Fondation Pierre Fabre
TERMS OF REFERENCE
EVALUATION OF THE SOHA PROJECT – Developing quality essential care for the impoverished in LEBANON
General
CONTRACTING ENTITY: “FONDATION PIERRE FABRE”
SUBJECT: EVALUATION OF THE PROJECT TO SUPPORT THE STRUCTURING OF THE LEBANESE ASSOCIATION THE ORDER OF MALTA AND TO IMPROVE HEALTHCARE PROVISION FOR THE MOST DISADVANTAGED PEOPLE LIVING IN LEBANON
PERIOD EVALUATED: 1 April 2021 – 31 December 2023
DEADLINE FOR SUBMISSION OF TENDERS: Friday 09 February 2024
PLACE OF EVALUATION: Lebanon (Beirut -Ain el Remmaneh and Achrafieh), Qobayat, Barqa, Khaldieh, Kefraya, Zouk, Roum, Yaroun, Siddikine)
1. Context
The Pierre Fabre Foundation (FPF), recognised as a public utility in 1999, has been providing public health support for over 20 years, particularly in Lebanon. Its 5 main areas of intervention are the training of healthcare professionals, the fight against sickle cell anaemia, access to quality healthcare, e-health, and dermatology. By 2023, the Foundation will be running 35 programmes in 21 countries. The FPF is the Pierre Fabre Group’s main shareholder (86%). This organisation, unique in France at this level of commitment, provides the Foundation with sustainable resources to finance its work. The FPF is not involved in the operational management of the Group and devotes itself exclusively to carrying out the missions as defined in its mission statement.
The Association Libanaise des Chevaliers de Malte (ALCM), which has been present in Lebanon since 1953, has developed its network of partially accredited primary healthcare centres to meet the needs of the most disadvantaged. An initial FPF evaluation mission, conducted in 2018, highlighted the need to consolidate this network to improve the care provided to patients and ensure the sustainability of the services offered.
To help improve access to healthcare within the ALCM network, the FPF is co-financing, with the Agence Française de Développement (AFD), a project to develop quality essential healthcare for the impoverished in Lebanon, also known as the SOHA Project. The SOHA Project was the subject of financing agreement CLB 1148 01K, signed between the FPF and the AFD on 11 August 2021, amended by amendment No. 1 through additional resolution C20221075 of the AFD Specialized Committee for Support to NGO Initiatives dated 13 December 2022. For the implementation of the SOHA Project, FPF has also concluded a bilateral partnership agreement with the Lebanese Association The Order of Malta signed on 10 December 2021, amended by amendment No. 1 on 22 May 2022 (hereinafter the “Agreement“).
The SOHA project aims to help strengthen the Ministry of Public Health’s (MoPH) network of primary health centres (PHCs) by consolidating the ALCM’s primary health centres, and to support the primary health system against the backdrop of a major crisis in Lebanon. The main challenges are to develop quality health services at a time when social indicators and the MSP’s financial resources are dwindling, to ensure the sustainability of the services offered and to ensure the relevance of medical guidelines in primary healthcare. The aim is to put in place a screening policy, improve the quality of patient care and set up a health information system to create and use medical data, while facilitating the administrative and financial management of such data. By the end of the SOHA project, more than 98,995 patients will have benefited directly from the project, 161,948 patients will have received medical-pharmaceutical care, 1,271 people will have been trained, the financial sustainability of the centres will have been improved, guaranteeing a better future for ALCM activities, centres that are not yet accredited will be accredited and/or ready to be accredited, and the proceeds from health monitoring activities will have been shared with the MSP. This will strengthen the Ministry’s network, while the data provided by the ALCM will help to guide public policy. Beyond the project, dialogue with the MSP and technical and financial partners is developing and the ALCM is playing a more important role in the primary healthcare system.
The specific objectives of the SOHA project are as follows:
Specific objective 1 – Improve the quality of primary healthcare and the management of more complex pathologies for vulnerable Lebanese populations and refugees.
Specific objective 2 – Improve access to well-managed and efficient healthcare services
Specific objective 3 – Provide clarification and decision support tools to influence public policies
The expected results are as follows:
R1: A regular prevention system has been set up and early treatment provided. Local needs are well identified, and some health centres are sub-specialised to become local references, offering comprehensive services in regions lacking resources and quality health infrastructure. The layout of the premises and the equipment allow us to meet the most demanding medical requirements, particularly in dentistry for the most impoverished people.
R2: The MSP’s Phenics health information system (HIS) is installed in all centres and medical data is available. Medicines and other products are available in the health centres and a safety stock is maintained at the central pharmacy. The governance of the network and of each centre is optimised and the centres are ready for accreditation or are accredited by the Lebanese Ministry of Public Health. Governance of activities and projects has been optimised.
