Guidelines for Remote MHPSS Programming in Humanitarian Settings: Step 1

Anticipate, Assess and Plan for Remote MHPSS Programming

What?

This step is a building block for any remote MHPSS programming and ensures remote activities are intentionally designed; reflect contextual realities; and address the needs on the ground. To anticipate a need for remote MHPSS programming is to consider historical and current trends as well as likelihood of events that may necessitate remote modalities (e.g., public health crises resulting in movement restrictions, inaccessibility due to geographic remoteness or security risks, barriers to access to in-person services by clients/beneficiaries, etc.). To assess is to systematically collect and analyze data on the country background and context; existing government or global guidelines, infrastructure and resources, as well as needs and barriers to remote programming. To plan is to use the data collected from the assessment to make evidence-based decisions about remote MHPSS programming and line up the necessary resources for implementation. These processes should be participatory and include the community members and beneficiaries intended to be served by MHPSS programming.

Why?

Anticipating a need for remote MHPSS programming, understanding the need through an assessment, and planning for it reduce the surprise element and enable teams to effectively mobilize the necessary resources when the need arises.

When?

This step will ideally take place during initial program design phase, with assessments and plans for MHPSS programming revisited and updated throughout program implementation.

Who?

MHPSS management and/or lead focal points, supported by M&E, in collaboration with coordination mechanisms and other MHPSS actors.

How?

The following sections provide specific guidance on how to anticipate, assess and plan for remote MHPSS programming.

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1.1 Anticipate the Need for Remote MHPSS Programming

In the design phase/program development of MHPSS programming, it should be anticipated that there may be a need, at some stage during the project, for remote programming and services. It is advised for MHPSS leads to conduct initial brainstorming and/or workshops to develop an initial and basic framework to include potential scenarios that would require remote programming or service provision. This initial brainstorming can inform the development of the assessment.
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1.2 Conduct an Assessment to Inform Adaptation to Remote MHPSS Programming

Information from an assessment is needed to make evidence-based decisions about remote MHPSS program planning and design person-centered approaches. An assessment can help identify:

  • Barriers and opportunities to providing or accessing face-to-face MHPSS services or capacity-building efforts.
    Existing national guidelines and efforts that support or prevent remote MHPSS service delivery.
  • Knowledge, attitudes, perceptions and needs of clients, community members and service providers regarding remote MHPSS programming and their level of comfort working with remote technologies.
  • Actors currently working on mental health at the national, regional and community level that need to be engaged to transition to remote MHPSS programming.
  • Capacity building needs of staff, service providers and partners to facilitate effective transition to remote MHPSS programming.
  • Available and needed resources at the organizational, community and national level to support the transition.
The assessment should include the following elements:
Assessment elements
  • Country-level analysis: Undertake a quick assessment of existing policies and regulations, national MHPSS approaches and strategies, efforts and systems that may support or prohibit remote MHPSS programming. For example, are there laws or regulations on telemedicine? Does the national/local government stipulate when and how healthcare can be conducted remotely? Are government stakeholders ready and supportive of remote MHPSS programming? Have there been any relevant experiences? This analysis should also include identification of secure and accessible technological platforms to be used for remote service delivery, keeping in mind surveillance and technology bans by some governments as well as data collection and sharing by technological platforms.
  • Community-level analysis: Conduct key informant interviews (KIIs) or focus group discussions (FGDs) with community members and leaders, clients and service providers to understand their needs and concerns as well as barriers to access to remote MHPSS services. For example, do clients and their family members have the means to connect to services remotely? What existing resources can be leveraged (e.g., crisis or helplines to connect clients to services, private and safe community spaces for taking calls, etc.)? If KIIs and FGDs cannot be conducted in person, consider collecting data remotely using the available technology. (Refer to the Resources List at the end of this section for guidance on remote data collection).
  • Organizational/program-level analysis: Conduct an assessment of strengths and limitations in staff and service provider knowledge and capacity to implement and supervise remote programming. What resources, tools and training do they need to do their job effectively? Does the program budget accommodate acquiring additional resources to support the transition? A desk review of available training materials that have already been adapted and used in remote MHPSS training should also be conducted.
  • Mapping: Identify MHPSS services available to clients and caregivers as some services transition to remote modality. This also includes assessment of whether and how other actors are implementing MHPSS programming remotely, and what resources can be leveraged to support local communities. (See Appendix A for a 4Ws tool, which is designed to be adapted to the local context and includes guidance on mapping of existing resources).

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1.3 Develop Contingency Plans for Transitioning to Remote MHPSS programming

A number of expected and unexpected circumstances may necessitate a full or partial transition to remote MHPSS programming. Contingency planning enables teams to anticipate and put in place mitigation measures and resources before disruptions to programming and activities occur. In the context of MHPSS programming, contingency planning may include:

  • Identifying scenarios that may disrupt face-to-face service delivery and overall programming (e.g., epidemics/pandemics, strikes, post-election violence, natural disasters, etc.).
  • Assessing the likelihood and impact of each scenario (e.g., closure or destruction of health facilities, loss of clients’ records and contact details, disruptions in referral pathways, disruptions in psychotropic medication supply chain, etc.).
  • Planning a response for each scenario (e.g., having a second copy of the contact details of clients saved in a safe place, mapping of areas/affected population without access to in person MHPSS services, information sharing and coordination with partners, deploying trained response teams for remote service delivery, etc.).

Refer to Appendix B for a country-level contingency planning template, and the Resources List at the end of this section for additional contingency planning guidance.

Key considerations in anticipating, assessing and planning forĀ remoteĀ MHPSSĀ programming
  • Staff or client willingness to transition to remote modalities should be actively inquired about rather than assumed.
  • Program staff, service providers, clients, community members, partners, government and other stakeholders should be engaged in assessment and planning. In line with person-centered approach, the needs of the individuals intended to receive remote services should be at the center of decision-making, planning and designing remote modalities.
  • Consider risks associated with collecting primary data in person and whether doing so would expose staff, community members and stakeholders to harm or jeopardize client confidentiality. (Refer to the Resources List for guidance on ethical standards of MHPSS data collection).
  • Updated data should be used to complete the assessment. Global and national guidelines, national/local context (including security situation, disease control measures, etc.), needs/perceptions, availability of existing services are dynamic and program planning needs to reflect current trends.
  • The national telemedicine policies and laws, if in place, should be taken into consideration and abided by, while adapting the guidance as needed. In contexts where these policies and laws do not exist, these guidelines should be used as the primary guidance, while taking into account normative practices, practicalities and what is acceptable within the cultural context.
  • Additional financial and human resources for remote MHPSS programming may not be available at the time when remote programming is required, which should be accounted for at this stage.

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