Background
The compounded financial and political crisis coupled with the pandemic and the Beirut port explosion had a severe impact on the mental health of the population. Request for mental health services and psychosocial support is on the rise.
Worldwide about 10% of pregnant women and 13% of women who have just given birth experience a mental disorder, primarily depression. In developing countries this is even higher, i.e. 15.6% during pregnancy and 19.8% after childbirth. In severe cases, mothers’ suffering might be so severe that they may even commit suicide. In addition, the affected mothers cannot function properly. As a result, the children’s growth and development may be negatively affected as well. Maternal mental disorders are treatable. Even well-trained non-specialist health providers can deliver effective interventions. (https://www.who.int/mental_health/maternal-child/maternal_mental_health/en/)
According to reports by the National Mental Health Programme of the Ministry of Public Health, there is an immediate need to address the psychological needs of women in reproductive age including mothers, adolescent girls etc . This is also urgent and evident for women and girls affected by the explosion, with a focus on post-traumatic stress, psychological first aid and psychological support needs including for sexual and reproductive health and gender-based violence (GBV) https://reliefweb.int/sites/reliefweb.int/files/resources/lebanon_situation_report_5_1.pdf)
UNFPA supported the PHC assessment, aiming to rapidly assess the various types of healthcare centers with regards to functionality, services provided, and drug storage, post Beirut Explosion and during COVID-19 outbreak in Lebanon.
According to the collected data, there is shortage of needed resources and capacities to ensure provision of needed mental health care services, especially with the growing need for it in the aftermath of the blast. Even though more than half of the facilities have referral options, the lack of support services, private rooms for consultations, and even willingness to assign a focal coordinator for mental health integration probably impact proper referral mechanism.
Several factors need to be addressed to ensure access to mental health care including for the physical structure that ensure privacy of the patient, capacity development for the health care staff and establishment of a proper referral mechanism. One of the recommendations is to train general practitioners, family physicians, and midwives on providing adequate mental health services and psychosocial support in order to fill the gap of the lack of psychiatrists.
UNFPA is supporting provision of different forms of psychosocial support (PSS), including psychological first aid, group non-targeted PSS support, individual specialized psychosocial support to people in the affected neighborhood through mobile teams and static centers.
The management of mental health problems during pregnancy and the postnatal period differs from at other times because of the nature of this life stage and the potential impact of any difficulties and treatments on the woman and the baby (https://www.nice.org.uk/guidance/cg192/chapter/Introduction)
Purpose
The purpose of the consultancy is to develop/adapt a guideline, in line with WHO recommendations, on maternal mental health. The guideline should make recommendations for the identification/recognition, assessment, referral and care/treatment of mental health problems in women during pregnancy and the postnatal period (up to 1 year after childbirth) and in women who are planning a pregnancy.
The guideline will be developed as well in line with the National guidelines for mental health and in close collaboration with the National Mental Health Programme, and will be used by health care providers offering services to women planning and/or during pregnancy and after the delivery, who are in need for psychosocial support hence the main target group include mental health nurses, gynecologists/ obstetricians, midwives, psychologists and psychiatrists as well as care providers trained earlier on mhGAP. In addition, the developed guidelines should be streamlined in the revised SRH service delivery guidelines and the PHC package
Tasks
Under the guidance of UNFPA Head of Office and in close collaboration with the UNFPA programme personnel, the consultant will be expected to carry out the following
- Carry out inception meeting with UNFPA to ensure full understanding about the scope of the TORs and final deliverables;
- Carry out inception meeting with the NMHP to ensure full coordination and alignment with national mental health guidelines
- Conduct desk review for evidence-base guidelines on maternal mental health and relevant guidelines and a quick round of key informant interview (UNFPA, WHO, and other relevant UN agencies, NMHP, LSOG,LOM, Mental Health Professionals etc then develop a methodology for the guideline development process that is validated by UNFPA, NMHP and WHO.
- Develop/ adapt a guideline on maternal mental health during pregnancy and post-delivery, up to one year after the delivery. The consultant needs to coordinate with the national mental health program for the development of the guideline/ protocol of care for pregnant women/post-delivery. The guideline should make recommendations for the identification/recognition, assessment, care and treatment of mental health problems in women during pregnancy and the postnatal period (up to 1 year after childbirth) and in women who are planning a pregnancy.
- Pilot the guideline through training of health professionals providing maternal health care (Gynecologists/Obstetricians, midwifes, psychologists etc) and incorporate all inputs and comments received during the piloting stage (2 training sessions for 15 staff each);
- Finalize the guidelines based on the pilot training, the input of UNFPA and the input of the NMHP
Expected Deliverables and Outputs
- Maternal Mental Health Guidelines
- Pilot training of 20- 30 health care providers on the guidelines (Gyn/Obs, psychologists, etc)
- Training material ( PPT. pre-posttests)
- Final Report about the consultancy
Duration of assignment
The consultancy duration is for 6 weeks from the date of contract signature and to be completed by December 18th at the latest.
Required Qualifications
- Qualifications in medicine with specialty on psychiatry, or psychology and/ or Public Health
- At least 3 years proven experience of data collecting, analysis and assessment;
- Professional knowledge of mental health;
- Previous experience in delivering similar assignments;
- Strong quantitative and qualitative data collection and analysis skills;
- Excellent writing and reporting skills;
- Fluency in English/French or other language;
- Excellent consultation and engagement skills;
UN experience is an asset.Support to be provided by UNFPA
- Provide consultant with necessary and relevant reports and documents as applicable
- Facilitate contact with the main stakeholders
- Review and provide technical input on the draft guidelines/ training package
- Facilitate training sessions with entities
How to Apply
Interested candidates may apply online by providing:
-Most updated CV
- Cover letter mentioning the relevance of past/current experience with the requirements of the consultancy
- Requested fees in USD
The above documents must be sent to the following email address:
bids_lbn@unfpa.org by no later than October 28th, 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.
ONLY individual consultants, not companies, are eligible to apply.
