Consultancy to conduct a Rapid Assessment and develop migrant friendly service delivery models and associated M&E tools

CALL FOR APPLICATIONS

Position Title: Consultancy to conduct a Rapid Assessment and develop migrant friendly service delivery models and associated M&E tools for increasing access to HIV, TB, COVID-19 and other health services for migrant populations in Lesotho

Type of Contract: International Consultant

Duration of Assignment: 45 working days (October to December 2022)

BACKGROUND: International Organization for Migration (IOM), the United Nations Migration Agency, is a dynamic and growing inter-governmental organization, with a membership of 166 states. IOM is committed to the principle that safe, humane, and orderly migration benefits for all. Established in 1951 and now active in over 173 field locations worldwide, IOM works with partners, government, and civil society to promote international cooperation to address operational challenges of migration and mobility, assist in the search for practical solutions to migration problems, and to provide humanitarian assistance to migrants in need, including refugees and internally displaced people. IOM addresses the migratory phenomenon from an integral and holistic perspective, including links to development, to maximize its benefits and minimize its negative effects. Within its Migration Health Division (MHD), IOM delivers and promotes comprehensive, preventive, and curative health programmes which are beneficial, accessible, and equitable for migrants and mobile populations. Bridging the needs of both migrants and IOM’s Member States, MHD contributes towards the physical, mental, and social well-being of migrants, enabling them and host communities to achieve social and economic development. Through the Project Management Unit of the Ministry of Finance Lesotho, under the support of the Global Fund, IOM Lesotho will implement a project titled: “Preventing Lost to follow up and sustaining HIV and TB treatment Among Migrant population in Lesotho.” The Project seeks to contribute to the health outcomes of Basotho migrants and migration affected communities through enhancing access to HIV, TB and COVID-19 related services in Lesotho.

IOM Lesotho has prioritized the following activities for this financial year: Activity 1.1.1 Recruit a consultant to conduct Rapid assessment of Basotho migrants to map key migration affected communities and existing service provider (HIV/ TB and COVID-19) for migrants regardless of their immigration status; Activity 1.1.2. Recruit a consultant to review and strengthen existing migrants-friendly service delivery model for migrants (internal and international migrants) to meet with the needs and characteristics of migrants to improve continuity of care (specifically ART as well as syndromic management, TB screening, testing and treatment, Sexual Reproductive Health services), follow-up support and access to COVID-19 testing and vaccination services Activity 1.1.3. Recruit a consultant to review and strengthen Monitoring and Evaluation (M&E) tools to assess migrant-friendly services at service delivery and cross border points;

Through this project, IOM Lesotho will contribute to integrating migration and population mobility into current national plans for HIV, TB, and COVID-19 especially the promotion of continuity of care for HIV and TB among migrants and migration affected communities and building the capacity of the MoH, NAC to implement and lead migration sensitive strategies in Lesotho. In the existing HIV strategy, migration (human mobility) is not currently included and migrants are not considered a key populations despite migrants experiencing several HIV related vulnerabilities that include limited access to services and lost to follow-up for continuity of care due to their nature as migrants and their high level of mobility, risky behaviours associated with being away from home and or workplace conditions.

It is against this background that IOM Lesotho is currently soliciting applications from a qualified international consultant to undertake a consultancy for 45 working days over a period of July to September 2022. The successful candidate/firm will be capable of multi-tasking and meeting the requirements associated with conducting this assessment of mapping of key health service delivery points for migrants, review of migrant friendly service delivery models and development of monitoring and Evaluation tools in line with these Terms of Reference (ToR).

It is expected that a qualified international consultant will undertake an in-depth mapping of the existing health service delivery points in migration affected communities, review and analysis of migrant friendly health service model and strengthening of existing monitoring and evaluation tools for assessment of migrant friendly services. Special attention will be paid to understanding the needs and characteristics of migrants and migration affected communities in as far as health service delivery (HIV/TB) is concerned migration. Additionally, based on this assessment the consultant is expected to prepare a report of service provider mapping, analysis of existing health service delivery models for migrants and proposed model, and analysis of monitoring and evaluation tools and proposed solutions.

