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Consultant for HEARTS Project Quantitative Research

: Save the Children

: Nonprofits / องค์กรไม่แสวงหาผลกำไร

: 1085

: 11 August 2021

25 August 2021

Consultant for HEARTS Project Quantitative Research: Mental Health and Well-being of Children and Youth with diverse SOGIESC

1.             BACKGROUND AND CONTEXT

Children and youth with diverse sexual orientation, gender identity, gender expression, and sex characteristics (SOGIESC) still face stigma and discrimination that hinder their development and well-being. At a national level, Thailand has not legalized same-sex marriage and does not have gender recognition law, which means that citizen cannot request to be legally recognized as the gender they identify as. Although Gender Equality Act, B.E. 2558 has resolved a complaint on discriminatory curriculum in health subject, which led to curriculum revision in 2019, gaps for SOGIESC-inclusive education still remain. Schools do not have an explicit zero tolerance policy on SOGIESC-based violence and teachers are not yet equipped with attitude and skills to teach SOGIESC topics, and other subjects’ curriculum still reinforce harmful binary gender norms. Research from Mahidol University has found that 55.7% of self-identified LGBTI students reported having been bullied in the month prior to the survey because they were LGBT.  Nearly one third (30.9%) experienced physical abuse, 29.3% reported verbal abuse, 36.2% reported social abuse and 24.4% reported being victim of sexual harassment. Even among students who did not identify as LGBT, 24.5% reported having been bullied in some way because they were perceived to be transgender or attracted to the same sex. In a national survey conducted by UNDP, it has found that 36.6% of general population felt negatively towards having LGBT children in the family and 40.6% disagreed that students should be able to wear uniform according to their gender identity.

The multiple layers of barriers often impact mental health of children and youth with diverse SOGIESC. Findings from Mahidol University showed that students who faced SOGIESC-based violence were more likely to be depressed or have attempted suicide compared to those who have not been bullied and those who were bullied for other reasons. Another research indicated that LGBT adolescents have higher burden of illicit drug use, which is found to be indicative of depressive symptomology and suicidal ideation.  In the mentioned national survey, findings demonstrated that almost half of LGBT people have contemplated suicide, and nearly one-sixth have attempted suicide.  Additionally, 49% of LGBT respondents viewed mental health services as a high priority, while one in five people reported having difficulty accessing mental health services. Although it is recommended by WHO to have national mental health plans for specific vulnerable population, including LGBTIQ+ persons, Thailand still lacks such plan and implementation.

Mental health issues remain a major concern among LGBTIQ+ population, including children and youth with diverse SOGIESC. According to Mental Health Act, B.E. 2551, patients under 18 years old will need to be accompanied by guardians to receive mental health treatment.  In March 2020, it has been resolved that as children under 18 years old who would like to seek initial mental health service are not yet qualified as ‘patients’ (as patients refer to those with psychological diagnosis); therefore, children are able to walk in to see a psychiatrist and receive initial counselling. Although accessibility is now improved, a youth has shared her experience in seeking mental health services during consultations conducted in 2020 that when she turned 18 and got to see a psychiatrist, she was suggested that changing her sexual orientation to heterosexual might be better for her mental health.   This reality reflects the gap in practitioners’ competency in providing service for LGBTIQ+ clients. Research has recommended that mental health practitioners should understand LGBTIQ+ identities and concepts, as well as accepting diverse SOGIESC and reject stereotypes.  When it comes to psychological services for transgender and/or gender-non-conforming children and youth, such services related to transitioning are not covered under the universal health coverage scheme, which led to children and youth buying hormonal pills without prescription nor professional psychological support.

 

Issues and emerging crisis (COVID-19)

As shown that LGBTIQ+ community face several existing barriers, the impacts of COVID-19 pandemic have severely affected the community. Research from UNDP and Asia Pacific Transgender Network (2020) has shown that major impacts on the LGBTI community were the loss of income/job (47%), and unsafe living situations (36%), while 60% of respondents said that they have not received any assistance from the Government. The research also found that the community affected by isolation had increased loneliness, stress, and depression.

