Knowledge, Attitudes and Practices (KAP) survey and assessment of barriers to access to health, Tunisia At Doctors of the World – Belgium

Full description of the terms of reference in the PDF to download from 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 around 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 do not have or no longer have access to health care. In particular, they are structured around five axes: people on the margins of society, children in vulnerable situations, women, migrants or displaced persons and victims of crises or conflicts.

To carry out our mission, we rely on three pillars:

• Care : provide real access to care for populations.
• Change : more than helping, we want to change things in the long term.
• Bearing witness : 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

In Tunisia, the Sexual and Reproductive Health and Rights (SRHR) of young people is a major concern. Young Tunisians face several challenges in terms of SRHR, exacerbated by social and cultural barriers that hinder their access to health services. Indeed, the prevalence of HIV/AIDS was less than 0.1% in 2022, according to UNAIDS [1] . However, this prevalence is higher among key populations. In addition, the National Strategic Plan for the Fight against HIV/AIDS (PSN) 2021-2025 identifies young people among the populations most vulnerable to HIV/AIDS in Tunisia. Despite the commitment of public authorities and strong community mobilization, many efforts remain to be made in the fight against stigma and discrimination of key populations, particularly within public health institutions. These are the main barriers to access to screening, prevention, treatment and social protection services [2] . Key populations only represent 10% of the people treated by the Free and Anonymous Testing Centers (CDAG)3, the latter turning more readily to community structures. The difficulties of geographical accessibility to the provision of care for people living in inland areas represent another obstacle in the fight against the epidemic: the only care centers are in fact all located in coastal areas [3 ] . Furthermore, the level of information on sexual and reproductive health and rights (SRHR) is currently generally low, particularly among young people. [4]

[1] AIDSinfo | UNAIDS

[2]  plan_operationnel22-23vih.pdf (rns.tn)

[3] FORSS Program – MAHJOUBI Mohamed Bilel, Status report on available services in the fight against HIV/AIDS in Tunisia, June 2019

[4]  FORSS Program – MAHJOUBI Mohamed Bilel, Status report on available services in the fight against HIV/AIDS in Tunisia, June 2019

Description of the consultancy

Mission objectives:

• To assess young people’s knowledge, attitudes and practices regarding STIs/HIV, with a focus on key populations and high-prevalence geographic areas. We recommend a mixed methodology combining questionnaires for knowledge, focus groups for attitudes and practices and key informant interviews.
• Analyze the supply of STI/HIV services and identify barriers to access to services (information, orientation, counseling, screening and treatment)
• Analyze the legal framework in relation to the themes of the mission in the countries of the MENA region
• Formulate recommendations to improve access to and the quality of sexual and reproductive health services for young people, in alignment with the priorities of Médecins du Monde and the specific needs of the target population.

DELIVERABLES

There are five (05) expected deliverables:

1. Detailed methodological note with collection tools, an ethical protocol and a mission schedule
2. Bibliographic review
3. CAP survey report for young people/key populations
4. Report presenting the range of services and analyzing the barriers to accessing these services
5. Report of recommendations to improve access to and quality of sexual and reproductive health services for young people, including concrete measures to be taken by relevant stakeholders. The formulation of recommendations should adopt a participatory methodology with the populations concerned

EXPECTED PROFILE

• Proven professional experience in the field of sexual and reproductive health, with specific expertise in issues related to the health of young people and key populations in Tunisia or in similar contexts.
• In-depth knowledge of sexual and reproductive health policies and programs in Tunisia, as well as the challenges and opportunities associated with these policies.
• Demonstrated skills in qualitative and quantitative research, including data collection, analysis and interpretation.
• Ability to work independently and in a team, with demonstrated ability to collaborate with a diversity of stakeholders, including young people, health care providers and policy makers.
• Excellent written and verbal communication skills in French, Arabic, with the ability to write clear and concise reports Relevant academic training in public health, social or political sciences or other relevant field, preferably at Master’s level or equivalent.