International Consultant to undertake assessment of opioid substitution treatment services in Moldova

International Expert to undertake evaluation of opioid alternative treatment services in Moldova

Testimonial general OST normative framework (scientific procedures, internal regulations, psycho-social assistance standards, etc.) and provide suggestions for enhancement; The Center for Health Policies and Research studies (PAS Center) is currently executing the “Reinforcing HIV Control in Moldova” Job, which is funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria and means to use part of the proceeds for carry out extensive assessment of opioid replacement treatment program in Moldova. The Republic of Moldova, a country with an overall population of 4.1 million, consisting of a breakaway area of Transnistria with population of 0.52 million, has a focused HIV epidemic, with people who inject drugs (PWIDs) being the primary affected group and an enhancing prevalence amongst guys who make love with guys (MSM). As of the end of 2015, a total of 10,249 new HIV cases had actually been registered in the country (consisting of Transnistria– 3,284), with about 800 newly registered HIV cases each year in 2014-2015. Occurrence and prevalence are estimated to be steady, with overall prevalence below 1 %. The breakaway area of Transnistria is the most afflicted area with HIV occurrence of 3.5 times higher than in the rest of Moldova (48.1 per 100,000 in Transnistria region versus 16.47 per 100,000 in the rest of Moldova in 2014). The PWID is the most affected group. According to 2012/2013 Integrated Bio-Behavioral Surveillance (IBBS), the HIV occurrence amongst PWID was approximated to be 8.5 % in Chisinau, the country capital, compared to 16.4 % in 2009, and 41 % in Balti, the 2nd largest city, compared with 39.8 % in 2009. The estimation variety of injecting drug users in Republic of Moldova is 30,200 [1], 19,400 of PWIDs on the ideal bank and 10,800 PWIDs on the left bank. The HIV response is assisted by the National Program on Avoidance and Control of HIV/AIDS and STIs (NAP). HIV avoidance in MARPs is among the two NAP vital methods and the focus of Government interventions as a reaction to the epidemic. Since 2003, the national HIV response has been carried out with support from Global Fund and there has been commendable progress in mobilization of resources and efforts for the scale-up of prevention programs for MARPs, consisting of in penitentiary system. Reflecting the concentration of the HIV epidemic amongst key populations, primarily PWID in civilian and prison sectors, with a smaller proportion of SWs and MSM, the overall objective of present Global Fund program is to support an effective reaction to HIV in order to lower prevalence amongst crucial afflicted populations and decrease AIDS relevant death through improving access of key affected populations to important HIV prevention, diagnostic, treatment, care and support services. Currently HIV avoidance in PWIDs, consisting of OST, relies greatly on Global Fund Grant. Since 2014, the National Health Insurance Funds is funding 30 OST patients per year to the Republican politician Narcological Dispensary and there is governmental dedication to fund 2 damage reduction jobs. Substitution treatment with methadone (OST), acknowledged as a reliable tool for avoidance of HIV infection amongst PWIDs, is implemented in Moldova since 2004 in civil sector and since 2005 in prisons and it is part of the NAP. Throughout year 2015, the OST services have been geographically scaled up from 2 websites to 7, and in penitentiary sector from 11 to 13 penitentiary institution. On the course of OST program application, a series of independent examinations had happened and a range of external suggestions have been implemented and improvements are in location, consisting of alignment of OST scientific protocols to WHO suggestions, release of opioid medications in the house for clients in stable remission, geographical extension of OST program to bring services near patients, the client-centered multidisciplinary method to attend to the medical and psychosocial needs of OST patients, integration of psycho-social support services within the methadone distribution sites, continued capacity building for personnel and information sessions for clients. Although development has been signed up in the field of OST in Moldova, there are still restrictions related to accessibility, protection, quality and sustainability of extensive OST services to PWIDs. Nationally, OST protection is low and not yet at levels essential to effect HIV occurrence at population level. The estimated coverage on left bank [2] is less than 3 % at the moment. The uptake of new patients in 2015 was 166, and the number of everyday clients at the end of December 2015 was 468. The advancing variety of clients ever registered in OST since program initiation in 2004 raises to 1,479. Geographical availability of the OST in the country is still low, and OST access limited for PWIDs from other site, moving OST clients or OST clients released from detention. Despite the psycho-social support to increase adherence to OST, the dropout rates stay high – only 63 % of people who started OST completed 6 months of constant treatment [3] With the objective to enhance extension and quality of current OST services for PWIDs in Moldova, PAS Center and Republican Narcological Dispensary (RND) issues this call for propositions for an international specialist or group of consultants to undertake comprehensive evaluation of opioid substitution therapy program in Moldova (in community and prison) and to develop suggestions for improvement of efficiency, quality and protection with OST, consisting of program coordination, program M&E, ease of access, availability and sustainability of OST. As a result of the consultancy, a comprehensive report needs to be produced and findings and recommendations presented to the national authorities. A global specialist or group of consultants will be employed to carry out an extensive assessment of OST service in the Republic of Moldova. The consultancy includes both in country and out of country working days. To conduct a detailed assessment, the following tasks are suggested for application: Carry out a desk evaluation of Moldova OST program: achievements and restraints based on desk testimonial of files. Design the assessment methodology beforehand to the field objective to Moldova, carry out a field objective and execute the