2.             SCOPE OF RESEARCH

2.1 Purpose and Key Research Questions

In 2018, Save the Children produced an exploratory research report on LGBTIQ+ youth in Thailand. In 2020, we have initiated the HEARTS (Highlighting Equality and Respect Towards all SOGIESC) project under the child protection programme to ensure that children and youth with diverse SOGIESC can enjoy their rights. To support our goal, we will build on the exploratory research and strengthen evidence-based knowledge in order to lead policy changes for improved mental health outcomes of children and youth with diverse SOGIESC.

The HEARTS project intends to conduct a quantitative research on mental health and well-being children and youth (15-24 years old) with diverse SOGIESC. The research aims to generate substantive evidence-based knowledge by identifying factors affecting mental health of children with diverse SOGIESC. This research is intended to understand the extent of risks and protective factors (including resilience of children). The findings from this research will be highly useful in providing recommendations for Save the Children, CSO partners, and the Thai government on strategy to build self-esteem, and enhance mental health of sexual and gender minorities. The research is expected to take place from September 2021 to July 2022.

The overall objectives of this research include:

• To understand factors that affect mental health and well-being of children and youth with diverse SOGIESC and analyze how risks and protective factors operate on the multiple levels (to identify what are the risks and protective factors centering on children’s development and explain interaction between children, families, communities, and society and the impact of that interactions to mental health outcomes: depression, suicidal ideation or attempts)
• To inform evidence-based prevention and protection programming strategies and advocacy focusing on children’s empowerment and self-esteem, basic services that are
• safe, socially appropriate and protect dignity, and mental wellbeing of children and youth with diverse SOGIESC, and in return, contributing to the prevention and resilience against SOGIESC-based violence.

Key research questions:

1.             What are the risk factors, protective factors for mental health and wellbeing of children/youth with diverse SOGIESC? Using the socio-ecological framework with intersectionality approach to explore this question (examples of factors):

a.             Child:

i.              Wellbeing and signs of negative mental health: depression, suicidal ideation or attempts

ii.             Ability to disclose or express their SOGIESC

iii.            Empowerment to speak up and advocate about their SOGIESC identity and experiences

iv.            Self-esteem and body-esteem

v.             Internet use to obtain information and connection with other diverse SOGIESC; and experience of SOGIESC-based online bullying

b.             Family:

i.              Perceived support from family and fostering healthy environment that accepts children’s SOGIESC

c.             Community:

i.              Children know and have access to mental health services and support, including mental health professional or access to desired transition services

ii.             Access to support services at schools or other units in the community

iii.            Peer support/acceptance (includes positive relationships with peers, support of friends)

iv.            School factors as per the introduction: Anti-bullying policy; School Curricula Inclusive of LGBT Identities etc.

d.             Society:

i.              Relevant systems and practices in regards to mental health support for children and youth with diverse SOGIESC

e.             Gender and power dynamics:

i.              SOGIESC-specific factors e.g., perceived acceptance from family, peers, teachers; discrimination or violence (trans and LGB specific factors)

f.              Impact of COVID-19

2.             How risks and protective factors operate in different levels (child as an individual, families, community and society); what do the interactions between children, families, and societies look like; and how does it affect to the mental health outcomes?

3.             How are children developing resilience? What are the key supportive factors to create/develop resilience of the children?

Note on terminology:

Resilience is the ability to overcome adversity and positively adapt after challenging or difficult experiences. Children’s resilience relates not only to their innate strengths and coping capacities, but also to the pattern of risk and protective factors in their social and cultural environments.

Wellbeing describes the positive state of being when a person thrives. In mental health and psychosocial work, wellbeing is commonly understood in terms of three domains:

1. Personal wellbeing – positive thoughts and emotions such as hopefulness, calm, self-esteem and self-confidence.

2. Interpersonal wellbeing – nurturing relationships, a sense of belonging,

the ability to be close to others.

3. Skills and knowledge – capacities to learn, make positive decisions, effectively respond to life challenges and express oneself.

