UNICEF UKRAINE
TERMS OF REFERENCE
Consultancy for Development of Concept for Early Intervention Services
Duration: 3 months
1. Purpose of Special Service Agreement:
Ukraine has traditionally applied a medical approach to addressing disability issues, where extensive focus has been on “curing” the child with disabilities rather than enabling the environment for the child and his/her family. Children with disabilities are often isolated and have limited access to community services and opportunities within the community. For children with more serious disabilities, education options are either home schooling, which is of a lower education quality, or attendance in specialised residential institutions for education, separating these children from their parents and sometimes de facto severing their family connections. There are only limited social services for parents who have children with disabilities, and often medical professionals still advise parents with children having more severe disabilities to place them at birth into institutional care. In 2010, Ukraine had 165,121 children registered with disabilities[1] and more than 40,000 children with disabilities living in institutions[2].
Development interventions at early ages are important for all children but critical for children at risk of having disabilities or with disabilities. In Ukraine, early intervention (EI) services have been evolving in different regions with leaders in oblasts such as Kharkiv and Lviv. In Kharkiv, the Ukrainian NGO, Institute for Early Intervention has worked over 10 years to provide early intervention services for children and their families and has successfully integrated the early intervention approach with government partners such as children’s medical facilities (polyclinics). The Institute is currently planning to disseminate this service approach to a pre-school facility and social rehabilitation centre. Other regions such as Dnipropetrovsk, Simferopol, and Odessa have also been developing different formats of early intervention responses.
The Institute of Early Intervention has also influenced colleagues from the Kharkiv Oblast baby home for children with disabilities (0-4 years), which has initiated a transfer to day services. Over the last 15 years, the baby home has transferred from a residential home with capacity of 100 beds to an early intervention day care for 60 children and capacity for 20 children to stay in residential care. However, this residential care is largely outreach to families from the Oblast where early intervention services are not available; families stay with their children for 1 month periods where they work with specialists to learn how to better care for their children’s special needs. The baby home is planning to transfer to become a resource centre where it will provide residential counselling support for families on early intervention services, reaching families from the Oblast where local specialised services are not available.
These initiatives are now at a stage where there needs to be a move from a pilot-project level to a more macro-level approach, requiring more systematic analysis and planning. Furthermore, political momentum has been developing with the President calling for early intervention initiatives and noting Kharkiv as a progressive model. Colleagues from the Ministry of Health also express interest in transforming baby homes, where early intervention services within communities could also be one type of response to enable young children to remain effectively within their families.
In November 2012, UNICEF conducted a conference in Kharkiv that took stock of early intervention services in Ukraine. While it showed that important innovations have been taken, it also revealed that there is not a clear agreement or understanding about the early intervention services. Specifically, the conference identified the need to:
· advance greater common understanding about early intervention approaches among service providers and policy-makers;
· clarify the multidisciplinary role of specialists in early intervention services, and the role of parents/ family/ caregivers;
· define the level of effectiveness of early intervention services and statistical data that validates this service approach.
UNICEF sees the need to develop a concept on the early intervention approach, providing examples of good practices of the service among other countries and assessing the status of the service within Ukraine. This concept will provide the information for UNICEF to work more effectively with policy-makers to advance the early intervention service, defining better what the service should look like and how it can be developed further in Ukraine. This analysis will provide evidence about the impact of the service. In addition, knowledge from this analysis will also be used by UNICEF to develop communications materials that promotes a common understanding about the service among service providers (specialists).
2. Objective:
The objective of this special service agreement is to develop a concept on early intervention that clearly defines the “standard” for early intervention services; highlights good international practices of the services; maps and assesses existing practices in Ukraine; and establishes recommendations for an action plan to advance the early intervention service.
This concept will inform UNICEF’s work in policy development and establishment of clear messaging about early intervention services for advocacy purposes.
Specifically, the concept (strategy) should comprise:
· Explanation of the early intervention service: description of early intervention goals and target groups (range of ages of children, types of disabilities included if not all), defining what specialists at a minimum are required for the service and how they should function (providing a specific description of the “flow of services” – i.e. how a client is referred, types of services and coordination among services); explanation of “exit plan” and where older children should receive further services; definition what EI is and what are its benefits for child development; present the key principles of EI; outline of EI services – types and way of functioning; underline the role of professionals and families in the process of EI.
· Summary of international best practices of early intervention services (including, CIS countries and the EU): evidence of the service’s effectiveness and impact, and legislative and inter-agency protocols that regulate the service.
· Overview of current early intervention service practices in Ukraine, supported by statistical data received by UNICEF from the Ministries and other authorities and from specific service providers in Ukraine; at least 3 case study examples of Ukrainian child/children who received early intervention services and stayed in the family in contrast to child/children who did not receive the service and leave in an institution.
In description of both the international and Ukrainian practices, analysis should include comparison of the practices to the definition of early intervention service, highlighting examples of the “flow of services” and nuances that may exist. Provision of examples of how the services are conducted in rural versus urban settings is also required.
3. Scope of Work:
(1) Finalisation of Work Plan for establishment of early intervention concept developed with consultation from UNICEF colleagues on proposed activities and timeframe.
In response to the terms of reference, the consultant should provide a brief description of how the work will be conducted: proposed countries for the desk review, Ukrainian regions to be reviewed, methodology used in the analysis for the Ukrainian review (i.e. whether field trips are required), and timeframe envisioned for this work. In the first week of the consultancy, the consultant is expected to finalise this plan with UNICEF colleagues.
Developing components of the Early Intervention Concept:
(2) Review of international standards/ guidelines to derive a commonly agreed upon definition of the early intervention service.
