Development of GBV/SRH integrated models and guidelines for the health care facilities

Background

UNFPA’s mandate focuses on preventing and responding to Gender Based Violence (GBV), meeting the sexual and reproductive health (SRH) needs and empowering young people, including in emergency situations. UNFPA is committed to three transformative results:

• Ending preventable maternal death
• Ending the unmet need for family planning
• Ending gender-based violence and harmful traditional practices

Through collaboration with key stakeholders and sectors/ clusters, UNFPA works to promote standards of services and to mainstream GBV in all sectors. The integration of GBV-SRH services into one complementary and comprehensive service package is considered an opportunity to limit barriers in accessing services and to utilize resources in an efficient way. The linkage between GBV and SRH services is based on a human rights based approach, and on the need to offer a comprehensive basket of health and protection services where clients receive a continuum of preventative and curative services according to their needs similar to a “one stop shop”. However, in most cases, the links between GBV and SRH - namely women’s health - are often disregarded by the health sector for various reasons including their lack of knowledge, appreciation and importance about these linkages, limited time made available by the service providers to offer a comprehensive service package, limited capacity of the health care providers who might overlook violence against women and consider GBV as a social rather than a public health problem. In fact, many health care providers are not trained to recognize, manage and/or refer a wide range of harmful practices including abuse, and will miss signs of GBV. Few have the appropriate training to manage GBV ethically and effectively. Even so health care providers are often a first point of contact for survivors and health care organizations - namely those working in the field of SRH – who have the capacity not only to promote the quality of women’s health care but also to address their needs and safety when they are subjected to violence. Medical response to GBV including Intimate Partner Violence (IPV) depends largely on readiness of the health facility and care providers to support the survivors of violence. 

The integration of GBV-SRH was first limited to mutual referrals of GBV survivors to SRH/CMR or of women/girls at risk to GBV to reproductive health care services. In 2016-2017, the inter-agency rolled-out the “Guidelines for Integrating Gender-Based Violence Interventions”^[1]during which the shared responsibility of GBV risk mitigation was recalled and the SRH service providers were sensitized and trained on GBV mainstreaming.

Building on this initial step, UNFPA and partners started prioritizing different models of integration across ASRO region according to the operational specificities, and monitoring positive impact for beneficiaries in terms of enhanced access to services. Those models include: integration of GBV services in Primary Health Care Centers and mobile teams delivering SRH services; integration of SRH services in Women and Girls Safe Spaces; partnership between GBV organizations providing specialized services in mobile and static safe spaces and SRH service providers for joint interventions; and development of solid integrated referral pathways by GBV partners focusing on GBV and SRH awareness and information sharing and referrals.[2]

In Lebanon, the integration of GBV-SRH was initially introduced through a) mainstreaming a chapter on GBV in the RH service delivery guidelines in 2009-2010 (as well as the revised in the 2014-2016 version of the guidelines), b) developing a training manual for health care providers on communicating with survivors of violence in 2013-2014, c) rolling out a training package to all health care providers on the manual for communicating with survivors of violence, d) training peer educators supported by UNFPA Lebanon on RH and GBV related topics, e) mainstreaming a GBV module in the midwifery curricula at the St Joseph university and f) distributing drugs for women survivors of rape at more than 40 primary health care centers along with training selected health care survivors on administering those drugs.    

In addition to the above key activities, UNFPA Lebanon implemented a 2 years project in 2017 and 2018 that introduced an SRH-GBV integrated approach on a pilot basis through 6 implementing partners (local and international NGOs) across Lebanon. The project aimed at improving the wellbeing of women and adolescent girls through empowerment initiatives, access to support and safety networks, access to multi-sectorial service/ information package including reproductive health, psychosocial support, and legal services.  An evaluation of the project in terms of the piloted RH/GBV integrated approach was conducted end 2018/early 2019 to assess the effectiveness, relevance, and sustainability of this approach including successful elements of this integrated approach, as well as to identify challenges and deduce lessons learned and good practices for replication/scaling up[3]. The evaluation concluded that the model was very relevant and effective on the one hand and contributed to enhancing access to a comprehensive continuum of care service package by beneficiaries. In addition, the evaluation proposed the development of 3 service provision models for the GBV integration in the health sector that would need to be introduced at health care facilities to guarantee minimum to advance mainstreaming of GBV within the health care package.   Those models are as follows:

• Selective provider and/or facility-level integration (same site): a few selected services are integrated into existing services by the same provider and/or on one site.