assessment approach in nation according to preliminary concurred program for both civil and prison sectors. Conduct interviews with key OST stakeholders, key staff of all OST treatment centers and psycho-social support centers, in both civil and penitentiary sectors, with unique concentrate on brand-new civil websites and penitentiary sector. Conduct interviews and/or focus groups with OST patients in both civil and penitentiary sectors, with unique focus on pre-trial detention. Evaluate coordination of care and client support and collaboration in between NGOs and OST websites from civil and penitentiary sectors, consisting of mechanism to ensure follow up and continuity of care and support upon imprisonment or release of OST clients and recommend ways to improve. Assess the degree of integration of clinical and psycho-social elements of OST program, address normative framework, programmatic arrangements, suitability and adequacy of the incorporated services and recommend methods to progress. Assess efficiency of integration designs in old and brand-new websites, and penitentiary system. Examine partnership in between needle exchange and OST programs, from civil and penitentiary sectors, including mechanism to ensure recognition and linkage of PWID to OST services and advise ways to improve. Assess scale-up chances of OST program in Moldova, offer suggestions and possible designs for extension and quality boost. Address cost ramifications of OST on national spending plan. Evaluate expenses of existing shipment vehicle, consisting of from National Medical insurance Fund perspectives, and advise cost-efficiency increase for future extension of OST program. Provide suggestions for OST program monetary sustainability. Present and go over initial findings with PAS Center and RND. Formulate initial conclusions and suggestions. Seek advice from the report findings and recommendations with nationwide counterparts and CCM HIV prevention TWG. Organize an in-country 2- days training for provider on opioid replacement treatment and psycho-social assistance, work as primary specialist, facilitator and establish the action prepare for OST program further development. Agree the plans in advance to the field objective. Assessment plan has to be talked about with PAS/RND and authorized prior to the mission to the field. Draft and last assessment reports focused on primary restraints to guaranteeing coverage, availability and quality of services; and crucial tasks for accomplishing development and effectiveness in OST program application. The report ought to consist of analysis of present OST program strengths and weaknesses (SWOT), shortcomings of program execution, analyses of existing designs of delivery and advised designs for further program extension, assessment of existing expenses and recommendation for performance gains and the majority of effective methods of supplying integrated care to OST clients, sustainability analyses including future expense ramifications on nationwide spending plan. PAS Center in connection with RND will assist in access to any readily available details, in relation to the project that might be required by the consultant or team consultants and assist coordinate OST implementers, national authorities and other stakeholders. The specialist or group of consultants is expected to carry out all the work in close collaboration with and report to the PAS Center/RND. · A minimum of a Master’s Degree or equivalent in Public Health, Sociology, Social Work, Public Administration or related field connected with HIV/AIDS; · At least 7 years of pertinent experience at the national or/and international level in supplying monitoring and evaluation of OST programs, and services offers’ capacity and needs evaluation; · Knowledge and understanding of theories, principles and approaches appropriate to HIV avoidance, including among injection drug users and in prisons, WHO/UNAIDS/UNODC guidelines arrangements; · Knowledge of using numerous research approach and sources, consisting of ones relevant to capacity and requires assessment; · Understanding of context of post-soviet nations and experience of working in post-soviet area would be an asset; · Deep understanding and understanding of specific of technical assistance provision to HIV and harm reduction related services, particularly opioid substitution therapy; · Experience in conducting research, evaluations, and analyses, with strong abilities in quantitative and qualitative analysis; This consultancy is expected to begin throughout the 2nd quarter of 2016 and last over a period of 3 months. It is approximated that the external expert or team of specialists will invest as much as 1,5 weeks in country. 20 % of the Contract– upon the discussion of Assessment Plan, according to the TOR, following the invoice and approval of the Plan by the PAS/RND. 80 % of the Contract – upon discussion of the Go to Report and other sub-products (technical notes, memos, plans, presentations and other files) that might be needed by the Client, according to the TOR, following the invoice and approval of the Report by the PAS/RND. [2] There is no methadone alternative treatment in Transnistria area (left bank of Nistru river) The PAS Center now welcomes eligible consultants to suggest their interest in supplying the services. Interested specialists should offer details showing that they are certified to perform the services. The Consultants are hereby welcomed to send their updated CV. Experts might associate to improve their credentials. Please keep in mind that the PAS Center is not bound to accept any of the CVs. The selection of specialists will be performed in accordance with the treatments set out worldwide Bank’s Standards: Option and Employment of Professionals by World Bank Customers (present edition). The PAS Center will choose an expert on the basis of contrast of expert’s certifications for the assignment and conformity with the TOR’s requirements. First-hand information about the ToR can be obtained from the you below throughout workplace hours 09.00 to 18.00 Moldova local time. ReliefWeb has been the leading online source for dependable and timely humanitarian details on international crises and disasters since 1996. Find out more about ReliefWeb In 2015, ReliefWeb topped our own record again for the number of website gos to and reports and maps released. 2015 saw 14.5 million sessions, a 20 % increase from the previous year, by 5.7 million …
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