Country: Somalia
Closing date: 22 Feb 2016
Background:
Somaliland with an estimated population of 3.5 million people has a history of conflict, which lasted from late 1980’s to early 1990’s, and this resulted in the collapse of the health sector. After attaining its independence from Britain on 26 June 1960, Somaliland merged with the Italian Protectorate Somalia on July 1 1960 forming the Republic of Somalia. Somaliland seceded from Somalia in 1991 and now functions as an autonomous, independent Republic. Though not internationally recognized, some years of relative stability indicate Somaliland is ready to realign its focus towards long-term developmental plans.
Health and demographic data in Somaliland is largely lacking, however according to the UN, the country has some of the worst health and nutritional indicators in the world and is unlikely to reach the health related MDGs &SDGs with women, girls and the poorest groups having been most affected in this context. Women’s, adolescent girls’ and children’s health and access to health care are disproportionately affected, with particular risks to sexual and gender based violence. According to the UNICEF MICS, 2011 and other surveys, Somaliland has some of the worst health indicators in the world as can be seen below;
- Under 5 mortality 90/1000
- Infant mortality 72/1000
- Neonatal mortality 35-48/1000
- Maternal mortality ratio 1044/100,000 (MIS, 2006)
- Only 5% of Children are fully immunized by age 1
- 26-37% of women are married before 18
- Use of effective contraception stands at 3%
- Skilled attendance at delivery stands at 60-30%
- 98% prevalence of FGM
According Human Rights Watch report, “chained like prisoners, October 2015”, there are no official estimates of the prevalence of psychosocial disabilities in Somaliland. Yet, small-scale studies carried out by international and local organizations point to high rates of mental disabilities. A 2002 study found that one in five households were caring for someone with mental health problems. Twenty-one percent of the sampled households in Hargeisa were caring for at least one family member with severe mental health problems. The research also found that veterans of the civil war were four times more likely than the general population, including survivors, to experience a severe mental health condition. Research points to the war, exposure to significant levels of violence and trauma, poor health care systems, as well as the widespread use of khat as key factors contributing to widespread mental health problems. Individuals interviewed by Human Rights Watch also pointed to high-levels of unemployment and financial dependency (especially of men) as additional contributing factors.
THET is a specialist global health organization that educates trains and supports health workers through global health partnerships, strengthening health systems and enabling people in low and middle income countries to access essential healthcare. In 2000, the THET programme in Somaliland began working with health institutions already working in country to improve the provision of health services in Somaliland. THET works in partnership with institutions in Somaliland and the UK to draw from the invaluable experience of partners working within both health care systems. THET Somaliland takes an integrated approach to Human Resources for Health and works at three levels:
o Individual health workers
o Civil society institutions
o Government
Rational for the mental health Nurse Tutors training :
Mental health nursing uses the study of human behavior as its science and the purposeful use of self as its art. This is an introduction to the practical body of knowledge that constitutes the art and science of mental health nursing. According to Somaliland health workforce survey, there are very few specialists of this subject and none of them is involved in health training. The general nurse graduates become teachers of all subjects without any specialization.
According to 2014 report from Amoud Nursing tutors who supported the final OSCES, mental health was one of the weakest subjects that 70% of students failed. The results were not shocking because, even medical faculties have the same gap when it comes to mental health subjects. For medical faculties, Kings College London in partnership with THET Somaliland, availed NHS volunteers for mental health gap filling for medical interns and for teaching of medical students on mental health subjects up to now, but nurse students do not get that privilege.
Thus, we are looking for an experienced mental health facilitator who can train existing nurse tutors on mental health subject. The facilitators will transfer skills and knowledge both theory and practical to nurse tutors to enable them to develop schemes of work on mental health subjects, develop lesson plan, deliver the lesson in the class, clinical learning and assessment and overall assessment of students in mental health subject. Furthermore the facilitator will use mental health word at Hargeisa Group hospital to demonstrate to the tutors how to mentor nurse student in mental health course.
Most of nurse/midwife mental health tutors have never been thought as teachers and lack the skills and knowledge of effectively delivering mental health tutorials to their students. Few of them received short- term training in teaching methodology: How to prepare, deliver and assess the course, regular update of the course content, students’ knowledge assessment, linkage between theory and practices. The overall training aim is to transfer the skills and know how to deliver quality and useful mental health teaching courses to nurse/midwife tutors in Somaliland.
Key tasks of the consultancy
- The mental health training for nurse/midwife tutors consultancy shall focus on the following key areas;
o Teaching / Facilitation methods
o Use of technology for training and learning
o Teacher-student relationship
o Clinical teaching by the ward
o Assessment of students
o Research
o Community outreach for medical students
- The key tasks include but not limited to;
o Preparation of training notes
o Facilitating a 12 days training programme on the above and other relevant topics
o Provide relevant resources and reference to the trainees (tutors).
o Document a quality training report with clear recommendations for further action by the health training institutions and THET
Expected outputs from the Consultancy
- Tailored training module of an effective and well delivered mental health teaching Skills for tutors that includes but not limited to:
o Teaching/Facilitation methods
o Technology and training
o Communication, facilitation and presentation skills
o Teacher-Student relationship (Role modelling)
o Coaching and Mentorship through clinical teaching
o Assessment of student performance
o Operational Research
- Subjects to be covered should include but not limited to:
Ø Understand international mental health legislation guidelines relevant to mental health.
Ø Recognize the features of range of mental health disorders and be able to classify them according to the classification system on mental health and disorders
Ø The range of interventions including psychosocial, pharmacological approaches in mental health care.
Ø Discuss the complexities of service response
Ø Formulate assessment and service response to complex presentation utilizing an interdisciplinary approach
Ø Integrate the principles of recovery approach in responding to the client.
Ø Understand the implication of diverse client characteristics including, values, beliefs, age and cultural background.
Ø Demonstrate ability to research and utilize the latest evidence.
- 14 nurse/midwife mental health tutors trained on effective theoretical and clinical mental health teaching methods.
- Nurse/midwife mental health tutors trained on how to conduct mental health community interventions such as outreach and community social rehabilitation.
Person/Institution Specifications:
- Consultant with Maters or Postgraduate certificate in psychiatry.
- Proven experience in health sciences teaching in medical faculties/health institutes in low resources settings generally and within the East, Horn and southern African context specifically.
- Willingness to travel and live in Somaliland for a period of 2 full weeks to perform the assignment.
- Ability to establish a permanent network with training beneficiaries for continuous coaching and remote mentoring.
- Availability to deliver the task within 14 working days (consultancy paid days) and the assignment should be completed latest by 10th March 2016.
How to apply:
Interested persons should submit a letter of interest accompanied with proposal with detailed and updated CVs, detailed work schedule and financial proposal (in USD $) with indication flexible for negotiation or fix non negotiable to Somaliland@thet.org with cc: Saafi.Noor@thet.org not later than February 22, 2016, 2:00Pm EAT.
Due to the urgency of the assignment, the selected expert must be ready to travel to Somaliland to start the assignment within 2 weeks from the date of official communication of the offer.