1. OBJECTIVE: Mapping of Key migration affected communities and existing health service delivery points available and gaps: The overall objective of this activity is to conduct a mapping of migration affected communities around the border areas and existing service providers (HIV/TB and Covid 19) for migrants. The service mapping will serve to identify both available services and gaps in service provision based on population movement trends; it should also highlight barriers preventing vulnerable migrants from accessing available services. The consultant is also expected to comprehensively assist IOM and Government of Lesotho to better understand migration related challenges to accessing health services and develop a common understanding of key areas of vulnerability, in relation to HIV, TB and COVID-19 and migrants’ health. Solutions and mechanisms for ways to strengthen migrant friendly health services will also be proposed, based on local best practices as well as practices in similar settings in the region.

The specific objectives of the assessment are as follows:

1. To identify population mobility trends, gaps, challenges and service utilization for migrants in Lesotho, with particular focus on key mobile populations with high vulnerability to HIV, TB and COVID-19.
2. To identify existing health service providers and suitability of services in key migration affected communities around border areas in Lesotho
3. To propose appropriate mechanisms to address the identified challenges and solutions for strengthening health service delivery for migrants and migration communities Review of migrant friendly service delivery models: The overall objective of this assessment is to review the service delivery package and models for delivery of migrant friendly services with the aim of identifying the needs and characteristics of migrants to improve continuity of care, follow up support and access to HIV, TB and Covid 19 related services. Consultant is also expected to look into existing referral pathways which chart the procedures and agreements among actors for referrals and counter-referrals, and will specify individual department’s roles and responsibilities in regard to health service provision.

The specific objectives of the assessment are as follows:

1. To identify and assess the quality of service delivery package, models of care and gaps in provision of migrant friendly services in Lesotho (health and non health)
2. To propose a model (based on existing service delivery models and where required new models) that promotes access of migrants HIV, TB and COVID-19 services in Lesotho, regardless of their migration status. This proposal should highlight the needs of migrants and what differentiates their needs from those of the general population Review of monitoring and evaluation tools: The overall objective of this assessment is to assess existing monitoring and evaluation tools used to assess migrant friendly services at service delivery points in Lesotho.

The specific objectives of the assessment are as follows:

1. Assess existing instruments or tools, indicators, methodologies and information systems in relation to M&E tools for HIV, TB and COVID-19 services?
2. Propose M&E tools or package to strengthen existing tools or develop migrant friendly health services M&E tools where non existent

2. METHODOLOGY: The process will be participatory and should ensure that Government representatives, Partner organizations and service provider networks are proactively involved in the process. The methodology must be designed to ensure that voices of migrants regardless of their immigration status are heard, and their participation is inclusive i.e. there is a clear focus on reaching and empowering the migrants and their communities to ensure that they are part of the findings and analysis. Note: IOM is flexible to discuss with the selected consultant on the methodology and process of this assignment. The below is a proposed methodology which IOM is open for further discussion Mapping of Key migration affected communities and existing health service delivery points: The assessment should include the following elements, inter alia:

1. Mapping of population mobility trends with particular focus on key mobile populations with high vulnerability to HIV, TB and COVID-19
2. A documented analysis outlining strengths and weaknesses in the service provision of migrant friendly services
3. Describe different units, their functions and community based structures working with health facilities
4. Describe physical, structural and attitudinal barriers that may pose as barriers to access for migrants.
5. Provide recommendations on how service provision for migrants can be improved; compiling and documenting stakeholders’ (service providers and targeted users) suggestions for improving migrant friendly service provision.
6. Update service map with accurate information about the services, information and support available for migrants

Review of migrant friendly service delivery model:

1. Review different models of care developed in Lesotho and similar settings in the region to service migrant populations
2. Provide recommendations on which model may work best compiling and documenting stakeholders suggestions for improvement Review of monitoring and evaluation tools:
3. Review of existing tools to assess friendliness of health services for migrants
4. Propose M&E tools or package to strengthen existing tools or develop migrant friendly health services M&E tools where non existent

