Study of barriers to access to primary health services for migrants, Morocco At Doctors of the World – Belgium

Full description of the terms of reference to download on our site

WHO ARE WE ?

Médecins du Monde is an international medical development NGO that is part of an international network. We provide medical assistance to vulnerable groups, in Belgium and the rest of the world. We want universal health coverage where everyone has access to care, without obstacles.

In Belgium and around the world, our projects are aimed at all people who have no or no longer access to health care. In particular, they are structured into five axes: people on the margins of society, children in vulnerable situations, women, migrants or displaced people and victims of crises or conflicts.

To carry out our mission, we base ourselves on three pillars:

• Care: providing real access to care for populations.
• Change: more than helping, we want to change things in the long term.
• Testify: we do not remain silent. Thanks to our experience and our presence on the ground, we challenge the authorities (local, regional and (inter)national) with facts, figures and realities.

Our projects follow a series of values ​​common to our entire organization: Social Justice, Empowerment, Independence, Commitment, Balance.

CONTEXT

Morocco has long been considered a country of emigration and transit to Europe. From the 2000s, following the intensification of the migratory phenomenon, and international policies focused on the tightening of border controls, Morocco has gradually transformed itself into a “stopover” country and even a destination for migrants. As a result, these people find themselves stranded for a long time and are often in an irregular situation in very precarious living conditions. In 2018, the IOM estimated the number of migrants in an irregular administrative situation in Morocco to be between 25,000 and 40,000. Generally speaking, the lived experiences and very precarious living conditions of migrants have consequences on their physical and mental health.

In Morocco, the management of migratory flows is subject to a difficult balance between integration actions and policies and border security management. In September 2013, Morocco launched a new migration policy, based on a report from the National Human Rights Council (CNDH) which was based on four components: “The situation of refugees and asylum seekers, foreigners in an irregular administrative situation, foreigners in a regular situation and the fight against human trafficking”. In 2014, the government council adopted the National Immigration and Asylum Strategy (SNIA). Faced with this growing irregular migrant population, the Moroccan government launched two massive regularization processes, the first in 2014 (24,000 migrants regularized) and the second in 2016 (figures not yet available). This regularization gives them the right to work and gives access to social services. However, many of these services face numerous challenges and public perceptions of migrants have become increasingly negative, undermining government efforts to integrate them into society.

MdM BE considers that health is a universal human right. Our vision is to achieve universal health care coverage, through which every person would have access to health care. MdM BE implements advocacy to improve access to health rights and services, particularly at the first line of health, for migrants with a focus on migrant women and children.

In this context, the objective of this study is to identify and analyze the main barriers to access of migrants (and in particular women and children and young people) to primary health services (and in particular to sexual health services and reproductive, management of gender-based violence and mental health and psychosocial support services) in their care pathways and to formulate precise recommendations which will form the basis of joint advocacy to remove these barriers and will nourish advocacy tools (e.g. policy brief).

OBJECTIVE OF CONSULTANCY

The project “Improving access and quality of health and protection services for migrants in vulnerable situations in Rabat and Oujda and in their regions (PROSAM)” is a 36-month project, led by a consortium of NGOs composed of Médecins du Monde Belgique in Morocco (MdM BE), MS2 and AMANE. The project is financed by the Delegation of the European Union to Morocco.

The general objective of the project is to contribute to strengthening the protection of migrants in vulnerable situations transiting, on an occasional or prolonged basis, through the cities of Rabat, Oujda and its regions.

• OS: access and quality of health (medico-psycho-social) and protection services, adapted to the specific needs of migrants in vulnerable situations, is improved.

The project will notably enable the development of assistance and protection strategies at the local, regional and national level through improved coordination and dialogue between implementation partners, public actors and political and economic decision-makers. . In this context, an advocacy strategy and thematic policy briefs targeted by audience will be developed.

YOUR PROFILE

Consultants must have the following profile:

• University degree (Master 2 or equivalent), preferably in development, political sciences, social sciences, legal sciences, health economics or related fields;
• Minimum experience of five years in the field related to the services requested, particularly in terms of participatory methodology and qualitative data collection;
• Specific experience and expertise in assessing access barriers to services and in the health economic sector;
• Specific experience and expertise in the field of migration;
• Specific experience and expertise in the field of advocacy;
• Knowledge of the specific sectors of the mission is an asset;
• Perfect command of French, mastery of other languages ​​is an asset;
• Analytical mind and synthesis skills;
• Excellent writing skills.