CONSULTANCY CALL FOR EXPRESSION OF INTEREST: Project capitalisation - Improving mental health and wellbeing of people living in Lebanon

1.Context

Médecins du Monde (MdM) is an international humanitarian organization that provides medical care to the most vulnerable populations affected by war, natural disasters, disease, famine, poverty and exclusion, those who do not have access to health care and those who the world is gradually forgetting.

MdM has been working in Lebanon for more than 30 years from the response to the civil war in the 1980s to the Syrian crisis that emerged in 2011 and during the recent political turmoil and instability in Lebanon. MdM mainly works in the sector of health, while ensuring cross cutting subjects in gender based violence and sexual and reproductive health.

Since 2012, in cooperation with civil society organizations as well as national and local authorities, MdM’s intervention aimed at increasing access to quality primary healthcare and strengthening the national primary healthcare system. Moreover, MdM has been actively engaged in providing access to Mental Health and Psychosocial Support (MHPSS) services and reducing the impact of the Syrian crisis on the mental and physical health of the Syrian refugees and vulnerable Lebanese. MdM is working at integrating mental health in the primary healthcare system and contributing to the development of community-based mental healthcare services, opening and running community mental health centers.

A Community Mental Health Center (CMHC) provides essential mental health care to people who would not be able to access the services any other way, regardless of nationality, gender, age, socio-economic status, and other factors. The CMHC consists in a comprehensive social, psychological and psychiatric care, acting as a step-up referral center both for patients from primary level health centers and a step-down referral center for those discharged from inpatient psychiatric ward.

MdM supported the opening of the first CMHC in Lebanon that was launched in Zahle in 2016 and handed over to Fondacion Promocion Social in 2018. It was closed in 2020. In 2017, MdM, in coordination with the MoPH, started the first CMHC based in a Governmental hospital in Lebanon. It works in collaboration with ICRC, with Beirut Skoun center for substance use treatment and with RHUH PHCC for the integration of mental health at primary care level. In July 2019, another CMHC was also launched in Baalbek Governmental Hospital, in close coordination and collaboration with MdM, Skoun and the National Mental Health Program (NMHP). The center is linked to three PHCCs with a functional external referral system and develops other activities to integrate mental health at primary health care and community levels. In October 2020, the center had to be moved to a PHCC based in Douris, leading to modification in its connections with external stakehoders.

MdM is now willing to learn from its experience, opening and implementing three CMHCs in Lebanon. Those three CMHCs were launched in various contexts, among which the political and social unrest which started in 2019 and the COVID pandemic. The three centers are/were based in three different locations and are/were running in collaboration with several partners. As a conclusion of this lesson-learned process and documentation, MdM is also willing to enrich its strategy by setting out a reference framework specific to the community mental health centers.

2.Objectives and target audience

In the scope of MdM global strategy to integrate MHPSS in primary health care linked with a community-based approach, this consultancy aims at documenting the CMHC projects, both the processes of opening and implementation, the present running of activities in regards to the initial objective of the projects and the constraints faced in Lebanon since October 2019. The document should gather knowledge and understanding gained by experience through the review of the challenges, the identification of good practices and recommendations that will be used to create process change.

The consultant should also formalize the lesson-learned document and a guideline or a tool allowing MdM to support the opening of other CMHCs. The document should have two main parts:

- Learning from the experience of opening 3 CMHCs:

The lesson-learned should analyse differences, advantages and drawbacks between Zahle and Beirut and Baalbek CMHC model as well as challenges and limits of the overall model in order to provide key recommendation for promoting community based mental health services. In particular, it should provide key components needed for achieving the sustainability of such services especially in terms of finance, of ownership from national and local stakeholders and of exit strategy for MdM.

It should answer those questions:

• Was the objective of providing comprehensive, integrated and responsive mental health and social care services in community-based settings reached?

• Are the CMHCs centered and adapted to people’s needs through a recovery-oriented approach?

It should also review how MdM adapted its strategy and services to the socio-political context in Lebanon since October 2019 and to the COVID pandemic.

- Tool box aiming at supporting the opening of other CMHCs:

After reviewing the experiences of MdM and Skoun in Lebanon and having a literature review of the experience of community mental health centers implemented by other organizations and in other locations, design a tool box/guide that MdM could use to ease the opening of other CMHCs.

Both parts should take into account the following components:
1.The steps to follow before the opening of the center
2.Internal functioning of the centers
3.Involvement of the community
4.Network of health and MH partners to ensure CMHC integration and pathways from PHCC to CMHC

3.Methodological approach

Quantitative/qualitative methods:

The evaluation is expected to be a mix method approach, using qualitative (semi-structured individual interviews and/or focus groups with CMHC staff, patients, partners and other relevant stakeholders and observations) and quantitative tools to collect data.

4.Expected output

• Inception report, including the methodology, the work plan as well as the tools used for the process of lesson-learned (questionnaires, interviews, guides)

• Preliminary results and recommendations: a workshop should be organized during which the consultant will report their results through a PowerPoint presentation which will be used for feedback and discussions.

• Final report should be issued in English. MdM then has a few weeks from receiving the provisional report to circulate its comments and observations.

5.Organisation of the mission

The consultant who will apply should submit the following:

• A technical proposal including:

o an appreciation of the terms of reference

o the technical approach developed and the detailed methodology

o the team’s composition, the assignment of responsibilities to each of its members, the proposed CVs and the members’ availability

o the provisional working plan, and an estimate of required staff time in working days

o References to 2 similar previous works

• A financial proposal including: the total financial quotation (including tax) incorporating the budget allocation (fees, living expenses, transportation, interpreter, etc.)

The mission should take place as soon as possible and end before 1 June 2021.

6.Skills required for conducting the mission

The skills required may cover the following areas:

• Knowledge and professional experience of evaluation/lesson-learning

• Professional experience in NGOs

• Previous experience working with NGOs

• Technical expertise in MHPSS

• Knowledge and professional experience in Lebanon

• Arabic and English proficiency – French an asset

7.Application file

The consultants invited to bid shall provide the above-mentioned details to the following email address: hr.lebanon@medecinsdumonde.net specifying the subject reference “CMCH Capitalisation”.

Final date of receipt of the application files: 6 February 2021 - 9.00 a.m. Beirut time

Consultants should send their application to hr.lebanon@medecinsdumonde.net specifying the subject reference “CMCH Capitalisation” before 6 February 2021 - 9.00 a.m. Beirut time.