TERMS OF REFERENCE
A consultant for technical assistance on basic mental healthcare for HIV care providers
1. CONTEXT
The Partnership for Health Advancement in Vietnam (HAIVN), a collaboration between Harvard Medical School (HMS), Beth Israel Deaconess Medical Center (BIDMC), and Brigham and Women’s Hospital (BWH), seeks to develop capacity for high quality medical education, medical research and healthcare quality in Vietnam. HAIVN/BIDMC has been working to improve the health systems in Vietnam since 2003.
HAIVN/BIDMC, through a cooperative agreement with the US Centers of Disease Control and Prevention, provides technical assistance to the Vietnam National HIV program. HAIVN/BIDMC collaborates with the Vietnam Authority for HIV/AIDS Control (VAAC) and provincial Departments of Health to build capacity in HIV care and treatment, improve the quality of care provided to people living with HIV, scale up antiretroviral therapy, and reach the goal of 90-90-90.
Globally, people living with HIV (PLHIV) experience high rates of mental health disorders. Depression, anxiety, and other mental health conditions lower quality of life and increase risk for negative health outcomes. In Vietnam, there is increasing evidence that unaddressed mental health conditions are significant barriers to HIV care for PLHIV and key population (KP) groups (i.e., men-who-have-sex-with-men, people who inject drugs, transgender people, commercial sex workers). In the 2022 PLHIV Stigma Index study, implemented by HAIVN/BIDMC and the Vietnam Network of PLHIV (VNP+), 18% of study participants reported receiving a mental health diagnosis in the past year and more than one quarter had symptoms consistent with depression or anxiety in the two weeks prior to the study interview. However, despite this high prevalence, access to mental health services for PLHIV and key populations (KP) in Vietnam is limited. COP/ROP23 guidance underlines health equity and the transformative partnership with national and local mental health plans and programs to continue the integration of psychosocial support interventions as well as specialized mental health or addiction services for KPs and PLHIV.
The VAAC has taken initial steps towards addressing this important gap in care for PLHIV and KPs. As part of broader efforts to design person-centered HIV care, efforts are underway to integrate mental health services within HIV prevention and care models. The latest Vietnam National HIV Guidelines recommended that basic mental health screening be performed using validated screening tools (e.g., PHQ4) at the HIV clinics for all PLHIV. Patients with concern for moderate to serious mental health symptoms are to be referred to specialist; those with mild symptoms may be counseled by their HIV providers. However, many health workers are not competent in mental health screening, counseling, and referral. HAIVN/BIDMC is responsible for providing training, mentoring, and technical assistance to public health and clinical providers to improve the quality of care provided to PLHIV, including mental healthcare. HAIVN/BIDMC has already conducted a needs assessment and developed a training package.
2. OBJECTIVE
The goal of this work is to improve the mental health knowledge, skills, and attitudes of HIV health providers and, indirectly, to improve the health and well-being of PLHIV and KPs in Vietnam. The consultant will assist HAIVN/BIDMC technical experts in the provision of training, mentoring, case consultation, and technical assistance activities. The consultant will be expected to train HAIVN/BIDMC staff and to support/join HAIVN/BIDMC staff in providing technical support to HIV providers and clinics in 3-4 target provinces.
- Location: This position will be based in Hanoi or HCMC with potential travel to the following provinces (Hanoi/HCMC, Thai Nguyen, Binh Duong).
3. SCOPE OF WORK, DELIVERABLES AND TIMEFRAME
3.1. Specific tasks:
- Review existing health worker needs assessment, screening tools and algorithm, training curricula, national HIV guidelines, national mental health guidelines, and existing models for mental health delivery at HIV sites (e.g., one stop shop model).
- Provide 1 training to HAIVN/BIDMC staff on the basics of mental health, including epidemiology in Vietnam, common syndromes, diagnosis, treatment, and Vietnam laws and policies; with a particular focus on mental health needs of PLHIV and KPs.
- Develop a practical tool or checklist to guide TA activities and to guide education on mental health and health equity when providing TA.
- Provide training on mental health screening, counseling, and referral for HIV providers in target provinces (may be online or on-site).
- Provide on-site and/or on-line mentoring and TA to approximately 15-20 HIV care sites in 3 target provinces.
All documents and training materials will be developed in both English and Vietnamese and will be reviewed and approved by HAIVN/BIDMC.
3.2. Expected outputs:
- One 2-day training for HAIVN/BIDMC staff
- One practical tool checklist to guide TA activities and educational messages
- 4 one-day trainings on MH for HIV providers in 3 target provinces (including input to agenda and training materials).
- TA visits to approximately 15-20 HIV care sites in 3 provinces.
- Detailed report on outcomes of training/TA activities and recommendations
3.3. Timeframe:
The consultancy activities must be completed before the end of September 2023. A detailed workplan will be developed together with HAIVN/BIDMC at the start of the consultancy.
3.4. Specific conditions:
The consultant will report to the HAIVN/BIDMC HSS Lead.
The consultant will be expected to complete the work independently without HAIVN/BIDMC resources. All equipment, software, and communications needs must be met by the consultant to complete the project deliverables. Logistics for travel to provinces (e.g., hotel, airfare, ground transport) will be arranged by HAIVN/BIDMC through existing vendors.
3.5. Compensation
The expected compensation is between 100USD to 300USD per day, depending on experience, for a maximum of 30 working days following the table below.
Activity | Expected output | Days |
Review existing health worker needs assessment, screening tools and algorithm, training curricula, and national HIV guidelines. |
Understanding of current situation and policies |
1 |
Update, add, supplement to existing training materials |
Training materials developed for subsequent trainings |
2 |
Provide training to HAIVN/BIDMC staff | One 2-day internal training | 2 |
Develop a practical tool or checklist to guide TA activities. | TA tool developed for use | 1 |
Develop agenda, review/adapt training materials and provide training on mental health screening, counseling, and referral for HIV providers in target provinces. |
4 one-day trainings on MH for HIV providers in 3 target provinces |
10 |
Provide mentoring and TA to approximately 15-20 HIV care sites in 3 target provinces. |
15-20 sites with at least one half-day visit |
13 |
Detailed report on outcomes of training/TA activities and recommendations |
Final report with recommendations |
1 |
Total | 30 |
4. QUALIFICATION AND EXPERIENCE REQUIREMENTS
- PhD in Psychology
- Experience in working with PLHIV and/or key populations.
- Have knowledge and understanding of Vietnam’s health system.
- Experience in providing training, mentoring, and health worker capacity building.
- Experience in working with Vietnam government and public health agencies.
- Excellent command of written and spoken Vietnamese and English.
- Excellent interpersonal skills and ability to work well in multicultural teams and partners.
- Able to generate creative, practical approaches to overcome challenging situations.
5. APPLICATION
Interested candidates are invited to submit a CV, cover letter, relevant references, and a brief proposal to Ms. Dam Thuy Huong at thuyhuong@haivn.org no later than May 5, 2023.
Shortlisted candidates will be contacted to participate in the selection process. The selected consultant is expected to start work immediately.
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