Kyrgyzstan: Secours Cathoique / Caritas France - Evaluation in Kyrgyzstan theme "Mental Health"

Terms of References

EXTERNAL CONSULTANT

Evaluation of Project PI120264“Development of Outpatient Day Care Center in Bishkek city”/ “Centre d’accueil de jour pour personnes souffrant de troubles mentaux à Bichkek »

The Terms of Reference (TOR) is designed to contract an Evaluation Expert for carrying out External Evaluation of the “Development of Outpatient Day Care Center in Bishkek city” project implemented by Public association “Promotion of Alternatives”. The evaluation will cover a period of 2012-2015 years. In addition, based on the evaluation results, the expert will help the project staff to elaborate the project strategy.

Background

Kyrgyzstan became independent in 1991 and formerly was one of the fifteen republics of the USSR. During the past twenty or more years the country had prioritized establishing a national economy and all political decisions were aimed at reforming, from communist centralized to free market-based system. The reforms to improve the national healthcare system till present days represent a major challenge for the government. While addressing the problem of financing the infrastructure, the medical personnel and maintaining quality services among other issues, the reforms in mental healthcare services were often neglected.

Since Kyrgyzstan inherited a soviet methodology of treating psychiatric and psychological diseases/problems the most common method used for many years was the institutionalization of persons with mental disorders. Meanwhile the conditions and treatment of patients in these psychiatric institutions equate to isolation in prisons and maltreatment is widespread.

To allow changes in terms of improving the situation, the Law on Mental Health Care and Guarantees for Citizens in its Delivery was adopted in 1999. Also, the inclusion of psychotropic medicines in the Medicine Package of the State Benefit package was another government’s effort to improve access for people with mental health problems. However, the implementation of both reforms are not followed to their extent and the mental health problems are for the most solved by the number of NGOs who provide psycho-social assistance or professional psychiatric rehabilitation with the use of modern methodology.

The Public association “Promotion of Alternatives” is one of those few specialized NGOs that provide psychiatric assistance and social rehabilitation to persons with mental health problems.

Initially as part of the NGO “Mental Health and Society” projects, the first model of ‘Outpatient Day care’ service has started in 2006 and was funded by the Secours Catholique - Caritas France (SCCF). Later in 2010 the service has separated and registered as a separate NGO - “Promotion of Alternatives” which continues its activities up to date under the projects funded by SCCF. The current 3 years phase co-funded by the Open Society Institute (2012-2015) is finishing November 2015.

During the previous years the project advanced in promoting institutionalization of community based psychosocial care on the national level. The Daycare center run by ‘Promotion of Alternatives’ offers a variety of rehabilitation services to people with mental health problems and has succeeded to mobilize its beneficiaries to form up self-help groups and lead advocacy activity. The organization is not only active in lobbying the rights and interests of the beneficiaries but also have increased awareness of population about mental health issues. Finally, the organization staff is engaged in developing psychiatric social work standards and training of regional social workers and psychiatrists within the framework of the national pilot program of establishing community based mental health care services.

Project objectives

Goal: to improve the quality of life people with mental disorders and their families, to better cope with their disease, as well as creation of outpatient community based care for people with mental disorders in Kyrgyzstan.

Specific objectives:

1. Reduce the number of admissions to the hospital during a year.
2. Increase the duration of remission;
3. Protection the rights and interests of the mental health services consumers to receive community based care;
4. Help in the expansion and acquisition of social skills;
5. Restoration of their ability for self service
6. Restoration of their ability to control their behavior
7. Restoration of their ability to work
8. Increasing their ability to study
9. To promote the restoration of communicative abilities;
10. Spreading the experience of work in Outpatient Psychosocial Care over the Republic;
11. Increasing social activity of users thru development of self-help groups activate user’s creativity.

Purpose\*The purpose of the evaluation is to conduct a thorough analysis of the strengths and weaknesses of thePublic association “Promotion of Alternatives”**and**to develop its long-term strategy. Specifically, the review of their efficiency, organizational capacity, and working methodologyshould be done. Thus the following points are to be studied with special attention.*

• To assess the degree to which the objectives pursued have been achieved, in terms of qualitative and quantitative results; to review the organizational mission and approach.
• To investigate to what extent the project’s outcomes (physical and immaterial services delivered to the beneficiaries) are met if they are sustainable in the long term.
• To review the project cost-effectiveness;
• To assess the organizational structure in terms of management and governance;
• To evaluate organization’s fundraising strategy and capacity;
• The evaluation should contain conclusions and recommendations at both the strategic and operational level.

Expected results

• To examine project management, work plan and project outputs results;
• Stakeholder analysis and deviation from plan analysis;
• Qualitative survey on the perception of stakeholders and beneficiaries of project outcomes;
• Information concerning relevance, efficiency, effectiveness, sustainability and impact of the project;
• Overall evaluation of perception, knowledge and feelings of stakeholders and beneficiaries of the project.

Methodology (for site work)

• Evaluator will review all activities with on-site observations and considering the quality of the work accomplished. A combination of observation and discussion will allow identification of the changes.
• This can be considered on both a network and beneficiaries level: partner institutions/organisation, beneficiaries.
• Interviews with all actors: government authorities, psychiatric institutions, ombudsman institute, social and medical service providers, other NGOs and key sources of information in the area.

Activities (for evaluator)

• Study of documents related to the project
• Meeting with donor for briefing/debriefing
• Interview/working groups with NGO staff
• Site visits and interviews with beneficiaries
• Focus groups and interviews with stakeholders (depending on context)
• Further evaluation activities (the need for which will be identified by the evaluator during preparation of the mission or report)
• Report writing

Debriefing and submission of reports

• The first draft report, in accordance with the format provided in Annex, shall be submitted by electronic transmission (Word 7.0 format or a more recent version) within 10 calendar days after the consultant's return from the field. The partner being evaluated has 5 working days to make its comments.
• A final report should be given to the donor office after 5 calendar days after the comments from the partner being evaluated (and in any case 2 week (s) after the end of the implementation period).

Timeframe

The evaluation will take place in October 2015 and will last 5 working days in Bishkek, plus additional time to complete the report, beginning with the date of signature of the contract by the parties, and ending no later than two weeks after the end of the evaluation, with the acceptance of the final reports.

Qualification requirements

• Higher education in psychiatry, psychology. Graduate degree in social sciences (sociology, public health).
• Quantitative (working with data) writing and analytical skills.
• Experience in conducting interviews and independent research.
• Proven expertise in psychiatry, psychology, social protection, public health and human rights evaluation in post-soviet area.
• Good organisational and planning capacity.
• Excellent reporting and communication skills (working with beneficiaries and different partners including authorities).
• Knowledge of Russian, English or French languages.
• Computer use skills (Excel, Word, and Powerpoint).

Proposal submission

The proposals must be submitted no later than 30 September 2015 to:

hugues.rostaing@secours-catholique.org

The decision on the selected proposal will be given on 9 October 2015.

Presentation of the technical proposal and selection criteria

The technical offer will include at least the following:

• Detailed CV of the consultant with the list of publications
• Proposal of evaluation framework
• Working plan
• Financial proposal including daily remuneration and taxes

NOTE:

All expenditures related to the professional travelling, daily subsistence and other administrative expenditures will be reimbursed on the basis of effective expenditures that are duly justified. The consultant will charge SCCF for that.