I.          
BACKGROUND

1.     Project Summary

The Middle East and North Africa (MENA) region is one of the world’s regions with the lowest coverage for both prevention and treatment services and where AIDS-related deaths continue to rise.

The HIV epidemic in the MENA region is mainly concentrated among key populations. The region is challenged by limited access to testing services, very low Antiretroviral treatment coverage (32% of average), significant stigma and discrimination and weak community-led monitoring systems.

In response, Solidarité Sida, in partnership with ITPC-MENA and five partner NGOs launched the FORSS Program (“FORmer, Suivre, Soutenir: Mobilisation communautaire pour lutter contre le VIH en région MENA”) in June 2018. Funded by the Initiative, this program aims to set up five community-led monitoring systems in Egypt, Lebanon, Morocco, Mauritania and Tunisia. It also aims to implement advocacy actions to influence national and international strategies. This community-led monitoring system will improve the supply and quality of prevention services, care and treatment services delivery in the MENA region for PLHIV and key populations.

The proposed approach entails the establishment of data collection sites in the 5 countries that will target several at-risk populations in order to collect data both on the barriers encountered by PLHIV and key populations (cost of services, inadequacy of the care offer with the needs of beneficiaries, etc.) and the identification of discrimination or stigma suffered during the course of care. The experience of these pilot community-led monitoring systems will make it possible to identify and document existing obstacles to the availability, access and quality of prevention, testing and care services in order to carry out effective advocacy to refine HIV/AIDS strategies in the MENA zone, both at the legal level for key populations and at the medical level for all PLHIV.

2. Project Partners

SOLIDARITÉ SIDA – France

Since 1992, the history of Solidarité Sida has been that of a collective and generational commitment based on the desire to act. It strongly demonstrates that, contrary to popular belief, young people are ready to get involved. Through its initiatives, the association offers them a field for citizen action or responds to their concerns in terms of health and/or sexuality. There are more than 3,000 volunteers who keep the chain of solidarity on which the Solidarité Sida approach is based alive.

The missions: Help, Prevent, Defend and Mobilize 

Help: From Paris to Bombay, from Lomé to Dakar, Solidarité Sida works to support the most vulnerable and reduce inequalities in access to treatment and care. Prevent: People are still dying of AIDS in France and one in three young people do not systematically use condoms. Here or elsewhere, there is a great need for innovation to be listened to. Defend and mobilize: Fighting the scandal of unequal access to treatment is a matter of individual awareness and political will. Solidarité Sida mobilizes young people and calls on governments and the media for universal access to treatment through specific campaigns.

ITPC-MENA – Morocco

ITPC-MENA is a regional network of activists, people living with HIV and their advocates working together to ensure universal access to treatment, prevention and health services for PLHIV and key populations. The association hosts the MENA Regional Platform, one of the six regional platforms supported by the Global Fund and drawn from civil society and communities. These platforms work on the development, implementation and monitoring of Global Fund programs. Thus, ITPC-MENA ensures the provision of a wide network of partners and information sharing; capacity building on Global Fund processes; compilation and processing of Global Fund and civil society data and information (needs assessment, mapping of regional NGOs, contextual analyses, etc.); identification of civil society technical assistance needs and networking with technical assistance providers; provision of information materials, good practices, and guidelines on the Global Fund translated into the different languages of the MENA region.

AGD – Mauritania

AGD is a civil society organization that was founded in 2003 in Nouakchott to respond to the population’s need for education and behavioural change. The organisation focuses on promotion of human rights education (citizenship and good governance), sexual and reproductive health and rights, HIV/AIDS, youth participation and entrepreneurship as part of its mission.

AL SHEHAB – Egypt

Al Shehab aims to assist vulnerable and marginalized populations (with a special emphasis on women and children) in slums areas and informal settlements in Egypt, and to provide them knowledge and tools to enjoy their human rights and to promote their participation in the community development process. Al Shehab addresses violence against women, HIV among FSWs, and providing legal support for PLHIV in the Governorates of Cairo and Alexandria.

ATP+ – Tunisia

ATP+ is a key actor for the provision of support and care for PLHIV in Tunisia. Its work focuses on the rights of at-risk populations, including women, girls and LGBT+. Its main mission is focused on provision of support people targeted by discrimination to ensure that their rights are respected, and they can have access to HIV services with fairness and dignity of.

M-COALITION / AFE-MENA – Lebanon

The mission of Arab Foundation for Freedom and Equality is to encourage and support activists in the MENA region who work on human rights, sexual health and gender equality, including activists who work specifically on LGBT + issues. M-Coalition, hosted by AFE, was officially launched at the International AIDS conference held in Melbourne in 2014. M-coalition focuses on the right to health and the other human rights of MSM, to providing them with prevention, care, treatment, and other services; all this by promoting the exchange of good practices between activities from the countries of the region.

RDR-MAROC – Morocco

The Moroccan association for harm reduction (Réduction des Risques-Maroc) has been created in 2008. The association focuses on the provision of harm reduction services in several priority locations in the North of Morocco (including Nador, Rabat, Al Hoceima and Oujda) as part of the National AIDS strategy to address the HIV epidemic among people who inject drugs. In addition, it contributes to the oversight for eight addiction treatment centers all-over Morocco. It is also a key actor in the mobilization of civil society groups and governmental bodies as part of its mandate on harm reduction and drug abuse.