R3: The medical data from our activities is analysed and measured, and regular epidemiological monitoring is carried out, leading to publications. The monitoring and research work carried out by the ALCM, based on the results of its activities, is exploited and the end product is used as a decision-making tool to influence public health policies.
The beneficiaries as defined in the logical framework are :
Direct beneficiaries :
- Patients screened, treated, and given medication: 98,995.
- Trained staff (medical, paramedical and administrative): 1,271
- People reached by awareness campaigns: 171,764
- Patients receiving medical-pharmaceutical services:161,948
Indirect beneficiaries :
- Other staff and partners: 260
- Patients’ families: 100,000 or 200,000 people
The FPF is therefore proposing to recruit the services of a consultant to carry out an assessment of
(the “Evaluation”) The Consultant will be entrusted with all the following tasks.
2. Assessment objectives
The FPF’s objectives for the Evaluation are :
- Report on the activities implemented under the Agreement
- Rigorously and impartially assess the results of the SOHA Project, in relation to the objectives and indicators defined in the Agreement.
- Assess the relevance of the activities developed (To what extent were the services provided as part of this project relevant to the health needs in the areas of intervention? To what extent are the measures implemented as part of the structuring of the ALCM relevant?)
- Measuring the effectiveness of the activities implemented and the results achieved (Do beneficiaries feel that CSP staff provide services in a gender/age/diversity-appropriate way? To what extent has the support provided to the PSC helped to increase staff knowledge and skills? To what extent has the support provided to the PHCs improved their level of efficiency to absorb the increase in demand for healthcare in the long term? To what extent have the features and implementation of the health information system (HIS) made it possible to meet the requirements of the project and the national strategy?)
- Measuring the efficiency of the project’s medical activities
- Assess the impact and sustainability of the intervention
- Draw both positive and negative lessons from the experience of implementing the SOHA project
- Formulate recommendations and proposals for the continuation and/or preparation of any follow-up activities.
The evaluation will also answer the following questions:
- What was the nature of the FPF’s support throughout the project?
- How would you describe the partnership between the FPF and the ALCM?
- How has the ALCM been structured and developed?
- How was the gender issue addressed?
- How has environmental protection been integrated into the development of the ALCM?
3. Tasks/Activities to be carried out by the Consultant
In order to carry out the Evaluation, the Consultant shall carry out the following activities (the “Advisory Services“):
- Meet the project’s internal stakeholders (FPF and ALCM directors, field coordinators and agents, primary health centre representatives and staff) and external stakeholders (MSP, AFD, partner universities, joint national health sector working group chaired by the UNHCR and WHO)
- Collecting and analysing all reports (half-yearly and annual), audits and studies produced during the life of the SOHA project in order to measure the project’s progress
- Visit some (3 or 4) of the ALCM’s primary healthcare facilities, particularly those rehabilitated as part of the SOHA project, and meet the healthcare and administrative teams
- Visit the ALCM head office and meet the teams
- Analyse the quality of the infrastructures, systems, processes and organisations put in place and/or developed, and measure their relevance and effectiveness
- Analyse the use of the Phenics health information system and assess the effectiveness of this use
- Assess the improvement in medical care in primary ALCM health centres
- Assess the improvement in the management of medicines within the ALCM network
More generally, measure the level of execution of activities entrusted to the ALCM in accordance with the terms of the Agreement and its amendment.
4. Conditions of implementation
The Evaluation conducted as part of the Consultancy Services will be carried out at the ALCM, the sole stakeholder in the implementation of the SOHA Project. To carry out the Consultancy Services, FPF and ALCM will ensure all staff involved in the implementation of the SOHA Project and documentation related to the SOHA Project are made available to the Consultant for the Evaluation. The evaluation shall include, but not be limited to, the following groups:
- Target beneficiaries (Syrians, Lebanese, and other nationalities) (women and men), who will be included in the quantitative and qualitative evaluations.
- The programme management and field teams of the implementing partners
- Medical and non-medical staff of the targeted PHSC’s
- Government agencies: Ministry of Public Health, municipalities.
5. Assessment process and expected results
- Within two weeks of signing the Consultancy Services contract, a scoping meeting will be held between the FPF Project Coordinator and the Consultant. The meeting may be held remotely. The main objective of this meeting is to ensure that the Consultant has a good understanding of the SOHA Project, the scope of the Evaluation and the expected results.
- In the middle of the Evaluation, the Consultant will organise a meeting with the FPF Project Coordinator, the Medical Director, and the ALCM Project Manager, in order to inform them of the initial results of the Evaluation and make any proposals or recommendations that are considered relevant in light of the expected results of the Evaluation.
