Consultant to develop a study on strategies for the conflict’s affected population to access healthcare in Humanity & Inclusion’s area of intervention

1. About Humanity & Inclusion (HI)

Our vision: Outraged at the injustice faced by people with disabilities and vulnerable populations, we aspire to a world of solidarity and inclusion, enriched by our differences, where everyone can live in dignity.

Our mission: HI is an independent and impartial aid organization working in situations of poverty and exclusion, conflict and disaster. We work alongside people with disabilities and vulnerable populations, taking action and bearing witness in order to respond to their essential needs, improve their living conditions and promote respect for their dignity and fundamental rights.**

On its 35th anniversary, the Handicap International network changed its name to Humanity & Inclusion.

Our Values: Humanity; Inclusion; Commitment; Integrity

2. About Humanity & Inclusion (HI) in the country/region

HI has been operational in Middle-East and responding to various humanitarian crises consistently. HI’s coordination office is based in Amman, and coordinates activities in various geographical hubs.

Through its long-established presence and reputation, HI has built strong coordination networks and collaborative working relations with other actors responding to humanitarian crisis. Indeed, HI has been co-leading the PRDWG under the Health Cluster, steering a cross/inter-hub and operational coordination mechanisms with 14 organizations.

HI is part of the current mine action coordination participating to protection coordination meetings and Clearance coordination meetings, and has been a key-actor in the field of Risk Education in the region, having directly reached over 317,000 beneficiaries in 2018. For the clearance component, HI is already well-recognized and in links with all existing Humanitarian Mine Action actors and authorities.

As a key-actor in health and HMA sectors, HI has specialized and highly qualified human resources present both in field and in each operational hub. Furthermore HI has been developing over the years a portfolio of technical resources (training courses, technical guidelines, etc.) adapted to the specific challenges of humanitarian interventions in middle-east and regularly adjusted to take into consideration lessons learnt and needs, which is highly valuable for the implementation of the activities.

3. CONTEXT & OBJECTIVES

HI’s area of intervention has been affected by conflict for more than nine years in 2020, and the level of needs by the affected population continues to be alarming across the country -according to OCHA, around 11.7 million people are in need of various forms of humanitarian assistance[1]. Nevertheless, according to the same document, people in need of health services have increased from 11.3 to 13.2 million persons in 2019. The severity and complexity of the crisis led to scores of civilians being killed and/or injured as a direct result of hostilities and an significant increase in need for trauma and burn care as well as rehabilitation and MHPSS. In line with this information, a study done in 2018[2] found that 45 percent of those injured are expected to sustain a permanent impairment and that the average disability prevalence rate in the area was around 30 percent.

In addition to the high rates of injuries stemming from hostilities, the crisis has also led to a significant deterioration of the physical environment contributing to new permanent impairments as well as deteriorating access to health care for persons with pre-existing disabilities or other health conditions. The crisis has led to severe disruption of basic services (varying from healthcare to water treatment and waste management), increase in communicable and non-communicable diseases, as well as to people resorting to negative coping mechanisms (such as changes in eating and personal hygiene habits). Concurrently, hostilities led to serious damage and destruction of health facilities (with around 46 per cent of hospitals and primary health care facilities being partially functional or not functional).

The 2018 Health study also found that the most common barriers to accessing healthcare were high costs of services, high costs of transportation (and absence of outreach), lack of adequate information (mostly about PSS services). With this wide array of information in mind and aiming to develop an effective long term plan for health services, Humanity & Inclusion will carry out a study to understand the reasons behind the barriers to access healthcare as a way of identifying sustainable solutions.

General objective:

Understand different barriers for the affected population to access healthcare as a way of informing sustainable and durable health related interventions.

Specific objectives of the study:

1. In-depth situation analysis on access to healthcare in the area of intervention–general and specialised services, including:

2. Decision-making related to accesing healthcare. i.e. how healthcare is prioritised in household spending, especially among persons with disabilities and their families.

3. Coping strategies which impact their physical and mental wellbeing that could lead to need for healthcare, especially among persons with disabilities and their families.

4. Contextual limitations which impact provision of adequate health services –security, access, financial situation of health facilities, availability, accessibility and cost of transport, availability of quality and gender balance among health professionals etc.

5. Analysis of above mentioned information vis a vis pre-identified barriers to health services.

6. Collect and analyze data according to the intersections of age, gender and disability, identifying who and how they are the most excluded from health care.

7. Based on the situation analysis results, provide recommendations of the possible interventions which would ensure durable, ethical and sustainable solutions to remove identified barriers, including Gender Age and Disability (GAD) inclusion principles.

8. In coordination with programme and technical team, contextualise recommendations to HI interventions, including:

9. Modality of intervention for the three sub-sectors: Rehabilitation, P&O, MHPSS.

10. Priority geographical areas of intervention.

11. GAD inclusion principles to inform programming and interventions.

4. DESCRIPTION OF THE REQUIRED SERVICE PROVISION

The expected outputs of the consultancy are as follow:

1. Inception report detailing proposed methodology and overview of secondary data review.

2. A detailed plan for data collection inside and outside the area of intervention. This plan should include means to guarantee access to areas inside the area of intervention.

3. Development and translation of data collection tools.

4. Complete data set –from all areas/stakeholders covered in the data collection.

5. Initial report on recommendations of the possible interventions for HI (as per point 2 of the Scope and Specific Objectives section).

6. Facilitation of a workshop with HI technical and programme team.

7. Final report detailing analyzed findings and recommendations (as per point 3 of the Scope and Specific Objectives section).

5. CONSULTANT’S PROFILE

Essential criteria:

1. Advance University degree in public health, health economics or similar qualification.
2. Proven experience in health system strengthening research (atleast one paper/research on the subject)

3. At least 5 years of experience conducting qualitative and quantitative research in conflict settings including use of

4. NVivo, ATLAS or other qualitative data collection software

5. SPSS, Stata or other quantitative data collection software.

6. Proven ability to work in a multicultural setting (work experience certificates/ atleast one study research done in multicultural context).

7. Proven ability to deliver in a timely manner within cost and quality standards (Atleast two refrence from past consultancies).

8. Good writing and reporting skills. (atleast one article/paper/report to be shared)

9. Willingness to travel to in the middle east region (if context allows).

10. English fluent ( written; atleast a copy of report/article/research to be submitted and oral)

Desirable criteria:

1. Experience in conducting studies aiming to capture qualitative information about vulnerable groups, especially using the GAD lens (atleast two studies/reaseach on similar subject).
2. Arabic speaker.
3. PhD degree in public health, health economics or similar qualification.

6. SERVICE DURATION AND LOCATION

1. Work days will be distributed between February 2021 – March 2021 with a maximum of 30 working days.

2. Service location: Middle east region, exact location(s) to be clarified and discussed later.

7. RESOURCE PERSON(S)

Within the scope of work the consultant will be asked to collaborate and coordinate with;

1. HI WoS Technical Unit,

2. HI WoS MEAL Team,

3. HI WoS Programme Team

4. HI Inclusion Teams in Hubs

5. HI HQ Inclusion Referrent

8. SPECIFIC RESULTS – DELIVERABLES

REPORTs including:

1. Inception Report

2. Data set

3. Initial Report

4. Final Report

5. An end of consultancy report detailing;

o Methodology

Challenges and Recommendations