TERMS OF REFERENCE
National Consultancy for the development of the HIV/AIDS Case
Management Guide for Injecting Drug Users
A. Overall program background
The National AIDS Programme 2010-2015 implemented under
the Global Fund Round 8 Grant will scale-up comprehensive care and support for
PLWH by building on and expanding existing programs and services, and
introducing innovative approaches that are consistent with UNAIDS centered
models of care and support. The program will expand intensive psychosocial and
adherence support for 8,000 PLHA through deployment of grants to NGOs of the
National League of PLWH and through supporting ART Teams to cover
geographically the 4 regions of the country, with the aim to bring the services
closer to the final beneficiaries. The program will make use and increase the
capacity of 18 Multidisciplinary Teams functioning under the auspices of the
Ministry of Social Protection, Family and Child who can provide regular,
community-based services for PLWH and children, as well as identification of
people living with and affected by HIV/AIDS for social protection services,
contributing towards the goal of universal access and 100% coverage with social
services.
The program will provide PLWH and IDUs with an enhanced case management system
through the establishment of a Department to be responsible for proper
planning and interaction between the National AIDS Centre who is responsible
for testing, ART Treatment Section placed within the Dermatovenerological
Dispensary, M&E Unit, and the Ministry of Health and Ministry of Social
Protection, Family and Child who are responsible for ensuring the adherence of
PLWH to their regimen, one through the clinical part, the other through social
protection and care.
Activities of the project to be implemented by NGOs for identification of IDUs and
referral to OST have been planned to ensure higher rates of enrolment and thus
improving the success rate of Round VI proposal. This is essential given the
proposal’s focus on active IDUs, who typically require more support to remain
adherent to OST, with the aim to reduce high drop out rates that are currently
attested. The program will also sustain and enhance community centers to
provide social services to PLWH, a joint initiative by the local public authorities
and NGOs to complement the current gap in the social services system, to be
established in each of the 4 regions of Moldova and to be further supported by
the local public authorities by the end of program. In addition to care and
support services provided onsite, these centers will also serve as key vehicles for
the delivery of other components of the overall care and support package,
including counseling, self-help groups and job training.
The program will develop standards and train service providers to provide
palliative care for terminally-ill who require chronic home care or
end-of-life care. A Palliative Care section will be refurbished and further
sustained by the state
Goals: To reduced morbidity, mortality and HIV-related impact on people living
with HIV/AIDS. It is based on the achievement of 3 objectives:
1) to improve performance of GFATM, Round VI
2) to improve quality of life of PLWH and IDUs
3) to strengthen the National League of PLWH
B. Specific background
Improve the quality of life of PLWHA is the major aim of HIV care and support
and a comprehensive case management that will link PLWHA with appropriate
services is imperative for reaching this goal.
Most people living with HIV/AIDS have complex needs that exceed those caused
by medical or health conditions, they are likely to require additional assistance
with emotional, financial, legal, and social problems throughout different stages
of their HIV disease progression. Case management is widely used to facilitate
access to care and support services and should become the cornerstone of
HIV/AIDS programs that seek to address a wide array of medical, socioeconomic
and psychosocial factors that affect the functioning and well being of HIV infected people and
their families.
The separation between medical and social support systems characteristic for
our country present significant barriers to care for PLWHA and IDUs and to poor
retentions rates among ARV patients. Medical and social efforts should be
integrated in order to avoid service duplication, inefficiency and client confusion
and increase overall effectiveness of today's health and social care systems in
meeting AIDS patients' needs.
C. Objective of the assignment
The main purpose of the assignment is to develop a practical HIV/AIDS case
management guide that shall serve as a reference material for professionals in
view of contributing to a better understanding of the case management and
hence increasing of quality of services provided to PLWHA and IDUs.
Summary
The consultancy team shall develop a practical comprehensive HIV/AIDS case
management guide that will assist providers of case management services in
understanding their case management responsibilities and those of their
counterparts. The guide should be based on the principle of multidisciplinary
team as one of the most effective approach to case management and should be
tailored and organized in response to the country unique local, organizational
and client factors.
The guide shall cover clear definition of case management and description of
case management service model before and after the start of ART, case
management processes, roles and responsibilities of case managers, modality of
medical and social efforts integration from the perspective of varied levels of
client needs, client readiness for case management services, and country
available resources.
D. Specific responsibilities
Specifically the consultancy team should:
 identify the optimal case management approach based on country
existing services and available resources, establish clear services
integration, coordination and collaboration principles;
 define the target group that will use the HIV/AIDS case management
guide and the levels at which it will be used;
 delineate clearly between the case management services before and after
the enrollment in ARV treatment;
 describe the core processes of case management (intake, assessment of
needs, service planning, service plan implementation, service
coordination, monitoring and follow-up, reassessment, case conferencing,
crisis intervention, case closure, etc.);
 describe the core case management activities (assisting client to access
and maintain specific services, consultation with providers, navigation
through the service system, psycho-social support, supportive counseling,
etc.);
 specify the course of actions at each stage depending on client needs (as
algorithms);
 specify the responsibilities of medical and social case management and
the modality of medical and social case management efforts’ integration,
coordination and collaboration;
 present and discuss the concept and final draft with the CCM TWG on
treatment and care for PLWHA and CCM TWG on Social Assistance.
E. Deliverables
The final product of the consultancy will be the guide on HIV/AIDS case
management.
The consultant team will report to the UNAIDS. The guide should be
submitted in electronic version – 1,5 months after commencement of the
assignment. The final guide must be presented for approval in Romanian. Any
draft document produced by the consultancy team will be discussed and cleared
with the UNAIDS before final presentation.
The consultancy team will be managed by the UNAIDS and periodic
presentation and discussion of the product will be made to the CCM TWG on
treatment and care of PLWHA and the CCM TWG on Social Assistance through a
process agreed at beginning of the consultancy.
F. UNAIDS’s contribution
UNAIDS in connection with Ministry of Health, Ministry of Labor, Social
Protection and Family, UNAIDS, WHO and other partners will facilitate access to
any available information, in relation to the assignment that may be needed by
the Consultancy Team.
The consultancy team is expected to carry out all its work in close collaboration
with the UNAIDS.
G. Consultants profile and qualification
In order to accomplish the described responsibilities, UNAIDS needs to
contract a consultancy team comprised of two experts from medical and social
disciplines with a combination of the following qualifications:
 Advanced degree in related discipline, i.e. medicine, public health, health
management, social assistance, etc.;
 Professional background in Medicine/Social field with experience in
HIV/AIDS;
 In dept knowledge of services existent in the field of HIV/AIDS (medical,
social, supportive, etc)
 Demonstrated experience in HIV/AIDS sector for at least two years,
experience in clinical or social case management will be an asset;
 Proficiency in Romanian, English and Russian;
 Solid analytical skills.
H. Duration of service and terms of payment
1. The consultancy assignment will require up to 20 consultant’s days to be
distributed between consultancy team members, over a period of 1,5 months
from the start of contract.
2. The consultants hired by the Project for the elaboration of the HIV/AIDS
case management guide will closely work in team under the guidance of a team
leader appointed by UNAIDS.
100% of the Contract - upon presentation of the Guide and other subproducts (technical notes,
memos, plans, presentations and other documents) that may be required by the UNAIDS,
according to the TOR, following the receipt and approval of the Guide by the UNAIDS.