Short-Term External Consultant
Terms of References
Lead the development of a Competency-based framework for the Speech Therapy workforce in Cambodia in conjunction with OIC Cambodia and its partners
I. Background
Introduction to OIC Cambodia
The Organization to Improve Communication and Swallowing Therapy Services in Cambodia (OIC Cambodia) is a local non-government organization developing sustainable support for Cambodians with communication and swallowing disabilities, a group largely excluded and unrecognized within existing Cambodian services and systems. OIC has 10 years of experience using speech therapy (ST) technical knowledge for systems strengthening and to equip Cambodia's health, education, and rehabilitation sectors through training, resource development, policy development, and direct service provision. Our vision is to support the development of a speech therapy profession led by Cambodians and available to all who need it. We have the mission to establish speech therapy university courses and jobs for Cambodians, raise awareness, and influence government policy.
OIC Cambodia is committed to partnerships and supporting the collaborative development of a ST workforce in Cambodia. Our demonstrated ability to maintain strong relationships with the government for advocacy, capacity strengthening, service delivery, and coordination has earned us a strong reputation for delivering projects that ensure sustainable gains and quality design. OIC has partnerships with both government and NGO stakeholders at national and subnational levels including rehabilitation, education, and disability workforce leaders (government, professional rehab. associations/orgs, and NGO stakeholders) and direct service providers. At a national level, OIC collaborates with the Ministry of Education, Ministry of Social Affairs, Ministry of Health, Disability Action Council, and other key rehabilitation stakeholders (eg. ICRC, EXCEED, CPTA, PWDF, Speech Therapy Cambodia). These relationships will be essential for ensuring stakeholder input and shaping the competency framework for the Cambodian context.
Summary of speech therapy within the Cambodian Context
Cambodia has been proactively developing its health, education, and rehabilitation sectors, however, significant gaps in the scope and accessibility of services remain, including ST. A 2013 situational analysis estimated that 600,000 people have communication or swallowing difficulties in Cambodia, implying that at least 1 in 25 Cambodians would benefit from speech therapy, which is 4% of the total population. The 2021 Cambodia Demographic Health Survey reveals 3.8% of the population reported a mild-moderate communication impairment, with 0.8% reporting a severe communication impairment with swallowing impairment data not available.
Cambodia’s training, employment, and regulation of allied health professions and professionals are managed across three government ministries: Ministry of Health; Ministry of Education, Youth and Sport; and Ministry of Social Affairs, Veteran and Youth Rehabilitation. Each sector has its own management, service, and referral structures and consequently views speech therapy from its unique perspective. Limited recognition or discussion of ST in policy and services is common across the sectors (Bryce & Bong, 2020). However, OIC and their partners have been advocating for a broader scope of rehabilitation practice in Cambodia beyond physical disability. OIC are now recognized as government advisors within Health, Education, and disability initiatives. This is still a work in progress, for example, while Cambodia’s progress towards meeting good health and well-being targets (SDG 3) has included the establishment of a Health Equity Fund to provide access to free health care to 16.3% of the population who are categorized as poor (Royal Government of Cambodia, 2019a) and there is also a “disability card” benefits scheme being introduced. ST services are not yet recognized or available as essential for any primary health care or rehabilitation outside of the capital city reflecting common global geographical patterns limiting universal and comprehensive health coverage (World Health Organization, 2018, p. 10).
Currently, in Cambodia, there is a profound shortage of ST services, and other professions like educators, disability and health workforce lack specialist knowledge to support people with communication and swallowing difficulties. Cambodia’s education and rehabilitation support services focus mainly on assisting people with physical impairment. The few services and supports available are located primarily in Phnom Penh and are run by the private sector. Currently, there are no speech therapy services or recognized workforce within government health and rehabilitation outside of Phnom Penh. The limited NGO workforce are limited in geographical reach and scope, targeting mainly children (Bryce et al 2023). PWCD (including children without typically developing speech and language skills, and adults with lifelong and/or acquired disabilities), not only have few support services but experience barriers to accessing education, employment, and health services (OIC Cambodia, 2019). People with swallowing, eating, and drinking difficulties experience an increased incidence of health issues including a higher risk of mortality from choking or aspiration pneumonia. Both areas of therapy support are essential to ensuring an individual quality of life and achieving the Cambodian government’s stated development goal to “leave no one behind” (Royal Government of Cambodia 2019) unlike physical disability, communication difficulties are only beginning to be included in Cambodian government documents and policies, with speech therapy being named as a desirable extension service within physical rehabilitation centre management guidelines manual (Draft 2022). This change is reflective of the grounds swell of support for the development of speech therapy services and workforce amongst rehabilitation professionals, management stakeholders, the general public, and government departments with the local organization OIC Cambodia being active. Despite this receptivity, the vast majority of Cambodians who live with communication difficulties are solely reliant on informal community and family support with public services rarely considering inclusive practices (Net et al 2023). This mismatch of need and availability requires a significant investment, to build on the speech therapy supporting service responding to the community context.
