Consultancy for Clinical Management of Rape (CMR) Training for Health Service Providers Consultancy

BACKGROUND AND RATIONALE

Trócaire has been supporting communities in South Kordofan State primarily through a localization and partnership model, working alongside local non-governmental organizations, community structures, and local technical secretariats (such as the Secretariat of Health, Secretariat of Agriculture, and the Sudan Relief and Rehabilitation Agency – SRRA). Trócaire through local partners and in coordination with the Secretariat of Health, deliver comprehensive health-specific interventions across a network of 17 facilities including Primary Health Care Centres (PHCC), Primary Health Care Units (PHCU)as malaria, acute respiratory infections, pneumonia, and acute watery diarrhoea, supported by continuous essential medicine supplies and established referral pathways. The program also offers nutrition services at both outreach and facility levels, targeting children under five years of age and pregnant and lactating women (PLW).

A protection scoping exercise and partner level protection risk-analysis conducted by Trócaire found that specialized GBV case management and clinical response services for survivors of GBV are extremely limited in South Kordofan. Only one facility was identified providing Post-Exposure Prophylaxis (PEP) and dedicated clinical GBV care. Staff at other clinics lack training on survivor centred clinical care for GBV survivors. Additionally, most health clinics lacked segregated inpatient wards and latrines for men, women, and children, with patients of all genders admitted into single shared rooms. Confidential examination spaces for women including GBV survivors are largely missing.

Trócaire aims to support the Secretariat of Health (SoH) to improve the technical competence of clinical service providers in clinical care for survivors to promote quality clinical care for GBV survivors in South Kordofan in line with the GBV Minimum Standards, WHO clinical and policy guidelines for Responding to intimate partner violence and sexual violence against women (2013) and the national CMR protocols. Trocaire also aims to support facilities to meet the WHO minimum requirements for providing quality clinical care for survivors of rape and intimate partner violence (IPV). Trocaire’s support and funding does not include abortion services.

To address these needs, Trócaire is seeking a qualified, certified CMR Consultant/Facilitator to design, adapt, and deliver a comprehensive CMR Training and Coaching program for frontline health workers. This consultancy is expected to provide quality training covering the following key issues:

• First Line Support: first-line clinical support for gender-based violence (GBV) survivors focusing on empathetic, survivor-centered care using the LIVES framework.
• Clinical Support: In-depth, skills on physical examination procedures, administration of Sudan-specific CMR drug regimens and proper completion of standardized CMR medical/history intake forms.
• Adaptations for specific groups: Specific protocols for obtaining informed consent/assent and adapting communication approaches (modifications) when providing survivor-centered care to survivors living with disabilities (PwDs), child and adolescent survivors.
• Medico-Legal Pressures: Navigating complex local dynamics such as the traditional and cultural system with medical confidentiality, survivor safety, and healthcare worker protection against backlash and practices that aren’t survivor centered.
• Operational Constraints: Overcoming challenges associated with low resource setting and ensuring that training curricula, role-plays, and job aids are culturally and linguistically adapted for the South Kordofan context for maximum retention.
• Developing GBV protocols for healthcare facilities including informed consent, GBV information management, referral procedures etc. Only a few facilities will be positioned to provide CMR services , the workshop convenes different cadres and provides an opportunity to collaboratively develop GBV protocols.

The in-person training is expected to be undertaken in the last two weeks in October South Kordofan with curriculum and content preparations done in the first two weeks of October.

2. OBJECTIVES OF THE CONSULTANCY

2.1 Overall Objective

To enhance the technical and clinical competence of healthcare providers in Trócaire-supported health facilities in South Kordofan ensuring that high-quality, survivor-centered, ethical, and confidential CMR services are provided in full compliance with the Sudan National CMR Protocol and WHO standards.

