TERMS OF REFERENCE FOR CONDUCTING A NEEDS ASSESSMENT ON ACCESSING PUBLIC HEALTH SERVICES FOR REFUGEES WITH DISABILITIES IN SOUTHEASTERN TURKEY
Location: Hatay, Kilis, and Gaziantep provinces
Reports to: Deputy CD
Duration: 20 calendar days
Relief International (RI) specializes in relief and development programs that benefit people in acute distress. A registered non-profit in the US, UK, France and Belgium, our work targets those fragile countries or communities that suffer from recurrent man-made or natural crises that impede human development. The people that we serve live in seventeen countries across the Middle East, Africa, and Asia where the debilitating effects of political instability, forced displacement, and natural disasters are pervasive. Often, RI is the only organization providing healthcare, education, logistics, energy, capacity building, economic development, sanitation, and many other forms of assistance to these highly vulnerable communities.
Relief International (RI) has been working in Turkey since 2013. Currently, RI implements activities in 5 provinces across Turkey, providing specialized health service delivery for refugees, focusing on mental health and psychosocial support services (MHPSS), physiotherapy, prosthesis & orthotics, community health and livelihoods support;
According to the latest available figures from the Turkish Directorate General of Migration Management (DGMM), there are more than 4.9 million foreign nationals present in Turkish territory, 3.7 million of whom are seeking international protection. Most of those seeking international protection are Syrians (3,715,913 individuals) who are granted the temporary protection status in Turkey. In addition, international protection applicants are most frequently nationals of Afghanistan, the Islamic Republic of Iran and Iraq constitute another group of foreign nationals. According to DGMM, there were 31,334 international protection applicants present in Turkey in 20201, published annually. Moreover, according to UNHCR, there are close to 330,000 international protection status holders and asylum seekers (IOM, MPM Turkey Migrants’ Presence Monitoring Situation Report September 2021)
RI is looking for a consultant(s) to carry out a comprehensive assessment of the access to health services for people with disabilities (PWDs) in Turkey. The assessment will analyze the current gaps and barriers to access health services exploring at the same time the impact of COVID-19 on the target population. Additionally, the assessment will explore the cost of accessing health services for PWDs (including securing the assisted devices) and the capacity of Turkish health system (including migrant health centers and NGOs’ centers) in providing the needed health services for PWDs.
- Purpose and Objectives of the Assessment
The purpose of the assessment is to support RI in expanding the understanding of the challenges that PWDs face in accessing the health services in Turkey (Hatay, Kilis, and Gaziantep provinces) and the capacity of the health system in supporting this group.
Specifically, the assessment aims to:
- Review the regulations/ restrictions for accessing health services by refugees (Syrian/ non-Syrian) with a focus on PWDs.
- Provide a detailed overview of the barriers to access health services by refugees with disabilities (RWDs);
- Understand the cost of accessing health services by RWDs, including transportation, examination, investigations, and treatment;
- The capacity of the health system in the selected locations (including public sectors, migrant health centers, NGOs’ centers, and private sector) in serving RWDs; and
- Identify variation in the accessing health system in terms of cost and waiting time, if any, between PWDs and persons without disability, and compare the finding with the host community.
- Scope of Work and Research Question
The consultant(s) will conduct the assessment in locations (exact districts TBD), selecting the appropriate methodology in collaboration with RI team.
The study should include/cover detailed questions about the mentioned areas/domains with a protection lens in terms of gender, age, and nationality.
The assessment is expected to incorporate secondary and primary data, including KIIs and FGDs.
Main research questions:
- What are the main barriers for PWDs to access health services in public hospitals and clinics, migrant health centers, NGOs’ centers, informal clinics, and private centers?
- What is the cost of accessing the health services (in public hospitals/clinics, migrant health centers, NGOs’ centers, informal clinics, and private centers) for PWDs?
- What is the current capacity of the Turkish health system (including public hospitals/clinics, migrant health centers, NGOs’ centers, informal clinics, and private centers) to serve PWDs?
- What are the difficulties that refugees are facing when receiving health services at public hospitals/clinics, migrant health centers, NGOs’ centers, informal clinics, and private centers?
The consultant is expected to:
- Provide a comprehensive overview about the regulations in Turkey of accessing health services by Syrians under temporary protection and other nationalities under the international protection with a focus on PWDs.
- Compile and analyze the findings of the desk research and primary data.
- Draft and produce a final document outlining process, findings and suggested actions related to the main objectives of this consultancy.
Note: the process should be gender sensitive and a gender lens should be applied to the analysis and recommendations.
- Key Tasks
The essential tasks to be performed by the consultant(s) include but are not limited to the following:
- Develop a comprehensive assessment proposal.
- Develop and submit an inception report that details the process, methodologies, framework for analysis, and the different tools to be employed for the assessment. It should include a detailed work plan.
