recent experience on similar undertakings. Provide the profile of each of the assessment team members including an outline of the members’ recent experience & duration of involvement on assignments of work of similar nature.
• Your understanding of the Terms of Reference.
• Proposed methodology and approach. The methodology will include a detailed timeframe with clear schedule for deliverables along with all the proposed tools. The methodology should include quality control mechanisms and basic accountability tools.
• Proposed work plan and budget (Should express all proposed costs in Euros). The financial proposal should list itemized details of costs associated with the assessment.

Contractual issues

• MdM France will provide at no cost to the consultant/team:
• Transportation to PHCC.
• Space at MdM Offices to hold meetings/presentations with MdM France key staff and Coordination Team members when needed or required.
• Relevant project documents as deemed necessary.
• The consultant/firm must comply with MdM France rules and procedures related to security, confidentiality and relations with the media.
• The consultant/ team must respect the ethics related to evaluation practice under MdM France Code of Conduct.
• Security would be provided and organized by MdM France team; and consultant/team must comply with security rules established.

CONTRACT AND PAYMENT

50% of the total consultancy instalment will be paid upon the delivery of the first draft and annexes of the  final report , the remaining 50% of the total consultancy instalment will be paid after the review and approval of the final report and its related annexes by MdM France team . 

HOW TO APPLY

If you feel you/your organization fit the required profile and are available for the assignment, please submit your proposal with all the required supportive documents as specified above.

All technical proposals and supportive documents including the detailed budget need to be submitted in a sealed envelope to the following address 

OR 

Dead line: 20th November at 15h30