1. CONTEXT

Handicap International is running its projects under the new name of Humanity & Inclusion (HI).Outraged by the injustice faced by people with disabilities and by vulnerable populations, we aspire to a world of solidarity and inclusion, enriched by our differences, where everyone can live in dignity. HI is an international, independent and impartial non-profit organization that intervenes in situations of poverty and exclusion, conflict and disaster. Working alongside people with disabilities and vulnerable populations, HI takes action and takes notice, to meet their basic needs, improve their living conditions and promote respect for their dignity and fundamental rights.

HI in Occupied Palestinian Territory (OPT)

Since 1996, HI has implemented various actions with local partners in the West Bank and the Gaza Strip. In a territory beset by chronic crises, political instability, and a declining economic and social situation since the second intifada in 2000, HI aims to respond to the needs of persons with disabilities and to make structural improvements to their lives.

Great Return of March (GRM) crisis

Since 30th of March 2018, Gaza nationals protested at the border fence of the Gaza Strip to commemorate their return right and Palestinian day of earth. Based on a World Health Organization (WHO) situation report, a cumulative trauma analysis (since 30th March 2018 until 30th April 2019) shows the following breakdown:

- Deaths: From 30 March until 31 December 2018, 279 people have been killed.

- Injuries: The total figure of people injured stands at 28,778.

- Trauma Stabilization Points (TSPs): Out of 28,778 people injured, 14,556 were treated at the TSPs and immediately discharged. This has reduced the burden of casualties arriving at the hospitals by an average of 50%.

- Hospital caseload: The remaining 17,021 casualties were stabilized and transferred for treatment at the emergency departments (ED) of MoH and NGOs hospitals. Of them, 3,467 were children.

- Live ammunition gunshot injuries: Out of a total of 14,072 referred to emergency departments (ED) at hospitals, 7,013 cases were live ammunition gunshot injuries. This is 41% of the total casualties arriving at the hospitals. Out of the (7,013) gunshot injuries, 6,138 are limb gunshot injuries (88%).

- Permanent disability:

o Amputations: As a result of the conflict, 129 amputations have taken place since the start of the mass demonstrations. This includes 31 children and one female. Out of this total, 110 were lower limb amputations and 18 upper limb amputations.

o Paralysis: 22 patients are currently paralyzed due to spinal cord injuries.

1. Project Background

The mass demonstrations along Israel’s perimeter fence since 30 March 2018, as part of the “Great March of Return” have resulted into a significant number of Palestinian casualties in the Gaza Strip. As such Humanity & Inclusion through its project, entitled “Address the emergency and post-emergency rehabilitation gaps for the most vulnerable women, men, girls and boys with injuries and disabilities in the Gaza Strip”. The project was launched by a grant from CDC-France to implement an emergency intervention of six months (5 months for outreach) towards the casualties and persons with injuries. HI succeeded to secure another fund from Humanitarian fund HF (9 months for outreach activities) to enable HI and partners to carry on the activities and scale up the teams and target. HI as well is approached by Global Affairs Canada to be able to deploy centre-based teams and maximize the provision of assistive devices and increase wound dressing capability. Recently HI signed a grant agreement with HF to maintain homebased program functioning beyond 2019 to continue delivering rehabilitation and post-operative care to persons with injuries and persons with disabilities. The project seeks to enhance the trauma pathway, by specifically responding to the urgent care and rehabilitation needs of children and adults with injuries- many of them having been discharged prematurely from hospitals due to the lack of care capacity - so that they can recover and where possible prevent the onset of disabilities due to their injuries. The project focused on rehabilitation and post-operative service provision to bridge the gap and continue delivering services to the injured persons to improve their conditions and enhance their capability to perform daily life activities; in order to reach community participation.

1. Project Summary:

Project: Address the emergency and post-emergency rehabilitation gaps for the most vulnerable women, men, girls and boys with injuries and disabilities in the Gaza Strip.

Global Project lifetime: 15th May 2018 – 15th May 2020 (24 months).

Duration funded by Humanitarian Fund (HF): 16th May 2019 – 15th May 2020 (12 months).

Overall Goal: Address basic healthcare and rehabilitation needs of the most vulnerable persons with injuries and persons with disabilities in emergency and post-emergency situations.

1. Project Services:

This project is supporting the service provision of multidisciplinary rehabilitation and psychosocial support to persons with injuries and persons with disabilities. The project supports the following:

• Identification and assessment of persons with injuries & disabilities’ needs,
• Physiotherapy sessions,
• Occupational therapy sessions,
• Wound dressing sessions,
• Psychological support sessions,
• Provision of assistive devices,
• Provision of wound dressing materials and nurses’ disposables,
• Exchange over referrals with relevant actors to respond adequately to persons with injuries holistic needs,
• Provision of technical support, guidance and supervision to project partners and stakeholders

1. Project Partners:

This project is implementing partnerships with national rehabilitation organizations as follows:

1. Palestine Avenir Childhood Foundation (PACF); located in Gaza City and has 2 branches, a non-profit registered organization works to provide specialized caring services to persons with cerebral Palsy. Programs: rehabilitation, vocational training, and special education.