Currently, there are no ST university training programs in Cambodia, however, discussions and joint development of Bachelor and Master's degree curricula have been underway since 2019. OIC has current program activities to develop tiered training for supporting people with communication and swallowing difficulties. These training activities will be excellent opportunities to pilot the competency framework within Cambodia’s health and community centers.
II. OBJECTIVE OF CONSULTANCY
Lead development of a competency framework for a Cambodian speech therapy workforce, (compatible with the WHO rehabilitation framework and selected international ST frameworks). The framework will cover competencies for university-qualified Speech therapy professionals as well as the workforce with skills to provide support and information to people with communication or swallowing difficulties (potentially working within health, education, disability, or social service systems). It is designed to guide national workforce policy and resourcing for future Cambodian ST workforce and training initiatives.
II. SCOPE OF THE CONSULTANCY
Timeframe: March to Sept 2024.
Location: Remote but design is expected to include 1-2 in-country (Cambodia) workshops depending on consultancy design.
Key tasks include (but are not limited to)
Gathering and reviewing literature and existing frameworks,
Direct collection of data on context and current practitioner level and service need in Cambodia (including consultation with government and stakeholders)
Formation of draft framework,
Testing and review of the framework with Cambodian stakeholders
Presentation of a complete framework
Documentation of the process of framework development (report)
Piloting and other application of the framework will continue later in 2024 and 2025, through curriculum development and evaluation of training and practitioner skills levels in a variety of settings.
Examples of literature and information to be included in the review:
WHO rehabilitation workforce and any subsequent SLP-specific work within this format
input from Cambodian allied health/rehab actors (Gov and non-gov - esp allied health professions of Physio, P&O, Social work, audiology)
International SLP association's competency frameworks for graduates (SPA, ASHA, Singapore, Vietnam etc.)
Areas of practice for SLP in different contexts and priority areas for Cambodia
Allied health competency frameworks (international)
Needs and priorities of service users (Cambodia)
Cambodian health, education, and disability existing workforce frameworks and policy
other things identified by the advisor group
OIC staff and advisor involvement
OIC staff will provide orientation to documents and facilitate connections with advisors and Cambodian stakeholders
OIC will coordinate ST advisory team to support and co-develop the framework with the consultant (remote and in-country)
OIC staff will be available to support and coordinate the input of Cambodian stakeholders for specific input requested by the consultancy team
OIC will provide logistic support for any in-country workshops or meetings related to this consultancy
Key responsibilities of the consultant/consultancy partner
Outline monthly progress markers and report against these to the OIC program manager at agreed intervals
Coordinate input from the OIC advisory group ensuring timely delivery of activities and framework
Provide clear information and outline parameters of Cambodia-based consultancy at least one month ahead of scheduled activities (to enable OIC staff to organize and coordinate partners and resources).
Alert OIC if any delays or anticipated changes to the agreed schedule
III. Methodology
The Consultant will present their suggested methodology for developing the framework within their application. This will be refined and agreed upon with the OIC technical team and advisors. The consultant will develop a detailed work plan as the first deliverable within the consultancy.
Key Deliverables and timing (to be confirmed once consultant confirmed and joint plan discussed)
III. REPORTING
The consultant will report to OIC Executive Director, Mr Leang Kheal who will be the main focal point for this project and with parallel reporting lines to other members of OIC’s Management team. Ms Ruth Bryce, ST profession development manager will coordinate initial consultancy activities.
V. AVAILABLE RESOURCES
Budget range for this consultancy is 8000 AUD.
PAYMENT
The total remuneration of the gross consultant payment package can be paid to the consultant in 2 installments of 50%, or 100% of the payment can occur upon the acceptance of the agreed deliverables at the end of the consultancy, as negotiated by the consultant. OIC will withhold the amount of tax on consultancy of 15% WHT based on the Cambodian tax law and pay to the Cambodian General Department of Taxation.
2. Competencies/Experiences
The external consultant is expected to have:
Have relevant qualifications and education in International Development, Monitoring, and Evaluation, Research or Program management (Master or PhD).
Clinical experience and knowledge in allied health areas (Speech, OT, Physio etc)
Proven experience developing competency-based frameworks for training development and assessment and data analysis of a variety of data sources
High written and visual communication skills in English
Experience working within the health, disability, or social services sector in LMIC
Proven history of completing quality consultancies in a timely manner
Understand the Cambodian context, in particular, rural and government systems
3. Application Process
Interested candidates are requested to submit applications by 15th March 2024
Applications should consist of:
1. CV/Resume (maximum 2 pages);
2. Cover letter (maximum 1 page) - addressing competencies required;
3. A proposed work plan, listing key activities and dates for each activity/output.
All applicants must submit their complete application in a single pdf file with items in the order listed above.
All applications should be sent to: hello@oiccambodia.org or by hard copy to our Phnom Penh office
OIC Cambodia Office address: #35B, St 26BT, Sangkat Boeung Tumpun2 Khan Meanchey, Phnom Penh, Cambodia. Phone: (+855) 12 405 195.