- Fifteen (15) days before the end date of the Evaluation, the Consultant shall send the draft Final Report to the FPF Project Coordinator. Within one (1) week of this dispatch and allowing a reasonable time for review of the draft report by the FPS Project Coordinator, the Consultant will organize a meeting with the FPF Project Coordinator to discuss the draft report and review the latter’s comments.
- Following this meeting, the Consultant will submit the final version of the Final Report incorporating the FPF’s comments and remarks and will organize a feedback meeting on its evaluation to be attended by the FPF Project Coordinator, the FPF General Manager and Program Director, the General Manager, the Medical Director, and the ALCM Project Manager. In accordance with the timetable defined below by the FPF, the final version of the Final Report must be sent to the FPF by 23 March 2024 at the latest.
For all intents and purposes, it should be noted that the FPF would like the Final Report to be drafted in French and to include, in addition to the objectives set out in paragraphs 2, 3 and 4 above, recommendations on the conduct of activities and the organisation.
6. Deliverables
The Consultant undertakes to submit to the FPF (i) an Interim Final Report and (ii) a Final Report no later than 23 March 2024 at the latest.
The report must follow the following format:
- Cover page
- Table of contents
- List of acronyms
- Executive summary: self-contained summary describing the Action, the main findings of the evaluation and the conclusions and recommendations. Maximum 2 pages.
- Main body: the main body of the report should develop the points listed in the executive summary, including references to the methodology used for the evaluation and the context of the action. Each key finding should be matched by a recommendation. Recommendations should be as realistic, operational and pragmatic as possible, taking into account the country’s context.
- Appendices : Listed and correctly numbered. The format for the main body of the report is as follows:
The report should not exceed 35 pages (excluding appendices).
Dissemination of the compiled information and the final report is the prerogative of FPF and AFD. All documentation, including data related to the mission, will remain the exclusive property of FPF and AFD.
7. Reference documents
To carry out the Evaluation and Advisory Services, the Consultant will refer to the following documents:
- The agreement between the FPF and the ALCM,
- All reports (narrative and financial) drawn up as part of the SOHA Project
- And any other document deemed relevant.
8. Duration
The Consultancy Services will be carried out over a period of 15 working days (3 weeks) with the final version of the Final Report being sent to the FPF by 23 March 2024 at the latest.
9. Methodology, timetable, financial proposal and technical proposal
The Consultant invited to tender shall provide the FPF with the following information:
-a technical proposal, including the proposed methodology for the evaluation carried out by the Advisory Services
This technical proposal must include the following elements:
- Summary of theoffer: Understanding the FPF’s expectations, summary of the stages of the evaluation, general timetable for the assignment
- Strengths and added value of this offer for this assignment
- Detailed description of the offer:
- Detailed description of the content of the methodology for carrying out the assignments requested (approach and stages, practical arrangements for steering and coordinating the assignment, etc.)
- Schedule of planned activities for the entire duration of the assignment, including the deadline for submission of the Final Report as referred to above
- Detailed table of deliverables and work plan
- The means deployed and the resources used (including constraints and limitations)
if applicable)
- The proposal must include a detailed description of how the process for managing the above deliverables will be implemented
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Identifying and managing risks that may have one or more impacts on the assignment.
- Tender forms and Technical Proposal forms, together with duly completed annexes
- The financial offer
- The completed declaration of integrity and social and environmental commitment signed by the authorised person.
In particular, the financial bid must indicate the total costs of the Advisory Services excluding VAT and including VAT in euros and the terms of payment (payment schedule).
It is specified that the price of the Consultancy Services is a global lump-sum and that the maximum budget for these Consultancy Services is 18,000 euros inclusive of tax. It shall include all the Consultant’s costs and profits as well as any tax liability for which he may be liable.
How to apply
Consultant profile
FPF wishes to entrust the implementation of the Consultancy Services to a Consultant with the following profile:
- Holder of a higher degree in social sciences or a similar field.
- At least ten (10) years’ experience in the operation of health systems in the Middle East
- Have carried out at least five (5) project or programme evaluations in the last five years, including projects and/or programmes receiving public funding.
- Proven expertise in primary healthcare.
- Skills in managing and evaluating development aid projects, with a proven ability to analyse qualitative results.
- Experience in monitoring engagement with local communities.
- A thorough understanding of the issue of Syrian refugees and the host communities in Lebanon.
- Independence regarding the parties involved.
How to Apply :
Please send your application to [email protected] with “SOHA Evaluation” in reference, and before the 09th of february 2024.
Deadline: 9-Feb-24