ToR - Implementation of a Training of Trainers - ToT programme aimed at strengthening the capacities of 40 health workers in the area of mental health and psychosocial support.

1. TITLE OF THE ACTION

Implementation of a Training of Trainers - ToT programme aimed at strengthening the capacities of 40

health workers in the area of mental health and psychosocial support.

2. INTRODUCTION

INTERSOS presents the Terms of Reference for the realisation of a Training of Trainers programme, in the

framework of the project HOPE (Health, Opportunities, Protection, Education) - Promoting safe and

dignified access to essential health, education, and protection services for Ukrainian refugees and

vulnerable host community members in the Republic of Moldova, funded by the Italian Agency for

Development Cooperation - AICS, through the initiative AID 012832/01/0.

The project is implemented by INTERSOS in consortium with Terre Des Hommes Lausanne, and in

cooperation with the local partner Fundatia Don Bosco, in different areas of the Republic of Moldova.

Through this project, assistance is provided to Ukrainian refugees and vulnerable members of the host

community through Education, Health and Protection activities.

Since the start of the conflict in Ukraine in February 2022, Moldova has experienced a significant influx of

Ukrainian refugees. In 2014, the country initiated a comprehensive reform of the National Mental Health

Programme, implemented with the support of the Swiss Agency for Development and Cooperation,

through the Moldova Reform Project, led by the MENSANA Consortium. This reform promoted

collaboration between the health and social sectors and the revision of the regulatory framework. The

reform process resulted in the development of a social policy led by the national government and local

authorities. The main goal of this reform is to empower people facing mental health challenges to achieve

their recovery goals, live in their local communities and combat mental health-related stigma.

However, despite the fact that there are currently 40 Community Mental Health Centres (CMHCs)

operating in the country, there is a lack of awareness on the part of both the Ukrainian refugee population

and the host community regarding the presence of these facilities and the types of services offered, and

more generally a reluctance to request assistance, due to the stigma associated with psychosocial care

services, as reported by the WHO (2023). For this reason, through the integration of psychosocial health

protection and support (MHPSS) into health programmes and aid activities, INTERSOS offers

comprehensive assistance addressing both the physical and psychosocial needs of the affected population.

This proposal is therefore part of this approach, and is aimed at strengthening the national system and

capacities to respond to these needs.

3. OBJECTIVES OF THE ACTION

General objective

To strengthen the relationship between primary care and mental health services available nation-wide,

improving access to mental health treatment for the population in need.

Specific objectives

• To facilitate an integrated management of priority mental health conditions and diagnoses by

health care professionals.

• Provide healthcare professionals with the necessary skills and knowledge to recognise, manage and

refer individuals in need of mental health support and to disseminate this knowledge in further

trainings.

4. UTILITY OF THE ACTION

At national level, a process has been initiated to support the cases of patients in need of psychosocial

support; through this action INTERSOS aims to support this process, strengthen the exisitng system and

reduce the stigma associated with psychosocial support services. The Training of Trainers (ToT) programme,

aimed at professionals working within the national health system, aims to facilitate referrals between

primary care centres, specialised centres and centres dedicated to the treatment of MHPSS-related

conditions and pathologies. In addition, the ToT programme, followed by a further dissemination phase,

aims to maximise the effectiveness of the efforts made by enabling specialists to train other involved and

interested professionals.

5. EXPECTED PRODUCTS

(To be delivered in compliance with the deadlines set below in the "PLAN OF PAYMENT AND DEADLINES" table)

A. Adaptation of the curriculum for the mhGAP Training of Trainers to the needs of the context and

the aims of the action.

B. A detailed workplan and agenda of activities and sessions.

C. Materials for the delivery of the ToT (2 sessions) to 40 participants selected nationally from among

health workers in the National Health System, and a follow-up session.

D. Pre- and post-tests to measure the level of improvement in the participants' knowledge of the

discipline.

E. Activity reports after each training session and a final technical report at the end of the training and

follow-up activities.

6. WORKING PLAN

The mhGAP training sessions will be delivered by certified experts in the field to professionals from the

Moldovan National Health System. The sessions will take place between September 2024 and January

2025, with 20 participants per session, for a total of 40 participants. INTERSOS will facilitate the logistical

organisation of the sessions and the selection of participants for the training. The sessions will be preceded

by a preparatory phase in order to define and approve the materials and methods of administration. A test

will be given at the beginning and at the end of each session to assess the participants' comprehension and

understanding of the subject matter. Each session will last approximately 18 hours in total and will cover

General Principles of Care (GPC) and common mental health conditions, while the follow-up session will

focus on practical skills and workshops. At the end of both training sessions, the selected experts will

present a technical report on the progress of the activities and the results achieved.

Detailed activities:

• The trainer(s) will develop the material for the training programme and will deliver the training in

Romanian (preferably the material will also be developed and presented in English).

• The trainer(s) will deliver the mhGAP ToT training in two (2) separate sessions, for 20 participants

each. The total duration of each session will be 18 hours. At the end of each session the trainer(s)

will submit an activity report to INTERSOS.

• During each training day the trainer(s) will collect attendance lists signed by each participant and

evaluate the improvement of the participants' knowledge by using a pre- and post-test.

• Following the two in-person sessions the trainer(s) will conduct a follow-up session with the 40

participants.

• At the end of the training, the trainer(s) will issue a certificate of attendance for each participant

and will submit a final technical report to INTERSOS.

• INTERSOS will be responsible for the logistical organisation of the events, including the selection of

venues and participants.

7. CANDIDATE PROFILE

A. Academic background in Medicine or Psychology

B. Certification as mhGAP Trainer of Trainers

C. Previous demonstrated experience in the administration of similar or related training courses

D. Fluent knowledge of the Romanian language, good command of English

Applications submitted by individual trainers or by a consortium of trainers will be evaluated. In the latter

case, it is required to indicate a reference person among the consortium of candidate trainers.

8. SUBMISSION OF THE APPLICATION

The application must be submitted in electronic version no later than 06/09/2024 at 17:00, to the following email addresses (all of these must be copied in the email):

• health.manager.moldova@intersos.org (Umberto Manganiello)
• medco.moldova@intersos.org (Vanessa Gomez)
• logoff1.moldova@intersos.org (Alina Breazu)

List of mandatory documents to submit attached to the application is detailed as follows:

1. Submission of the Curriculum Vitae (CV) of the candidate(s), indicating previous experience as a

trainer in similar or comparable disciplines

2. Copy of registration documents (license, certification or firm registration)

3. Submission of an economic offer expressed in Moldovan Leu (MDL) and including VAT

4. Submission of a technical offer including a presentation of the methodology applied and a

proposed workplan

Any application submitted after the indicated deadline and/or not accompanied by the elements listed

above, will be considered ineligible and rejected.

9. PLAN OF PAYMENT AND DEADLINES

The amount of payment for the service will be contractually agreed between the selected applicants and

INTERSOS through a signature of a service contract, taking into account the compliant technical-economic

offers received and selected and the allocation of funds available for the activity.

Payment will be made by bank transfer, according to the following schedule:

*payment of the tranches is made following submission by the trainer(s) and approval by INTERSOS.