3. Project goal and objectives

Main goal: To improve the quality of HIV-related prevention and support services and the access to Antiretroviral Treatment especially among key populations in the MENA region, particularity within the target countries.

Specific objectives:

OS1- To Improve the knowledge and practices of community actors in prevention, care and treatment services for PLHIV and key populations;

OS2- To generate national and regional data on the quality and accessibility of prevention, treatment and support services for PLHIV and key populations;

OS3- To influence HIV prevention and care strategies on the national, regional and international levels and their implementation;

OS4- To sustainably strengthen ITPC-MENA’s positioning as a strong player in the MENA zone, through support for its strategic and organizational development.

OS5- In the context of the global health crisis linked to the COVID-19 pandemic, maintain the continuum of community-led prevention, testing and care services for PLHIV and key populations in the 5 intervention countries, in conditions that guarantee the safety of the partner NGOs’ teams and beneficiaries.

II. CONSULTANCY PURPOSE

In the five FORSS project intervention countries, the COVID-19 response implemented by governments (social distancing, total or partial lock-down, curfews, bans on movement within the territory, etc.), have impacted access to health services for PLHIV and key populations, especially in the most underserved areas. Prevention, testing and psycho-social support activities have been greatly reduced and community actors have not had the means (financial and/or health) to maintain these activities or to take over from the public authorities who usually implement them.

Thus, a 5th objective has been added to the Program. This consultancy falls within the framework of this OS5: ITPC-MENA is looking for a consultant to design and conduct a study on the impact of COVID- 19 on access to HIV services for PLHIV and key populations in the 5 countries of the FORSS Program.

The study conducted should promote the deployment of community-led monitoring systems and provide an additional prism of understanding and analysis. Indeed, it seems appropriate to understand the barriers to access to services encountered during the health crisis in order to ensure that the community-led monitoring systems are in line with the changes in the context generated by this crisis.

Important: It should be noted that many surveys and studies have been conducted in the MENA region by different actors since the beginning of the pandemic. This study should be thought in complementarity with these already conducted works and should be fully in line with the FORSS Program approach, and in particular the community-led monitoring mechanisms.  

1. Objectives and expected results

General objective: To generate data on the impacts of COVID-19 on access to HIV services for PLHIV and key populations in the 5 countries of intervention of the FORSS Program.

Specific objectives

• Make a balance of the impact of COVID-19 on health systems and the measures implemented by governments.
• To measure the impact of COVID-19, and in particular the policies of lockdown, movements restrictions, closure of numerous associative and state structures (etc.) on :
  • availability and accessibility of services (prevention, testing, ART dispensing, care, biological monitoring, psycho-social monitoring) for PLHIV and key populations;
  • mental health;
  • socio-economic situation of the beneficiaries;
  • stigma and discrimination.
• Highlight the place taken by community-led organizations in the continuity of HIV services.

Expected results:

• The barriers to access services for PLHIV and key populations during the COVID-19 crisis in the 5 intervention countries are known and referenced in a specific study;
• A specific analysis by territory of intervention of the project in each country allows to have a precise vision of the state of the services and to envisage possible modalities of adaptation of the methodology of the community-led monitoring systems if necessary.

2. Tasks Description

Placed under the responsibility of the FORSS project teams of ITPC-MENA and Solidarité Sida, and in collaboration with the project teams of the partner NGOs, the description of the tasks expected of the consultant is as follows:

DEVELOPMENT OF DOCUMENTS:

Define the protocol for the multi-country study

• Define the main question
• Define research hypotheses
• Define key indicators
• Define a representative sample
• Define the data collection methods: in view of the current health situation, online collection is preferred by the project’s partner associations (data protection measures will have to be defined by the consultant).

Develop the questionnaire(s) (in English, French and Arabic) for the different targets of the study (PLHIV, key populations, partner NGOs and other community-led actors in the region, institutional actors).

LITERATURE REVIEW

Analysis of international, regional, and national strategies for maintaining HIV services in the context of COVID-19;

Analysis of surveys and studies on the impact of COVID-19 on access to services, conducted by other regional actors (UNAIDS, WHO, other organizations, etc.).

DATA COLLECTION

Quantitative and qualitative data collection from:

• Beneficiaries of HIV services
• Community-led organizations, including FORSS partner NGOs

Interviews with other actors in the fight against HIV/AIDS (ministries, national programs, UNAIDS, etc.)

Note: Given the health situation and the impossibility of travel between project countries, as well as to ensure the safety of respondents, data collection (via questionnaires and interviews) will have to be conducted online. The consultant will therefore have to propose the appropriate digital tools to do so.  

ANALYSIS OF THE RESULTS AND WRITING OF THE REPORT

The analysis must give equal value to all opinions collected. The consultant will have to write down the information useful for the study, then classify the information by theme and observe the redundancy of certain information that will be highlighted.