2.2 Specific Objectives

1. Attitudes, Ethics and Guiding Principles: Sensitize healthcare workers to reflect on personal values, biases, and myths surrounding sexual violence, ensuring adherence to survivor-centered guiding principles (safety, confidentiality, respect, non-discrimination, informed consent).
2. Clinical and Physical Examination: Train clinicians on systematic, trauma-informed clinical history taking, physical examination procedures and detailed informed consent procedures for different aspects of clinical care. Clinical care is anticipated to be led by female midwives with doctors and clinical officer involvement in clinically complex cases.
3. Medical Treatment Regimens: Strengthen practical skills in prescribing and administering timely treatment regimen including informed consent for all parts of treatments including voluntary counselling and testing for HIV.
4. Psychosocial First Aid and Communication: Build core skills in first-line psychological support (LIVES / basic PSS), active listening, and adapted survivor-centered interviewing methods for marginalized groups, particularly Persons with Disabilities (PwDs).
5. Documentation and Medico-Legal Handling: Train providers on accurate completion of relevant standardized medical intake/history forms, managing pressures from external parties (family, community, police) while upholding survivor confidentiality and health worker safety.
6. Referrals and Follow-up: Guide staff on establish clear clinical follow-up schedules (at 2 weeks, 4 weeks, 3 months, and 6 months) and multi-sectoral referral pathways (safe shelter, legal aid, protection, and mental health services).
7. GBV protocols development: Facilitate collaboratory sessions with staff to develop relevant GBV protocols.

3. SCOPE OF WORK AND KEY TASKS

The consultant will work under the direct supervision of the Trócaire Health and Nutrition Programme Coordinator, in close collaboration with the Protection/GBV Coordinator and Medical Officers. The key tasks include:

1. Inception & Materials Adaptation:
   • Review existing training packages (WHO CMR Guidelines, Sudan National CMR Protocol 2015.
   • Develop a comprehensive, practical training curriculum, facilitator guides, participant handbooks, pre/post-test assessment tools, and evaluation forms.
   • Adapt training slides, case studies, role-play scenarios, and clinical forms into Sudan to ensure effective participant comprehension.
2. Training Delivery:
   • Conduct a 4-to-5-day intensive, interactive training workshop in South Kordofan (or designated training hub) for clinical staff (Medical Officers, Clinical Officers, Midwives, Hospital Matrons, and Nurses), with targeted orientation for Nutrition/Protection focal points.
   • Employ participatory and adult-learning methodologies (plenary presentations, simulated clinical demonstrations, anatomical models, role-plays, case scenario analysis, small group work, and gallery walks).
3. Support staff in developing practical, context-specific GBV protocols aligned with applicable standards and organizational requirements.

• Facilitate collaborative sessions with relevant staff to identify key gaps in health facilities in relation to GBV response and operational needs in the context.
• Discuss and document key procedures and protocols required for responding to all GBV survivors and CMR service provision protocols.

1. Practical Mentorship and Action Planning:
   • Supervise practical simulation of first line support, medical history intake including consent protocols for all aspects of CMR
   • Facilitate the development of county-specific facility roll-out/action plans and Continuing Medical Education (CME) cascade plans for each hospital and health centre.
2. Reporting and Follow-up Framework:
   • Administer pre-test and post-test assessments, analyzing learning gains and knowledge retention.
   • Submit a detailed Final Training Consultancy Report incorporating participant feedback, pre/post-test analysis, challenges encountered, facility-specific action plans, and strategic recommendations for sustained supervision.

4. KEY DELIVERABLES

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Deliverables

1

Inception Report & Adapted Training Package: Detailed training methodology, agenda, adapted for South Kordofan, training modules, role-plays, and pre/post-test questionnaires following inception meeting with consultant.

2

Training Execution: Delivery of the 5-day interactive CMR training workshop for target health workers in South Kordofan.

3

GBV protocols developed: context-specific set of GBV protocols developed through participatory and collaborative sessions with relevant staff and stakeholders. The protocols will define clear procedures for responding to survivors in GBV, confidentiality, referral pathways including within health facilities and survivor-centred support and will incorporate feedback from health staff engagement sessions.

3

Draft Training Report and Action Plans: Comprehensive draft report including pre/post-test analysis, participant evaluation, and facility-level CME cascade plans.

4

Final Training and Consultancy Report: Finalized report incorporating Trócaire feedback, actionable recommendations for clinical mentorship, and copies of distributed materials.

5. DURATION OF THE CONSULTANCY

The total duration of the consultancy will be 13 working days, distributed as follows:

• Inception phase planning and Preparation, Desk Review, and Content Adaptation: 4 days
• Training Delivery & Workshop Facilitation: 5 days
• In person mentoring in the field location: 3 days
• Reporting & Action Plan Finalization: 1 day

Note: Travelling to and from training location will approximately take (4 –5 days).

6. TARGET AUDIENCE / PARTICIPANTS

Approximately 10 to 15 participants across Trócaire-supported health facilities in South Kordofan:

• Doctors / Clinical Officers
• Hospital Matrons and Head Midwives
• Qualified Midwives

Tagged as: South Sudan, Trócaire