- Undertake desk review of all relevant documents including Humanitarian Needs Overview (HNO), Regional Refugee and Resilience Plan (3RP), UN and NGOs reporting, RI assessments, Government of Turkey (GoT) regulations on access to relevant services for the target population, and any other relevant documents.
- Design data collection methodology as appropriate, guided by the objectives and scope of the consultancy, including best practice approaches and relevant frameworks. RI technical staffs should comment on the data collection tools before finalizing and using them for the actual data collection.
- Conduct a comprehensive field-based assessment (using qualitative data collection methods) based on the purpose and objectives of the consultancy.
- Write and present a draft report, capturing key findings against the objectives of the assessment, with a summary of suggestions and technical recommendations.
- Submit a draft report to RI for feedback to facilitate sharing of the assessment result with a view of incorporating inputs from RI in the final draft
- Compile and submit a final assessment report to RI including an executive summary.
- Target Population of the Assessment
The assessment should explore the needs and challenges of the following target groups:
- People with disabilities either under temporary protection or international protection;
- Key informants working in the health system in Turkey, including Ministry of Health or Provincial Health Directorates representatives, NGOs representatives, migrant health centers representatives, and key medical workers in state hospitals.
- Refugees without disabilities and host communities to do a controlled study to show the variation in needs.
The total duration of assignment shall not take more than 20 calendar days including inception report preparation, field assessment and report write-up, which counts from the date of signing of the agreement.
The consultant(s) should indicate a breakdown of the timeframe showing the detail work plan including:
- Inception activities (e.g. inception report, desk research)
- Check-in meeting with RI technical team
- Tools development and review
- Data collection
- Analysis of findings, preparation of the report
The consultancy should develop the best approaches for undertaking this assessment, preferably using a protection lens and a gender sensitive approach, while taking into consideration the following guiding principles:
- Desktop review of secondary data.
- Key informant interviews (KIIs): the consultant shall conduct in-depth interviews among key informants including local authorities, target population and caregivers, NGOs and organizations working with refugees and PWDs.
- Diverse focus group discussions with refugee and hosting communities
- Any other applicable methods based on good practices
The consultant(s) shall prepare relevant tools and assessment methodologies for RI review before starting the data collection. RI will provide its recommended tools to the consultant(s) for reference and adaptation.
- Key Deliverables
The key deliverables expected are:
- Inception report including desk review and methodology before the start of the fieldwork for feedback of relevant RI staff members staffs
- Rationale for the selection of specific sub-districts in the target areas
- Data collection Tools and any other documents that is used in the course of the assessment
- Raw data set
- Final assessment report (one electronic copy in PDF format and one in DOC format) including strong data visualization and executive summary
- Debriefing meeting presentation of main finding with RI staff
The consultant(s) must demonstrate the following qualifications:
- Relevant university qualifications, preferably in a field related to development studies, health, refugees studies, and livelihoods. Master’s degree (or equivalent) preferred;
- A minimum of four years of experience with strong and demonstrable quantitative and qualitative research techniques and skills, data collection and analysis, and especially in similar assessments and surveys
- Demonstrated understanding of refugee, disability and gender issues, particularly in the Turkish context;
- Ability to work with a group of diverse stakeholders and produce results;
- Familiarity working with Humanitarian Organizations
- Political, cultural and gender awareness;
- Fluency in English language, both written and verbal;
- For consultancy companies: valid registration in Turkey and can issue financial invoices.
- Applicant Responsibilities
The selected applicant will be responsible of:
- Accessing the target population for data-collection, including securing the needed permission from relevant authorities;
- Hiring and supervising the data collectors;
- Securing the needed technology tools such tablets and phones;
- All the logistic support such as transportation, accommodation, printing, etc;
- Comply with Ministry of Health (MoH) safety regulations and measures related to COVID-19 prevention.
- Equipment for the Assignment
No equipment will be purchased or provided by RI. Any equipment needed to complete this assignment will be provided by the consultant(s).
Payment will be released upon RI’s acceptance of final deliverables following constant review by RI. RI will not cover extra costs for any accommodation, transportation (including transportation to and from project locations within and between cities), per diem or any other kind of allowances.
The service provider’s payment shall be based on the financial proposal developed for this consultancy.
- Application Procedure
Interested consultants must submit their application through email (email@example.com) by 10 December 2021, however, applications will be reviewed on a rolling basis. Only shortlisted candidates will be contacted.
Consultants who wish to apply for this consultancy must submit an application that contains the following:
- Resume or CVs of the study/consultancy team members with details of experience, qualifications, telephone number and names of three references.
- A technical proposal that summarizes understanding of the ToR and the proposed methodology
- Detailed work plan and timeline
- Financial proposal providing relevant cost estimates for the consultancy work including VAT and taxes.
- Samples of past work.
The deadline for submission of the application is 10 December 2021. Applications will be reviewed on a rolling basis. We might close it earlier if the right consultant is identified.
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