UNICEF IRAN

TERMS OF REFERENCE:

Assessment of Predisposing Protective and Risk factors in ATS Use

Submitted by:Najin Yasrebi, HIV/AIDS officer

Adolescents and HIV/AIDS Programme

IR 2.1.6: ATS Work Plan

1-Background and Context

The Islamic Republic of Iran has a population of approximately 75 million people, amongst which, 27.5% are young people between the ages of 10- 24[1]. Presently, Iran is having the second highest consumption rates of illegal narcotics.As reflected in the UNODC World drug report 2011 and stated in official statistics,over two percent of the adult population in Iran is being affected by some types of drug abuse or addiction. In recent decades, in addition to opium and regularheroin additional forms of illicit drugs are offered in the Iranian illegal market.

Evidence shows that the consumption of "crystal", which is a white powdered in crystalline form of heroin, crack a derivative of concentrated heroin and amphetamine-type stimulants (ATS) have rapidly increased[2]. The substance called shisheh (crystal meth)which is widely used in Iranis an instance of ATS.Furthermore, Drug Control Headquarter 2008 Rapid Situation Assessment on Drug Use in Iran indicates that out of a total number of 590,000 who sought treatment for their drug use problem almost 19% were below the age 24. Apart from problematic drug related dependency, which requires treatment, unprotected sexual behaviors of drug users are common and often lead to other health risks and problems such as STIs, HIV and AIDSwhich are additional burden to the health system.

Recognizing the tremendous needs and challenges and heightened vulnerability of young people with regards to ATS use, UNICEF and Iran’s Government country programme plan of action (2012-2016) is committed to ensure that the capacity of the government to promote healthy life styles and promotion of resilience-based drug abuse prevention among adolescent and youth (boys and girls), with a specific focus on social health and prevention of traffic accidents is enhanced. As such in their 2012-2014 work plan, UNICEF and Ministry of Health (MOH) Bureau of Psychosocial Health and Addiction have agreed to jointly invest in the area of prevention of ATS use among adolescents and young people.

2-Justification

“Risk and protection” theory is a dominant theoretical framework in understanding and addressing social problems such as drug abuse. Based on this theory the onset of psychological symptoms is determined by the interaction between “risk factors” which expose an individual to the development of a disorder and “protective factors” which safeguard individuals against disorders. A situation assessment is conducted to collect data on the distribution of risks and protective factors at the community level. This approach helps local planners identify geographic areas with the highest levels of risk and the lowest levels of protective resources. This analysis tool can also assist planners in selecting the most effective prevention interventions to address the specific risks of neighborhoods and subpopulations.

Given the fact that ATS is relatively a new phenomenon in Iran, MOH is keen to understand better the scope of and interaction between environmentalrisk factors that make young people vulnerable to ATS and those conditions, skills or events (protective factors) that on the contrary decrease the likelihood of ATS use or increase the probability of resilience. Improved understanding of trajectory of risks and protective factors among the contemporary Iranian youth will enable national policy makers and MOH experts to develop programmes aimed at empowerment of young people. It is expected that this results in not only the reduction of drug use but also HIV infections[3].

UNICEF in its 2012-2014 work plan has committed to provide technical support for enhancing MOH knowledge on assessment of associating predisposing protective and risk factors in ATS use. The Consultant recruited under this TOR will ensure materialization of this capacity building effort. The gained knowledge by the Iranian MOH will translate into a national survey and situation assessment that MOH will conduct on its own. The Consultant will only provide technical input to the assessment plan that will be developed by MOH experts after the workshop. Once the situation assessment is conducted at national level and the findings are analyzed and consolidated, as per UNICEF and MOH work plan a roadmap will be developed which highlights key ATS prevention strategies and service delivery point of care. The Consultant role at this point will be to review the roadmap and to give technical comment on the roadmap.

This technical assistance will be in form of an individual international consultancy with the following details.

3-Purpose and Objective

-Toconduct and facilitate a 3 day workshop for health professionals on assessments/tools/methodologies on ATS use problem among young people.

-To provide feedback to the 1) national situation assessment plan as well as the 2) response roadmap developed by MOH partners after the workshop is completed and the national implementing core team is established by the government partner.

4-Strategies and Approaches

Over the years, researchers have developed many tools to assess the extent of a community’s drug problem. Most of these tools assess the nature of the problem. Some of them assess the extent of abuse. Others assess factors associated with abuse. Researchers have also developed instruments that assess individual risk status and potential protective factors as well as methodologies to evaluate the process of capacity building for or outcomes of successful adaptation in the face of challenging or threatening circumstances .

