Country: LEBANON

Base: Beirut (Lebanon)

Status: Short-Term Consultancy (two months)

Starting Date: ASAP (01/12/2019 indicative)

BACKGROUND

Congenital malformations are responsible for the loss of 57.7 million disability-adjusted life years (DALYs) worldwide. Studies show that pediatric surgery is a cost-effective intervention that can prevent more than 67% of lost DALYs associated with congenital malformations, a number that highlights the fundamental role of surgery in healthcare. According to the World Bank, improving the accessibility and quality of pediatric surgical care can significantly reduce child mortality and permanent disability. However, in Lebanon, access to specialized healthcare is extremely limited for vulnerable populations, including refugees (estimated at 1.5 million people according to the Lebanese government): 75.8% report that access to specialist physicians is difficult, 74.6% that the cost of services is too high and 63.5% that they lack information (John Hopkins University, MdM 2015). Between 2% and 5% of children born in the Middle East have a congenital disease (WHO 2015) for Lebanon between 2,000 and 5,000 babies each year and a cumulative total of up to 72,000 children. Pediatric orthopedics is identified by key health actors in Lebanon as a public health priority for reasons of: (i) Prevalence: Orthopedic malformations would account for 26% of congenital malformations according to the national registry; the club feet concern about 1.19% of live births, congenital dislocation of the hip between 1.6 and 28.5%; ii) Barriers to access to care: congenital orthopedic malformations are generally ignored and not supported; (iii) Impact: access to care changes the lives of children and young adults with disabilities in terms of life expectancy and quality of life, human development, social inclusion, school and work, as well as their families and communities, especially women who are often in charge of care, thus impacting many SDGs.

Since late 2016, La Chaîne de l’Espoir has implemented a comprehensive paediatric orthopaedic surgery program in partnership with the Union of Relief and Development Associations (URDA) and the Sacré-Cœur Hospitals of Beirut and Shtoura in the Bekaa valley targeting vulnerable children living with orthopedic congenital anomalies. Now La Chaîne de l’Espoir intends to develop a new phase aiming at improving access for the most vulnerable children with congenital orthopedic malformations to prevention, detection (including at early stages), medico-surgical management and quality follow-up services in Lebanon. To this end, LCDE wishes to develop a new program with potential funding from Conseil Régional Ile-de-France followed with potential funding from Agence Française de Développement (AFD) aiming at strengthening the capacity of civil society organizations (CSOs) to achieve the following results: i) a network of health service providers is structured to improve the identification of children with congenital orthopedic malformations and their referencing, they can be diagnosed, receive medical and surgical treatment and be followed up post-operatively, including physical rehabilitation; ii) patients’ families actively contribute to supporting the care of children, organize themselves into self-help groups and act as interlocutors of the health services.

–          Internal and external coordination including in terms of local registration and security.

·         Map all relevant stakeholders for LCDE program and identify key implementing partners, involving them in the project design following a participatory approach

·         Develop and design LCDE project strategy and proposal including in terms of context, content, relevance and external coherence, risk assessment and sustainability. This also includes developing the logical framework, planning of activities and budget (potential donors: Conseil Régional Ile-de-France, Agence Française de Développement)

Human resource

• Design the organigram, main tasks and profiles of the different positions of the team required for the project
• Assess the availability of identified profiles in Lebanon
• Support LCDE field coordinator for Jordan and Lebanon based in Jordan in launching the recruitment of LCDE local team.

Internal coordination

• Ensure the handover to the incoming project manager (or other positons as per new team set-up as needed)

External coordination

·         Coordinate with national and local stakeholders in Lebanon (especially the Ministry of Public Health) and represent LCDE in-country

·         Be an active participant in humanitarian forums and relevant coordination meetings and thematic working groups.

Set up LCDE’s delegation in Lebanon

·         Launch and follow up on LCDE’s legal registration in Lebanon

·         Gather information on the applicable legal framework in Lebanon (taxes, import/export, labour legislation, etc.)

Security

·         Ensure a security monitoring and propose measures to prevent, adapt and react to security incidents

·         Propose updates to the Lebanon country specific Security Plan

·         Report security and safety incidents immediately.

Team relations

The Consultant:

·         Is under the direct supervision of Field Coordinator for Jordan and Lebanon based in Amman

·         Liaises with LCDE HQ technical referents any time required

·         Works closely with the local authorities, hospitals, the surgical teams, the key informants and any other relevant stakeholders