Needs Assessment and Proposal for Health Programme in Afghanistan At La Chaîne de l’Espoir

ABOUT LA CHAÎNE DE L’ESPOIR

La Chaîne de l’Espoir is an international NGO founded in 1994. Its mission is to strengthen health systems to give everyone, especially children, the same chances of survival and development. We intervene in 28 countries through a global approach, focused on the child but also on mothers and disadvantaged communities:

• Prevention and screening from the earliest age, particularly in the context of school health programs.
• Care and surgery to meet the most urgent needs of children and their mothers.
• Training and transfer of skills to local teams through our international network of experts in all areas of surgery.
• Construction and equipment of hospital structures adapted to local needs.

Since 2016, La Chaîne De L’Espoir has decided to take action to improve maternal health in several countries of intervention in Africa and Asia. By way of example, since 2016 it has built a maternity hospital in Kabul offering gyneco-obstetrics care to Afghan women, as well as neonatal care. This type of project helps to reduce the country’s still very high maternal and infant mortality rates.

Political and humanitarian context

After forty years of war, Afghanistan returned to relative peace in 2022 when the Taliban came to power on August 15, 2021, with the exception of sporadic actions by the ISKP (Islamic State of Khorasan). However, the human rights situation is deteriorating, particularly for girls and women exposed to gender-based discrimination and violence, with restrictions in many areas: education, work, mobility and dress codes.

The humanitarian crisis worsens in 2023, with 28.3 million people in need of humanitarian assistance, compared with 18 million in 2021 and 24 million in 2022. It is estimated that since the beginning of 2021, at least 1.6 million Afghans have migrated to neighbouring countries in addition to the 3.5 million internally displaced people, who have fled their hometown or village to another region.

La Chaine de L’Espoir in Afghanistan

The Chaine de L’Espoir built and equipped the first wing of the French Medical Institute for Mothers and Children (FMIC), which has been operating successfully since 2005. Following the original vision of the project, and after the success recorded for the pediatric part of the facility, a second wing dedicated to maternal-infant care was built and has been operating since the end of 2016. La Chaine de L’Espoir is active in two sectors: access to healthcare for the most vulnerable, and expertise in medical training.

Today, the need for support and training the Afghan teams remains high in the context of managing complex pathologies and facing a backdrop qualified personnel on departure.

The study

Study rationale

In view of the rapidly changing context and stakeholders, and the turnover of the team based in Afghanistan, La Chaine de L’Espoir would like to call on a consultancy to support the teams in the in-depth analysis of needs and stakeholders, and in the formulation of a La Chaine de L’Espoir program for the coming years, taking into account the strategy of institutional donors, which can then be submitted to institutional donors, particularly ECHO.

Study objectives

• Conduct an in-depth analysis of healthcare needs and stakeholders (with a focus on specialized care), given that a certain amount of quantitative and qualitative data has already been collected by La Chaine de L’Espoir teams in Afghanistan. The diagnostic phase aims to provide detailed information on the health system’s strengths and weaknesses, based on the WHO’s six pillars of the health system: governance, financing, service delivery, human resources, supply and health information systems.
• Providing further input into La Chaine de L’Espoir’s strategy in Afghanistan
• Formulate a complete project proposal for the coming years that can be submitted to institutional donors, in particular ECHO.

Methodology

Phase 1: preparation of the study

• Once the consultant selected, the Chaine De L’Espoir will forward all the documentation needed to understand the project.
• Secondly, the consultant and the Chaine De L’Espoir will meet to clarify expectations and discuss the organization of the study.
• The consultant will then draw up a detailed framework note, specifying the objectives to be achieved, how the evaluation is to be carried out (particularly in the field), who is to be met and how, and the data collection and analysis approaches and tools to be used.
• Once presented at the framework meeting with the Chaine De L’Espoir, the Chaine De L’Espoir will provide feedback on the framework note, which should be incorporated into a final version.

Phase 2: execution of the mission

In this phase, the consultant will conduct a survey and individual and/or group interviews in the field in Afghanistan, at La Chaine de L’Espoir headquarters, as well as with partners (remote interviews considered). On this basis, he or she will produce the deliverables detailed below.

Phase 3: restitution of work

In this final phase, a workshop will be organized with the project partners to discuss the work carried out. The consultants will review the main findings and recommendations of the study.

Deliverables and reports

1. Meeting and a framework note at the start of the study.
2. Intermediate report analyzing the needs, particularly in terms of specialized care, and the stakeholders involved, using a template proposed by La Chaine de L’Espoir (Excel-based analysis tool), in English.
3. Feedback meeting with regards to this analysis.

Final report analysing needs, particularly in terms of specialized care, the stakeholders involved, following a template proposed by La Chaine de L’Espoir (Excel-based analysis tool), in English.

1. Draft project proposal for submission to institutional donors, in particular ECHO, in a template proposed by La Chaine de L’Espoir (Word document), in English.
2. Feedback meeting on the draft report.
3. Final project proposal that can be submitted to institutional donors, in particular ECHO, in a template proposed by La Chaine de L’Espoir (word document), in English.
4. Debriefing meeting.

EXPERIENCE

A duo composed of an international consultant with experience of Afghanistan/health sector/institutional donors, in particular ECHO, and a local consultant with a good knowledge of the health sector in Afghanistan.

Skills and Abilities :

• Valued experience in humanitarian and development project management in the health sector
• Experience in needs assessment and health program design
• Knowledge of institutional donors
• Ideally, good knowledge of Afghanistan
• Ability to work in English
• Sensitivity to gender issues

CONDITIONS

• Beginning of the study: as soon as possible.
• Study Duration: 2 months.
• Consultants are asked to include a detailed budget proposal, including VAT, in their bids.
• This budget includes fees, per diems (in France and Afghanistan, including international travel days), visa and health expenses, communication costs, and travel (international, in the field and in France).
• Field trips to Kabul to meet partners may be made using project vehicles, on demand if these vehicles are available.
• Contingencies may be included in this budget (a maximum of 5% of direct costs, with supporting documents, may be used with the agreement of La Chaine de L’Espoir).