The Consultant is expected to undertake athorough desk review on drug problem especially the ATS problem in Iran. He/she should also familiarize himself/herself with the PHC system in Iran in order to be able to put together the best quality, interactive and state-of the art training content and materials that present some of the main concepts, experiences and examples above. The Consultant should adopt a flexible approach in order to tailor-make the training content to local needs and project objectives. As such the key strategies/methodologies to be adopted for this work would be:

  • Literature review of evidence in the relevant field;
  • Analysis and triangulation of data/information;
  • Flexibility and participatory approaches.

5-Activities and Tasks

The consultancy will have three phases:

  • Phase one, preparations for training: In this phase the Consultant will agree with UNICEF and its Government partner on the overall aspects of the training phase such as the agenda, the number and key objectives of each sessions, thelesson plans for the 3 days, an outline for each session and the methodology for conveying the topics. These need to be agreed mutually in advance based on audience level of knowledge/experience on the topic and project objectives; all other necessary training procedures will have to be endorsed at this phaseby UNICEF and MOH.
  • Phase two, facilitating the workshop: Creating an interactive learning environment, the Consultant will apply a participatory training methodology in introducing concepts as well as leading the discussions and facilitating group works during the 3 days of training in Iran (the exact location of trainingwill be determined).
  • Phase three, feedback to the national situation assessment plan: Upon completion of the MOH plan for the situation assessment, the consultant will review thedocumentand provide feedback to UNICEF and MOH.
  • Phase four, feedback to the roadmap of service provision: Upon completion of the draft roadmap for ATS prevention and service provision points of carethe consultant will review thedocument and provide feedback to UNICEF and MOH.

6-Outputs and Deliverables

Four outputs are envisaged for this Consultancy:

  1. Workshop plan (20%): Includingall details stipulated in phase one of section 5.
  2. Workshop report (50%): The report includesa summary of workshop proceedings, key highlights of group work discussions and conclusionsduring all three days, summary results of participants’ evaluation from the training event.
  3. Feedback to national assessment plan (15%): Consultant’s professional view in format of comments and recommendations to be provided to MOH’s plan on ATS situation assessment;
  4. Feedback to national draft prevention roadmap (15%): Consultant’s professional view in format of comment and recommendations to be provided to MOH’s draft roadmap on ATS prevention;

Consultant needs to ensure that all exact views and concerns communicated with the consultant by MOH are incorporated fully in the final versions of outputs and deliverables prior to final submission to UNICEF.

7-Management, Organization and Timeframe

The Consultant will work under the direct supervision of the HIV/AIDS Officer (NajinYasrebi)and the Deputy RepresentativeAnna Riatti (as the second supervisor).

This agreement is valid for a period of 12months starting fromthe date of signature of the relevant contract.The tentative timeframe for the deliverables is as follows:

Outputs / Due on / Expected Results
One(6 days) / Latest one month after signature of contract / Workshop plan is developed and endorsed by UNICEF and its partner.
Two(6 days) / Latest 3 weeks after completion of training / Training report is finalized and approved by UNICEF and its partner.
Three(3 days) / Latest 3 weeks after receipt of MOH assessment plan / Feedback is provided to MOH’s situation assessment plan.
Four (3 days) / Latest 3 weeks after receipt of MOH draft roadmap / Feedback is provided to MOH’s draft roadmap

8-Qualifications and Specialized Knowledge

PhD or Master’s degree in mental health and disorders, psychology or other relevant fields;

Pastdemonstrated experience inthe field of drug abuse research and field surveys.

Excellent facilitation/communication skills;

Experienced with interactive and participatory methodologies;

Flexible and excellent English writing skills;

Familiarity with UN system is an asset.

9-Conditions of Work

The consultant will work from his/her country for phases one, three and four and in Iran during phase two. He/she will be provided office space if required during his/her stay in Tehran. However he/she should have his/her own laptop.

Travel expenses will be covered by UNICEF as per the rules and regulations. Travel arrangements should be coordinated with UNICEF Iran.

10-Title Rights

UNICEF shall be entitled to all property rights, including but not limited to patents, copyrights and trademarks, with regard to material which bears a direct relation to, or is made in consequence of, the services provided to the Organization by the consultant. At the request of UNICEF, the consultant shall assist in securing such property rights and transferring them to the Organization in compliance with the requirements of the applicable law.

[1]Iran Census, 2012

[2]UNODC Iran, UNDAF Area V: Drug Control & Prevention, Narrative Report and Joint Work Plan 2012

[3]In an interview with Fars News Agency in September 2012 the Minister of Health had warned the that the increasing trend of crystal meth use by young people if not stopped will flame a new wave of HIV infection among young people.