Development of a toolkit on counselling for healthy lifestyle in primary health care for the Pacific Island Countries and Territories

BACKGROUND

Cardiovascular diseases, cancer, diabetes, chronic respiratory diseases and mental health disorders are the leading causes of death in the Pacific Island Countries and Territories. They carry a huge cost that extends beyond health sector to undermine workforce productivity and economic prosperity. Noncommunicable Diseases (NCDs) and mental health have also become an issue of equity. They disproportionately affect low- and lower-middle-income countries, and in all countries the poorest and most vulnerable are the most at risk and the least likely to have access to treatment.

Progress towards universal health coverage will increase access to essential services to prevent, treat and manage NCDs. In addition, protecting people from the impact of humanitarian emergencies and ensuring the continuity of health services will benefit populations living with NCDs. Therefore, promoting health and preventing disease will require intensified action on the major risk factors in addition to tackling social and commercial determinants of risk factors, such as tobacco, alcohol, healthy food and physical activity.

Crucially, a 15% reduction in premature mortality could be achieved by implementing 16 WHO Best Buys interventions in low- and lower-middle income countries alone. This would already prevent heart attacks and strokes and save lives and generate in economic growth.

Providing effective national responses to address NCDs requires strong and well-coordinated multi-sectoral and multi-stakeholder collaboration and partnerships. Partnerships are also vital because resources for the prevention of NCDs and the promotion of well-being are limited in most national and institutional budgets.

The challenge that the countries and areas are facing is how to provide the latest guidance to improve adherence on healthy lifestyle from the community to population levels as part of global efforts to reduce NCDs and contribute to achieving the health targets set out in the Sustainable Development Goals and national health plans. Health promotion concepts and a reaching out beyond health sector includes actions by all sectors to promote, support, advocate, and provide services and safe opportunities for all people to conduct healthy lifestyles. That require integrating health promotion into primary and secondary health care services and strengthening the health systems capacity to respond to the needs of people.

The counselling policies have been identified as a cost-effective intervention and a recommended ‘Best Buys’ for NCD prevention and treatment. To respond to the needs of patients in the primary health care services counselling may support them for healthier choices and changes in lifestyle. The key policy actions include establishing the regular assessment of patients’ adherence to healthy lifestyle, building support for people with risk factors and provision of brief advice tailored to context and capacity.

PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY

Purpose of the ‘Counselling for healthy lifestyle in the primary health care for the Pacific Island Countries and Territories’

The main objective is to enable health service professionals to improve counselling skills and processes with patients in the primary health care services.

The output of this activity presents an approach to support behavioural changes in constructive, continuous and supportive way to enable patients to make lifestyle changes through behavioural changes. The toolkit will

• • Understand the behavioral changes needed to change to healthier lifestyle and the long-term processes making impacts in the short to longer term perspectives on patients
• • Identify common behavioral change processes and counselling skills, methods and follow ups for patients
• • Improve skills on counselling, screening and respectful counselling and learn how to measure success, follow up and change approaches in case of challenges
• • Develop skills to identify collaborating partners and cross-sector actions for lifestyle changes in the communities and provide information and encouragement for patient engagement
• • Envision preferred, possible and plausible future scenarios for healthy lifestyle changes in the communities and how to support and develop joint action plans that are adaptive and promote innovations around achieving the best-case scenario as an integrated health service approach.

Strengthening counselling for healthier choices and behaviours

The counselling toolkit is being developed as based on the technical resource packages for the implementation of regional and global frameworks and technical packages (SAFER, MPOWER, ACTIVE, SHAKE, REPLACE) to enhance counselling skills in primary health care services in the Pacific Island Countries and Territories. The counselling toolkit follows the content of the HEARTS Technical package for cardiovascular disease management in primary health care (Healthy lifestyle counselling) with further adaptation into the local context.

The counselling toolkit aims to provide practical guidance relevant to the Pacific Island Countries and Territories on the effective actions on individual level to increase physical activity, eat healthy meals, stop smoking, decrease use of alcohol and strengthening primary health care services in prevention of NCDs. Although all the recommended counselling actions are relevant to all countries and areas they will require adaptation at country level according to context and resources at the very local level communities and examples of activities, screening questions, conversations and prompting for actions. The fundamental principles of counselling include autonomy, beneficence, non-maleficence, justice, and fidelity.