A 2-3 page synopsis should be developed explaining: what is the service, objective(s) of the service; target groups and age group for the service; as well as what at a minimum is required to provide an early intervention service.
(3) Desk review of 3-4 European countries and/or any other non-European country that have good early intervention practices.
In the analysis of these countries, a 10 page synopsis should be developed containing:
· Short description of how the service is provided: which specialists are involved, how they interact among themselves in providing services – providing the “flow of services”; role of parents/family in provision of the service; description of “exit” plan for early intervention services and where/ how older children are referred/supported in addressing further development/disability needs.
· Brief description of the legislative/regulatory basis for provision of early intervention service (if possible, identifying challenges that arose in the process).
· Impact of the service for children/families, including the international evidence in general: what are the changes (results) that service provides; differences in result between early intervention services and “alternative” services (effectiveness); what is the cost of the service compared to alternative services (efficiency); why was the service developed to replace more “medical”/ traditional approaches.
(4) Desk review/survey of existing practices of early intervention in Ukraine.
Review should comprise a detailed analysis of the early intervention services in Kharkiv, and Lviv, but should also consider developing practices such as in Dnipropetrovsk, Kyiv, Simferopol, Odesa, and Sevastopol. Within the submission, the consultant should propose criteria that could be used for choosing regions’ practices for review. Based on proposal, the exact regions for review will be confirmed in consultation with UNICEF and peer review.
Analysis of regional experiences should be at a maximum of 3-4 pages per region. The synopsis should provide:
· Short description of how the service is provided:
- group of children served (ages, types of disabilities);
- how children are referred to services and who provides and pays for services (state, NGO, private payment, etc.);
- which specialists are involved, how they interact among themselves in providing services, “flow of services”, how these specialists have acquired the expertise;
- role of parents/family in provision of the service;
- highlighting if there are any nuances in the way the service has been developed (i.e. from an education, medical or social basis, including inter-sectoral cooperation between different service providers);
- comparative analysis of provision of service versus “common” practice described in the good practices of other countries (section 3)
· Brief description of the legislative/ regulatory basis for provision of early intervention service
· Innovations and challenges of the service:
- How has the service evolved—are their specific nuances about the service (e.g. focus on particular sector)
- Does the service focus on a particular sub-group of young children with disabilities/ special needs (e.g. specialised baby home focuses on children with more severe disabilities)
- What have been the challenges in providing the service, considering other parameters as access, equity and quality? Have there been solutions in addressing these challenges?
· Results (effects) of the service for children/ families:
- what are the results that service provides;
- differences in results between early intervention services and “alternative” services (effectiveness).
(5) Recommendations for Actions Needed to Enhance Early Intervention Service in Ukraine
Based on analysis of best international practices and review of Ukrainian experiences, recommendations should be provided to advance the early intervention service in Ukraine. (maximum 3-4 pages)
4. Deliverables:
Guided by the UNICEF Ukraine Country Office, the Consultant will complete the following key deliverables under the contract with a tentative timeframe. Below is an estimated amount for the consultancy days. If the applicant feels that a different timeframe is required for completion of the work, the proposed consultancy should be stated, with reasoning for the difference.
Deliverables / Timeframe(consultancy days)
Work Plan for Development of Early Intervention Concept
Agreed with UNICEF colleagues on: countries for good practices; Ukrainian regions to be included, identified experts for peer review and timeframe set for deliverable deadlines / 2
Components within Early Intervention Concept
10-12 Page Analysis & Report of:
Definition of Early Intervention Service
Good Practices of 3-4 European countries and/or non-European countries / 10
20-25 Page Analysis & Report of Regions’ Practices in Ukraine / 30
(including time for field trips if needed)
3-4 Page Recommendations for Actions to Advance Early Intervention Service in Ukraine / 3
The presentation of findings and recommendations should be delivered at the round table to be organized by UNICEF
All materials developed will be reviewed by the programme communications consultant and a team of peer review experts. The consultant will fine-tune materials based on feedback from these colleagues.
5. Performance indicators for evaluation of results:
Evaluation of results will be based on the following indicators:
§ Technical and professional competence (will be measured by quality of reports provided to UNICEF, as well as feedback from peer review);
§ Quality of work, including quality of progress and final reports to UNICEF, and quality of developed recommendations;
§ Quantity of work, including quantitative indicators of the project.
Such indicators as work relations, responsibility and communication will be also considered during evaluation of the contractor’s work.
6. Qualifications/specialized knowledge/experience required to complete the task:
An expert to be selected for this Consultancy should meet the following requirements:
§ Proven record of work in early intervention services.
§ Understanding of international standards and good practices regarding early intervention services, understanding of such service practices in Ukraine an advantage.
§ Understanding about early intervention practices (disability responses) within post-Soviet system.
§ Excellent interpersonal skills and ability to work in a team.
§ Ability to express clearly and concisely, ideas and concepts in written and oral form.
§ Strong conceptual and analytical thinking skills and good writing skills.
§ Fluency in English. Command of Ukrainian and/or Russian would be an asset.
7. Definition of supervision arrangements:
Supervision will be provided by the Social Services Officer and Child Protection Specialist in cooperation with the ECD Officer of the UNICEF Office in Ukraine.
8. Description of official travel involved:
The assignment might require travels within Ukraine.
Prior to undertaking any travel, the consultant should complete UN Basic and Advanced Security in the Field Training Courses (linages to these courses will be provided by UNICEF Ukraine).
All travel costs of the consultant should be planned and included in the consultant’s contract. The consultant is responsible for managing all travel plans, though UNICEF can provide some minimal administrative support for travel plans.