Programs: Community Based Rehabilitation (CBR) Services for PwDs; awareness raising programs for families of PWD, Rehabilitation services for children with disabilities.

1. El-Amal Rehabilitation Society (ERS); located in Rafah governorate and has 2 branches, a non-profit registered organization works to provide specialized caring services to persons with disabilities with focus on with hearing impairment; aiming to maintain the continuity of the basic services provided to meet the needs of the target groups, and ensure their effective participation in local community. Programs: ERS Specialized school, Early intervention program, Hearing Audiology and Speech Therapy clinic, ERS Education Centre for adult, SANABEL Child Development Club and physical rehabilitation program.

2. DSA DESCRIPTION & OBJECTIVE

Resource Person: Within the framework of the service provision, the service provider will be asked to collaborate with Hl’s teams and in particular with the Project Manager who will be the point of contact.

1. Beneficiary/Beneficiaries:

• Premium targeted populations will be persons with disabilities & persons with injuries and persons with disabilities due to GRM, and
• Second group of beneficiaries will be their caregivers and family members.

1. Overall and specific goals:

Overall Goal: Address basic healthcare and rehabilitation needs of the most vulnerable persons with injuries and persons with disabilities in emergency and post-emergency situations.

Specific Objective: Identify the main needs, gaps and opportunities in the continuum of rehabilitation care (including MHPSS) at each stage:  identification, acute rehabilitation, adjustment process, functional recovery within their living environment, inclusion and advocacy, in response to traumatized persons.

1. Anticipated results and indicators to facilitate acceptance and validation of final outcomes:

This assessment focuses on one sector of intervention (rehabilitation) in order to have in-depth very detailed information that enables provision of quality and appropriate service provision. HI seeks to explore how to change its (and partners) response. Besides, ability to analyse how the response of the needs of persons with disabilities (not related to GRM) have changed before and after intervention.

• Effectiveness of collaboration and referral mechanism throughout the pathway of the care of the patient in complementing the work and matching the needs for GRM casualties using data available on the outcome measures through:
• Describing progress of MHPSS recovery of patients
• Giving an overview of the functional status’ recovery and progression of the beneficiaries seen by the project
• Providing a perspective on how the provision of Assistive products in the project has an effect on the mobility and independence of the patients
• Commenting the relevance and effect of wound care component in the project activities
• Accounting the Caregiver support and its patterns in the follow-up of the patients

• Estimate the Capacity of health actors’ preparedness plans to respond to the needs of persons with injuries and mitigation mechanism to improve the response in any future expected crisis through:
• Commenting on the inflow of patients referred by the actors
• Providing an overview of the type of patients sent by the main actors
• Giving an overview of the back and forth referral capacity of the main actors
• Assessing the potential gaps to address in case of missing referral and injured not seen by health actors, needing rehabilitation
• Flow and availability of Assistive products for preparedness by local Health actors

• Provide concrete figures and statistics to help HI (and partners) to develop strategic responses able to address the challenge of comprehensive rehabilitation (Rehab, MHPSS, wound care, Assistive devices provision, and referrals) during crises by exploring:
• Short Overview of response care provided by main actors to referred victims after TSP assessment
• Inquiry / alternative information insight on victims that had no referral services after TSP assessment and their potential needs
• Listing and identifying potential gaps to address access to comprehensive services for persons injured that had no follow-up after TSP assessment

• Support and advise the service providers/actors to develop prevention mechanism of acute and complication effects of crises by:
• Using figures and statistics collected with HI partners to asses preventive measures for gaps trap
• Presenting HI’s preparedness plan and establishment mechanism as an example for avoiding negative effects for response to future crises
• Inquiring to extend the service providers network (within clusters and existing working groups) in exchanging lessons learned about crises response   

• Analyse and provide discussion on the percentage and types of disability amongst persons with injuries and anticipate long term needs (after crises) for affected group with permanent disabilities in society by:
• Scan database of patients and activities to estimate number of persons injured having permanent impairment issues
• Dress profiles of care for comprehensive approach (widely accepted by HI) for each group of permanent disability cohort
• Compare basic long-term needs for each cohort with service availability in Gaza context
• Outline and select a few immediate actions to kick start reflexion on long term needs

3. DSA METHODOLOGIES AND STEPS

HI values the contributions of service providers towards proposing appropriate, innovative, and robust methods of assessment.

• The methodology should combine quantitative and qualitative data collection techniques and analysis.
• The proposed methodology should also describe how cross-cutting issues of gender, age and disabilities will be addressed and incorporated throughout the various stages of the assessment.
• The methodology should underwrite the process of checking that an inclusive approach towards activities with the beneficiaries and his environment has been met

The proposed methodology will be a criterion for evaluating candidatures. Here below are suggestions (service provider invites to develop more and/or rely on his experience and vision):

1. Design of the tools and teams training:

The assessment must be a participative and interactive process, and all tools developed should pass through HI for exchanging comments and review. If the tools (data collection) need to be implemented by partners’ teams, then a training session should be planned and delivered.

