Consultant – Social Protection and HIV

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The United Nations World Food Programme is the world's largest humanitarian agency fighting hunger worldwide. The mission of WFP is to help the world achieve Zero Hunger in our lifetimes. Every day, WFP works worldwide to ensure that no child goes to bed hungry and that the poorest and most vulnerable, particularly women and children, can access the nutritious food they need.

BACKGROUND AND PURPOSE OF THE ASSIGNMENT:

In Latin America and the Caribbean region, and in Haiti in particular whose HIV pandemic is generalized to the general population with a prevalence of 1.8 amongst adults aged 15-49 and women are more affected than men: 2.3% against 1.6% (Ministry of Health, 2021 National AIDS Estimates), HIV continues to be a serious health problem. HIV affects a significant proportion of the general population and is simultaneously greatly affecting and being driven by key populations, such as men who have sex with men (among whom prevalence is the highest nationally, at 12.9%), sex workers (8.7%), the LGBTIQ+ community and the prison population. In addition, priority populations such as young women and adolescent girls, women, internally displaced people, and migrants, an increasing percentage of the Haitian population, are exposed to a higher risk of HIV infection. Seventy-five percent of HIV cases are found among the 25-54 age groups, with a strong representation of the 15-34 age groups, with women significantly more affected than men. The ensemble of these populations faces higher risks due to persisting stigma and discrimination and vicious gender norms that continue to characterize Haitian society and that inevitably lead to gender-based violence.

Structural factors that increase most vulnerable groups’ vulnerability to HIV include poverty, gender inequality, gender-based violence, HIV-related stigma and discrimination, HIV-specific criminal legislation, and social barriers to treatment such as out-of-pocket health fees. Limited access to education and employment opportunities for young people, especially adolescent girls and young women (AGYW) is also a structural factor. Another among these factors relates to the deficit in human resources for the provision of general healthcare as well as treatment and care for those infected and affected by HIV and AIDS. Food and nutrition insecurity represents another important underlying factor, with the World Food Programme [1]highlighting that: [Food and nutrition insecurity] compounds HIV risks and vulnerabilities by undermining adherence to HIV and TB treatment and retention in care, whilst exacerbating the socio-economic impact of the virus, reducing work capacity and productivity, and endangering household livelihoods. At the individual level, adequate dietary intake and macro and micronutrient absorption are crucial for effective treatment outcomes because HIV/ AIDS weakens the immune system, impairing nutrient intake and absorption, augmenting vulnerability to undernutrition, and increasing morbidity and mortality.

The different functions of social protection alone and in combination contribute to advancing the AIDS response by supporting the prevention of new HIV infections and reducing AIDS-related deaths as well as stigma and discrimination. Fully resourcing and sustaining efficient HIV responses and integrating them into systems for health, social protection, humanitarian settings, and pandemic responses is one of the Strategy’s key areas of focus for ending inequalities by reaching less than 10% of people living with HIV (PLHIV) experiencing stigma and discrimination; less than 10% of PLHIV, women and girls and key populations experiencing inequalities and gender-based violence, and less than 10% of countries have legal and policy environments that lead to the denial of limitation of access to services. Simultaneously and as a consequence of reaching this set of targets, 95% of people at risk of HIV infection will have access to combination prevention services; the 95-95-95 treatment cascade will be reached, seeing 95% in testing, treatment access and viral suppression for PLHIV; 90% of HIV-positive women having access to sexual and reproductive health services, and finally 95% of PLHIV obtaining preventive treatment against tuberculosis and will be referred to other integrated services[2].

. Social protection is widely conceptualized as having the overall aim of responding to and providing protection from issues of risk, vulnerability, and extreme poverty. In essence, it entails a set of all initiatives, both formal and informal, that provide social assistance to extremely poor individuals and households; social services to groups who need special care or would otherwise be denied access to basic services; social insurance to protect people against the risks and consequences of livelihood shocks; and social equity to protect people against social risks such as discrimination and abuse. To be considered HIV-sensitive, the design and implementation of social protection measures needs to target and include people living with, at risk of or affected by HIV, by deliberately considering and addressing the multi-dimensionality of HIV risk and vulnerability without discrimination. Social protection is recognized as an essential catalyst for an improved AIDS national response and plays a critical role in helping people overcome the structural inequalities that the HIV pandemic accentuates and feeds on and that pose barriers to treatment, access to testing, and beyond the health domain to schooling and other essential social services.