This toolkit outlines how health care professionals should provide support to the patients, how to promote physical activity, how to prepare healthy meals, quit various types of tobacco use and Areca nuts and limit use of alcohol as a part of patient care in primary health care. It recommends effective and evidence-based techniques supporting patients’ behaviour changes and general adherence to advice given e.g. appointments, self-tests, foot inspection etc. The toolkit also encourages primary health care services to build networks, resources and activities to engage with communities to enhance physical activity, prepare healthy meals, quit various types of tobacco use and limit use of alcohol. The toolkit may provide outlines of the key supporting activities necessary to support patients to adhere advice given for healthy lifestyle changes.

Who is this toolkit for?

The primary focus is to support health workers effectively support changes for healthy lifestyle with the patients, scaling-up of services within primary health care services and the strengthening of the necessary links to community-based initiatives and activities.

As such, the toolkit is intended for use by health professionals, particularly nurses in primary health care services, who deliver risk factor assessment and counselling at the patient, strengthen and shape the primary and secondary care delivery of health promotion, chronic disease management and patient wellbeing.

Other sectors, such as patient organisations, consumer organisations, NGOs or faith-based organisations may also find this resource useful as it outlines the opportunities for community-based services to link with health services with appropriate adaptation according to context.

DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT

Phase 1 (3-4 months)

Output 1: Technical document on “Counselling for healthy lifestyle in the Pacific Island Countries and Territories”

• • Deliverable 1.1: Review of existing resources for counselling guidelines for healthy lifestyle in the Pacific Island Countries and Territories
• • Deliverable 1.2: Review of counselling practices, curriculum of health professionals and counselling training needs for healthy lifestyle counselling
• • Deliverable 1.3: Joint consultations with HPR/WPRO, DPS/WPRO and partners 
• • Deliverable 1.4: Toolkit for Counselling for healthy lifestyle in the Pacific Island Countries and Territories

Phase 2 (4-5 months)

Output 2: Workshop modules, programmes, presentations and evaluation on counselling

• • Deliverable 2.1: Draft trainer’s workshop module(s), content of presentations and other materials for the training of health professionals for the primary health care services
• • Deliverable 2.2: Pilot testing and collecting feedback for the technical document through workshops
• • Deliverable 2.3: Updated workshop modules, programmes, presentations and evaluation on counselling

METHODS TO CARRY OUT THE ACTIVITY

• • Review of literature and resources
• • Interviews and/or focus group discussions with relevant stakeholders
• • Joint consultation
• • Counselling toolkit and report writing

QUALIFICATIONS AND EXPERIENCE

Health promotion unit is looking for contractors with:

• • Extensive working experience in developing technical manuals and toolkits on health promotion, healthy lifestyle and prevention of noncommunicable diseases
• • Proven track record with technical writing in English focusing on communication for the improvement in public health. Working experience with international health agencies and government stakeholders in the Pacific Island Countries and Territories would be desirable
• • Good understanding of principles of adult learning, counselling and behavioural changes would be an asset
• • Should be able to start on the target date in July 2020

TIMELINE OF SUBMISSIONS

• • Submission of draft technical document (as per Output 1) and a financial statement or invoice (by 30 September 2020)
• • Submission of draft workshop modules (as per Output 2) and financial statement or invoice (by 28 February 2021)

ADDITIONAL INFORMATION

• • Upon finalization of the contract intellectual property of content and products shall revert to WHO.
• • Any data or results collected from the project may not be shared or distributed beyond the project team members without approval of the responsible officer in WHO.
• • The contractual partner will not be required to be based full-time at WHO WPRO, Manila, Philippines to perform the tasks related to this activity. The contractual partner may be requested to be available for virtual technical discussions with other partners as needed.

APPLICATIONS 

Qualified and interested contractors should submit their (1) curriculum vitae (for individuals) or company profile (for institutions), (2) expression of interest {cover letter} and (3) proposal, including budget, to the Supply Officer through WP RO UNGM at <wproungm@who.int> by June 12, 2020.

The cover letter should outline how their experience and qualifications make them a suitable candidate for this project.

Please use Tender Notice No. 108815 as subject to all submission.  Only successful candidates will be contacted.