The report should be organized as follows:

• Cover page with the title of the study
• Acknowledgements
• Table of Contents
• List of acronyms and abbreviations
• Introduction
• Study Goals and Objectives
• Description of the methodology used Steps in conducting the study

Study locations and target populations Collection and analysis method

Ethical considerations

Biases and limitations of the study

• Key findings of the study (to be categorized according to what emerges from the literature review and interviews/data collection)
• Conclusion and Recommendations
• Bibliography
• Appendices: study tools (questionnaires in particular), etc.

In order to make the results of the study easily understandable, visual elements such as pictures, graphs, tables to illustrate or supplement the findings can be integrated into the report.

Recommendations

• This report is mainly addressed to HIV/AIDS organizations in the target countries and in the MENA region, as well as to the various stakeholders in the fight against HIV/AIDS (Ministries, CCMs, etc.), and is intended to serve as an advocacy tool for the FORSS Program. It is important to adapt the language to the recipients and to make the statements as concise and clear as possible. Quotes from the questionnaires should be cited in the report to illustrate the findings of the survey.
• The consultant should ensure that the sources of information are listed in footnotes, whether they are reports studied or interviews conducted.
• The data must be entered in the report anonymously to protect the physical and moral safety of the respondents (unless the person concerned has given his or her written consent).

3. Expected Deliverables

Within the framework of this consultancy, the consultant will be asked to provide various deliverables for the project coordination (FORSS team at ITPC-MENA and Solidarité Sida) and partner NGOs, including the stakeholders in data collection, namely:

• The detailed methodology of the study;
• Data collection tools (questionnaires in particular) in 3 languages (French, English and Arabic);
• A report of 50 pages maximum without appendices in French or English in digital version (Word)
• A summary of the report of 5 pages maximum in French or English in digital version (Word)
• A PowerPoint presentation presenting the methodology and the main results of the study (in French, English and Arabic)

ITPC-MENA, Solidarité Sida and all project partners will be able to make internal and external use of the consultant’s productions related to the consultancy.

4. Duration and terms of execution of the consultancy

The duration of the consultancy is estimated at 30 working days (remote work).

The consultancy will start after signature of a contract between the Consultant and ITPC-MENA.

II. COMPETENCIES AND SKILLS REQUIRED

• Master’s degree in social sciences and/or public health;
• Demonstrated knowledge and experience in the field of health, particularly on HIV/AIDS and access to the rights of key populations;
• Knowledge of health systems in the MENA region especially among the targeted countries of the project (Mauritania, Morocco, Tunisia, Egypt, Lebanon);
• Similar experience working with international and/or organizations;
• Fluency in French, English and Arabic is mandatory.
• Master the digital tools for remote data collection.

III. APPLICATION PROCESS

Interested applicants must provide the following documents:

• Consultant’s CV demonstrating similar experience(s) in conducting multi-country studies (supporting by samples);
• A technical offer;
• A detailed financial offer outlining incurred costs.

1. Technical offer

The technical offer must include at least the following elements:

• Understanding of the expected objectives and deliverables;
• Presentation of the methodological approach. It is possible to suggest adjustments to the methodological approach outlined in this call, supported with justification;
• Implementation steps;
• Detailed timeline.

The technical offer should not exceed 20 pages (excluding CV). Other relevant documents may be attached as appendices.

2. Financial offer

A consistent financial offer must be submitted jointly with the technical offer. This financial offer must include a detailed budget indicating:

• The amount of the consultant’s remuneration (daily fee x number of days);
• Possible additional costs.

While developing the detailed budget, applicants should take into account the following elements:

It will not be possible for ITPC-MENA to reimburse additional expenses (regardless of their nature) beyond those stated in the financial offer.

IV. SELECTION PROCESS

1. Application

Interested applicants are welcomed to submit their offer by email only to zakaria.bahtout@itpcmena.org and amit@solidarite-sida.org, by November 25, 2020 – 11.59pm (Morocco time). The email subject should indicate the following: “FORSS-AC-04_Application NAME First name”.

Offers received after the deadline will not be considered.

Applicants can request additional information from Zakaria BAHTOUT and Anaïs MIT, FORSS Project Managers within ITPC-MENA and Solidarité Sida, through the same e-mail stated above, no later than November 20, 2020. Beyond this date, ITPC-MENA and Solidarité Sida will not be obliged to answer any inquiries regarding this consultancy.

2. Selection steps

A joint committee formed by ITPC-MENA and Solidarité Sida, (in consultation with the FORSS project teams of the partner NGOs), will be in charge of evaluating the applications received.

Following reviewing offers, the committee may contact applicants for further details about their offer.

Once requested details have been provided, the committee will select the applicant(s) according to the pre-set criteria.

3. Selection criteria

The consultancy will be awarded to the best technical offer (in terms of the proposed methodology and deliverables, experiences and profile of the candidate). The financial offers will be evaluated in terms of being realistic.

Particular attention will be given to the experience and references provided by the candidate who undertaken similar assignments.

Prior to final selection, shortlisted candidates might be contacted by the selection committee for fine adjustments of their technical and financial offers.

4. Timeline