JUSTIFICATION

Given the lack of information that exists on specific social protection needs of people living with HIV in the Haitian context, the World Food Programme (WFP), ILO, UNAIDS and other partners seeks to conduct a qualitative study, thereby contributing to a knowledge body serving as a basis of support for future action and planning.

In support of information gathering, the UN Interagency Group on HIV and Social Protection has developed a scan HIV and social protection assessment tool that is used for a rapid review of existing social protection programs and their sensitivity (or lack thereof) to the HIV response in a given setting (country) (https://www.unaids.org/en/resources/documents/2017/HIV–social–protection–assessmenttool) which will be utilized as a part of key documentation for this consultancy.

PURPOSE

MAIN OBJECTIVE

Generate the evidence to facilitate the development of HIV-sensitive social protection programmes and schemes, including in response to the socio-economic effects of the COVID-19 pandemic in Haiti. The findings of this study will be used for the operationalization of the HIV/AIDS National Strategic Multisectoral Plan (PSNM 2018-2023) and beyond.

SPECIFIC OBJECTIVES

1. Exploring the level of sensitivity of current social protection programmes to HIV and barriers to access to HIV-sensitive social protection programmes.
2. Identifying entry points, opportunities, and instruments,s to integrate PLHIV into social protection programmes and interventions, considering the relevant institutional arrangements, capacity gaps, and coordination mechanisms.
3. Providing recommended actions to reform and/or improve HIV sensitive sHIV-sensitive programmes.
4. Identifying concrete recommended actions for ILO, WFP, and the UNAIDS Secretariat as w, government governments society.

ACCOUNTABILITIES/RESPONSIBILITIES:

• Develop a methodological proposal, inclusive of study design, selection and recruitment of participants, data collection and data analysis.
• Develop a work plan
• Plan, coordinate and implement the study according to the pre-approved workplan
• Identify and select, in coordination with the members of WFP, ILO, UNAIDS and the Haiti Joint Team on AIDS, the sources from which various data required can be extracted and check their validity
• Develop the data collection process
• Coordinate meetings and interviews with relevant institutions and/or heads of relevant national authorities and international multilateral and bilateral organizations
• Consult periodically with the WFP focal point for the implementation of the study at the national level to ensure that the scope and deadlines of the study are being met
• Support the coordination, planning, and implementation of validation meetings of preliminary study results
• Develop the draft of the first report and the final report and organize a workshop to present them to the institutions concerned such as WFP, the International Labour Organization (ILO), the Joint Team on AIDS, Government authorities, and representatives of the Health, Social Affairs & Work, other key sectors such as Civil Society and national and International NGOs.
• Other additional activities required to achieve stated objectives and expected results such as active participation in intersectoral meetings, Joint Team ad hoc meetings, or other as needed.

DELIVERABLES AT THE END OF THE CONTRACT:

• A document with a methodological proposal that adapts the recommendations of the HIV and social protection assessment tool to the Haitian context. Delivery: 2nd week from the start of the consultation
• A first interim report presents advances and methodological challenges encountered and introduces adjustments to the research process, as needed. Delivery: 8th week from the start of the consultation
• Final report on the analysis of social protection programmes and schemes in Haiti with a focus on the specific needs of people living with or affected by HIV, including migrant and displaces populations and refugees. This should include recommendations on how to make existing/ previously implemented programmes and schemes, that can be replicated/reactivated, accessible to people living with, at risk of, or affected by HIV as well as relevant recommendations for the construction of an advocacy plan. Delivery: 16th week from the start of the consultancy.
• National Technical validation report Workshop
• Development of advocacy tools such as summary, briefs and publication papers

PAYMENT SCHEDULE BASED ON PRODUCT DELIVERY

• The first payment of 20% will be made upon submission and validation of the methodological proposal
• The second payment will be made for 40% upon delivery and validation of the first draft of the report
• The third payment will be made for 40% upon satisfactory delivery and validation of the final report

SUPERVISION

The recruitment process will be through the World Food Program (WFP) office in Haiti. The supervision of the implementation of the consultant's activities will be ensured by WFP Haiti Office with the support of the regional WFP office in Panama.

All communications relating to the implementation of the study, the administrative and technical supervision and the delivery of the products must be sent to the specific focal points in WFP Haiti and WFP Panama’ that will be provided upon contract signature.

WFP LEADERSHIP FRAMEWORK: COMMON STANDARDS OF BEHAVIOUR:

QUALIFICATIONS & EXPERIENCE REQUIRED:

Deadline for applications: 8, March 2023

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