1. Methods of collecting the information:

Several methods need to be implemented for information collection: Semi-directed interviews, Focus groups, individuals’ interviews/ questionnaires, Visits of clinics/hospitals/service providers, and Direct observation etc.

1. Steps:

• Preparatory phase (briefing with stakeholders, document review, appreciation-review of the assessment feasibility), sampling, preparation of data collection tools, logistic arrangements.
• Produce inception report and submit to HI for revision and validation.
• Field work - data collection.
• Data analysis and presentation of preliminary findings (meeting with stakeholders to present analysis, conclusions and recommendation and debating).
• Report drafting phase and finalizing the report.

1. Information treatment, analyze and reporting:

HI will provide all facilitation to the service provider as much as possible and make necessary appointments for meetings with partners, teams, beneficiaries and other respondents. The service provider will start with a meeting with HI project team and project partners.

1. Team:

Clear responsibilities among service provider team members reflect capacity for each individual profile, and the workload segregated in a harmony way.

4. DSA REPORT

By end of the assignment, the service provider should include the following in English in word electronic format:

1. Inception report. It must be approved prior to the commencement of any field work or any other substantive work.
2. Methodological framework for DSA including all tools produced. It must be approved prior to the commencement of any field work or any other substantive work.
3. Full transcripts of all in-depth interviews and focus group discussions in an electronic format.
4. DSA report (Max. 35 pages plus annexes; font: Arial 11) that include the following main sections:

• Table of contents,
• Abbreviations list,
• Executive summary (that can be used as a stand-alone document),
• Brief on general context of Gaza focusing on PwIs/PwDs health services and rights,
• Introduction that include the objectives of the DSA, methodologies and techniques used and limitations of the assessment, where relevant.
• Presentation of the DSA analysis and findings, covering the expected results.
• Lessons learnt.
• Conclusions and recommendations with a clear relationship between them.
• Report annexes that include: The Terms of Reference of the assessment; the techniques used for data collection; the program adhered to; the list of people met; list of document and bibliography and composition service provider team.

5. SERVICE DURATION & LOCATION

1. Assignment Duration:

The service provider is expected to complete the DSA process and submit the report during two months starting from 01st July 2019 until 30th September 2019. Therefore, the submission date is 25th of September 2019, any delay should subject to financial measurements unless it was communicated and agreed before with HI including reasonable justifications for any extension to the submission deadline.

1. Assignment Location:

The requested DSA must cover the five governorates of the whole Strip; where the service provider is expected to move and work within. The service provider will be accompanied by an assistant staff from HI, supporting him/her during the whole exercises, benefitting from the provider’s know how in this type of exercise.

جميع الحقوق محفوظة لموقع جوبس.

6. SERVICE PROVIDER PROFILE

The service provider (team) should enjoy the following competencies:

• At least a degree in the fields of Social Sciences, Statistics, Research Methodologies, Development Studies and any other related fields
• Strong experience in rehabilitation or public health field,
• Strong experience in disability field,
• Knowledge and experience in research and participatory methodologies and approaches
• Knowledge and experience in working with affected populations
• Knowledge of community mobilization and development and coordination spirit,
• Experience in data analysis, presentation methods and report writing
• Respect for timelines, in case of late in submission the report.

7. ETHICS & CONSENT

It is essential that the process of data collection, as well as storage of data, is supported by careful ethical practice, including informed consent, anonymity and confidentiality, no-harm and protection of data and data storage. Informed consent needs to include awareness of the evaluation data collection process and that the DSA report may be published and publicly disseminated. Extra precaution must be taken in involving project beneficiaries considering the sensitivity of the thematic issues tackled by this project. To protect the anonymity of communities, partners and stakeholders’ names or identifying features of participants (such as community position or role) will not be made public.

The service provider should engage in respecting the following ethical principles:

• Child protection principles,
• Integrity (respect of gender sensitivity issues, especially when performing interviews/focus groups, religion and beliefs),
• Anonymity and confidentiality,
• Independence and objectivity,
• Veracity of information.

8. TECHNICAL & FINANCIAL OFFER

1. Technical Offer: A document including the followings (but not limited to):

• Methodological approach,
• Work schedule. It must clearly specify the manner in which the service provider will approach the activities required to perform the service. The schedule must indicate the progress and/or the standard of service performance, including the criteria and/or indicators to check that the service provision is proceeding smoothly.
• Service provider (Team) CV(s).
• Similar of previous work implemented,
• Three references (at least one for international organization),
• Other related information.

1. Financial Offer:

Cost of service provision in ILS currency, including ancillary expenses (transportation, communication, taxes, insurance, printing, etc).