• Comprehensive provider and/or facility-level integration (same site); a wide range of services are integrated into existing services by the same provider or at same site.
• Systems-level integration (multi-site linkages) in addition to the facility-level integration. Coordination with other sectors establishes solid referral systems, usually for psychosocial counselling, legal aid, social support, police investigations, hotline services and shelter.

Building on the above knowledge products produced, capacities enhanced and integrated model piloted, and taking into consideration good practices and lessons learned from other countries, UNFPA Lebanon is seeking to engage a technical expert to develop the 3 different models of GBV-SRH integration in the health care facilities.

Objectives

The objectives of this consultancy are as follows:   

• Develop guidelines for the GBV-SRH integrated models including required criteria, services, standards, skills and capacities for each model to be introduced in the health care facilities  
• Propose a capacity development plan for each GBV-SRH integrated model along with suggested topics

Methodology

Under the guidance of the UNFPA Head of Office and in close collaboration with the SRH and GBV specialists, the consultant will be expected to carry out the following tasks:

• Carry out an inception meeting with UNFPA to ensure full understanding on the required tasks in the TORs and the detailed timeline as well as agree on mutual expectation
• Conduct a desk review of related resources and documentation including UNFPA Strategic Plan,  Guidelines for Integrating Gender-Based Violence Interventions, evaluation report of the pilot project on GBV-SRH integrated approach in Lebanon, regional reports and studies related to GBV-SRH integration, and other relevant documents
• Develop the 3 models followed by simple guidelines including criteria, services, standards, skills and capacities required for each model to be introduced in the health care facilities
• Propose a capacity development plan for each of the 3 models along with suggested topics
• Finalize the agreed upon products based on input provided by UNFPA

The consultancy extends over a period of 6 weeks as per below timetable

Weeks 1:             Desk review

Weeks 2-3:          Development of the 3 models + related guidelines

Weeks 4-5:          Review of the proposed models by UNFPA + development of capacity development plan

Week 6:               Finalization of the guidelines + capacity development plan  

UNFPA will provide overall guidance, necessary reports and documents pertaining to the consultancy, and input on the expected products. 

Final Outcomes

• Guidelines in English for the 3 GBV-SRH integrated models including required criteria, services, standards, skills and capacities for each model to be introduced in the health care facilities  
• A proposed capacity development plan in English for each of the 3 GBV-SRH integrated models along with suggested topics

Required Skills and Qualifications

The consultant must offer the following demonstrated experience, knowledge and competencies:

• Advanced University degree in social/development Sciences/international development /public health or other related areas
• At least 7 years’ experience in development related programme management, coordination and/or evaluation
• Significant knowledge and experience in SRH and in GBV
• Knowledge of the Lebanese context, structures and stakeholders is a strong asset
• Strong analytical, writing and communication skills, including ability to produce high quality, practical and user friendly guidelines.
• Solid experience in public health services delivery and research
• Knowledge in humanitarian contexts and familiarity with humanitarian related resources is an asset
• Excellent writing and reporting skills in both English and Arabic

HOW TO APPLY

Interested candidates may apply online by providing: 

• Most updated CV and P11 [attached]
• 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: bids_lbn@unfpa.org by no later than July 24, 2020
 

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.
 

Please make sure to specify the title of the consultancy in the subject of your email/application.

ONLY individual consultants, not companies, are eligible to apply.