Consultant - Expertise France

INTRODUCTION

•  NGO BACKGROUND

SIDC is a Lebanese Nonprofit civil society organization established in 1987 and officially registered 9/AD in
1992. SIDC meaningfully engages vulnerable populations, to promote their health and wellbeing pertaining
to HIV, Harm reduction, SRHR, and mental health, to support them in enjoying their human and gender rights,
and to work towards an inclusive society free of stigma and discrimination at the national and regional level.
SIDC ensures that vulnerable populations enjoy their health and human rights and fulfill their potentials in a
society free of stigma and discrimination.

• PROGRAM BACKGROUND

While 91% of people living with HIV (PLHIV) know their status, only 63% are on ARTs, and only 58% have an
undetectable viral load. These figures show that progress in treatment access is insufficient and reflect the
distance still to be covered to reach the UNAIDS 90-90-90 targets. Despite the decentralization efforts of the
National AIDS Program in Lebanon (NAP), most HIV testing, care and treatment services are still concentrated
in the capital and major cities, where most health facilities and CSOs serving VPS are located. This results in
significant travel costs for VPs, and therefore health care costs that are difficult to bear given their social and
economic precariousness. This poor geographical and financial accessibility of services is a first obstacle for
PLs living in certain regions such as South Lebanon and the Bekaa regions, which outreach actions can help
to alleviate.

Socio-cultural norms are another barrier to HIV testing and care and access to sexual and reproductive
health. In a patriarchal society where gender inequalities remain strong, women are not able to negotiate
safe sexual practices and the use of family planning, which generates harmful coping mechanisms (early
marriage, survival sex, etc.). They are also frequently victims of violence from their spouses and partners. In
these conditions, it is crucial to provide them with a safe environment that respects their rights, by training
and equipping health professionals in Lebanese health centers and CSOs.

In addition to these structural constraints, the security and health situation has worsened in recent years. In
recent years, the massive influx of refugees, widespread civil unrest coupled with the restrictions imposed,
and the resulting political and economic instability have already weakened the ability of households to
generate income and severely limited access to services, including health services. The Beirut Port explosion
in August 2020 and the COVID-19 pandemic, which has hit the country hard, have exacerbated this situation
by overwhelming Lebanon's health system, further limiting access to services and medicines for PLs, and
leading to HIV de-prioritization. It is therefore imperative to address the psychosocial support and mental
health care needs of PLHIV.

Through this project, SIDC intends to strengthen and expand the range of its services to VPs residing in Beirut,
South Lebanon and the Bekaa region, but also to contribute to building the skills of health professionals to
improve the accessibility of existing services, and to advocate for the recognition of PLs' rights by the
Lebanese health authorities and society.

 PURPOSE

To increase access to HIV services and promote decentralization of care for key populations all over Lebanon.
The specific objectives: SIDC will recruit a consultant to undertake service mapping for HIV services and to
develop referral guidelines as follows:

• To map health and HIV services for key populations all over Lebanon.
• To develop a referral guideline on health and HIV services for Key Populations all over Lebanon.

 RESPONSIBILITIES

The consultant's first primary responsibility is to map the existing services provided in Lebanon for key
populations (prevention, care, and treatment), with a focus on medical services, case management, legal,
and mental health services. This task includes:

• Consulting existing NGOs, government institutions, KPs, etc.
• Hold a meeting with SIDC and partners to discuss the purpose and objectives of the mission.
• Discuss the expectations from the consultancy from all partners and the support they can provide.
• Undertake a literature review.
• Develop methodology (quantitative, qualitative) and tools (in-depth interviews, focus groups,
questionnaire) in close collaboration with SIDC and partners.
• Follow on the implementation of the study methodology (train partners on data collection tools and
guidelines to implement them)
• Data collection and analysis
• Presenting the assessment findings in a comprehensive written report and organizing a validation
consultation with SIDC and partners. The results should also be presented during the final event of
the project.
The second primary responsibility is to develop health and HIV services referral guideline for the KPs based
on the service mapping and tailored to the needs identified of the KPs and resources available in Lebanon.