DELIVERABLES In accordance with the scope of work, key deliverables will include, but not be limited to: ▪ Draft inception report and workplan which presents the methodology to be applied in the analysis of service mapping, review of service delivery models and development of monitoring and evaluation tools including targeted participants, proposed report structure, detailed planning, and migrant friendly and participatory tools for the key-informant interviews and focus group discussions o The inception report should summarise and cover findings of the desk/literature review. ▪ Draft report on the analysis of existing service delivery models of care outlining primary results and preliminary analysis. This should incorporate review team ▪ It is expected to submit cleaned and validated raw data. ▪ Service Mapping report which is clearly structured and documents the findings, analysis and recommendations. ▪ The final report should address the comments received from IOM and partners ▪ Participate in validation workshop per key location with partners on the results of the assessment ▪ Specific dissemination materials including presentation of the findings that can be shared with different stakeholders, including Government officials and representatives of the affected community. ▪ Final, validated and user-friendly service delivery model and package together with Monitoring and evaluation tools ▪ Final 2-3 page policy brief A typed final version of the assessment report must be between 50 and 60 pages, giving a clear description of the health service delivery situation in migration affected communities in Lesotho, mapping of service delivery points, analysis of health service delivery models, proposed M&E tools and recommendations towards strengthening the capacities of health service providers working in migration affected communities. Note: IOM is flexible to discuss with the selected consultant on the content of the final product. The below is an indication of what is expected to be included in the report.

The following annexes need to be attached to the final report: • All notes from meetings with stakeholders • All interviews • All available statistics gathered in the course of the assessment • References • Any other material relevant to the assessment

1. TIMEFRAME The below is an indicative timeframe to undertake this assessment. Deliverables Duration 1.Inception meeting with IOM and PMU to discuss on the agreed next step for the assessments – 17 October 2022 2.Submit draft inception report which includes research design, methodology, key interview questions, and interview schedule on the mapping of existing health service providers – 21 October 2022 3.Incorporate IOM and PMU inputs in the inception report and submit the final inception report – 25 October 2022 4Submit the first draft of service providers mapping exercise IOM and to stakeholders to be coordinated by IOM – 21 November 2022 5.Submit the final service providers mapping assessment to IOM and incorporating all the inputs from PMU, Ministry of Health and other stakeholders – 28 November 2022 6 Submit the inception report for review of health service delivery models for migrants and Monitoring and evaluation tools (checklists) to IOM – 30 November 2022 7 Incorporate inputs from IOM, PMU and MOH and submit the final inception report for review of health service delivery models and Monitoring and evaluation tools (checklists) to IOM – 5 November 2022 8 Submit the draft report of migrant service delivery models assessment and a package of proposed tools and a policy brief to IOM – 7 November 2022 9 Submit final report of migrant service delivery models assessment and a package of proposed M&E tools and a policy brief to IOM – 8 November 2022

Qualifications and Experience The successful consultant should have the following qualifications and experience: ▪ Advanced university degree in social sciences, public health, international relations, development study, research or other relevant field ▪ Extensive knowledge of migration and public health system in Southern Africa ▪ The team leader has at least 10 years proven record of producing high quality and credible assessments of health programmes particularly HIV/AIDs and TB (a sample will be required) preferably in Southern Africa. ▪ Ability to think strategically and to analyse systematically ▪ Experience in presenting complex data and information to various stakeholders ▪ Experience with working in an international development context ▪ Excellent communication skills ▪ Excellent written and spoken English ▪ Strong writing and analytical skills ▪ Strong interpersonal and communications skills ▪ Excellent written and spoken English and Sesotho

Payment Schedule Total fee, inclusive of all travel and related costs, not subject to any deductions, will be paid to the consultant as follows; • 30 % upon the satisfactory completion of the deliverable 1, 2 and 3 • 30 % upon the satisfactory completion of the deliverable 4 and 5 • 20 % upon the satisfactory completion of the deliverable 6 and 7 • 20 % upon the satisfactory completion of the deliverable 8 and 9