Expected outcomes:

• A full research report in Thai and in English
• A presentation of the research findings, including media engagement, and research validation meeting with relevant stakeholders and government agencies
• Policy recommendations for the adoption of measures to promote mental well-being of children and youth with diverse SOGIESC into national initiatives

2.2 Scope

Due to the resurgence of COVID-19, the research team will be requested to prepare alternative data collection method, i.e. remote data collection and online survey, with support from Save the Children and CSO partners, in case the face-to-face research and data collection cannot be done.

2.3 Audience and use of findings:

• Primary target audience: professionals working with children, youth, and their families (including teachers, psychiatrists, psychologists, CSOs) to understand what support children and youth with diverse SOGIESC may need to promote mental health and well-being
• Secondary target audiences:

o              Department of Mental Health, policy-makers on mental health strategies and services to ensure that mental health services are accessible and sensitive for children and youth with diverse SOGIESC

o              General public to raise awareness about facilitating a safe space for children and youth with diverse SOGIESC

o              SCI to integrate findings and best practices into our programmes

3.             RESEARCH METHODOLOGY

3.1 Research design and Methodology

Target research population:

Children and youth (age: 15-24) with diverse SOGIESC nationwide

Research method/research structure:

This research shall employ a mixed methodology. Desk research and secondary data shall be compiled. For primary data, quantitative data to be gathered from conducting online and offline surveys. Furthermore, focus group discussions or interviews, as appropriate, will be conducted to gain qualitative data.

Prior to data collection, the research team will be trained on psychological first aid (PFA) to detect stress and provide initial support and refer to appropriate support.

The data collection method is convenient sampling and aims to collect 400 sample size per group (e.g., by sexual orientation and gender identity). To reach the participants, the research team will reach through CSOs, schools, paid social media ads, or other platforms. This is a focused study to target children and youth with diverse SOGIESC informants.

Quantitative data must be analyzed through the use of statistical software to produce descriptive statistical analysis. Data shall be disaggregated as required by Save the Children (i.e. sex/gender/age/people living with disability, ethnicity/nationality) as well as by location. The data analysis should employ Myer’s Minority stress model, also considering differences among transgender and LGB children and youth.

List contexts and possible groups

• Bangkok and central region: e.g. Thai TGA, SWING, Pink Monkey, Hinghoy Noy
• Northeastern region: LGBTIQ+ Esarn Network
• Southern region: local partners of SCI in Deep South, Buku
• North region: Mae Sot, Chiang Mai, Chiang Rai, Mae Hong Son, Phayao
• Children/youth-led groups receiving seed funds from SCI

3.2 Data

All primary data collected during the course of the research must be disaggregated by gender, sexuality, age, disabilities, and location and inclusive of children’s representation.

In case of the resurgence of COVID-19, which let to travel restrictions, the research shall propose remote data collection modality, using phone/Line/Zoom survey. All data collection methodology must ensure confidentiality and compliance to Save the Children Safeguarding and Data Protection policy.

3.3 Ethical considerations

It is expected that this research will be:

• Child-friendly and participatory. Children should be meaningfully involved in the research as a holistic process and not only as informants. Refer to the Practice Standards in Children’s Participation (International Save the Children Alliance 2005); and Global Indicator technical guidance (SCI M&E handouts Package, Volume 2).
• Inclusive. Ensure that children from different ethnic, social and religious backgrounds have the chance to participate, as well as children with disabilities and children who may be excluded or discriminated against in their community.
• Ethical: The evaluation must be guided by the following ethical considerations:

o              Child safeguarding – demonstrating the highest standards of behaviour towards children

o              Sensitive – to child rights, gender, inclusion and cultural contexts

o              Openness - of information given, to the highest possible degree to all involved parties

o              Confidentiality and data protection - measures will be put in place to protect the identity of all participants and any other information that may put them or others at risk.

o              Public access - to the results when there are not special considerations against this

o              Broad participation - the relevant parties should be involved where possible

o              Reliability and independence - the evaluation should be conducted so that findings and conclusions are correct and trustworthy

It is expected that:

• Data collection methods will be age and gender appropriate.
• Research activities will provide a safe, creative space where children feel that their thoughts and ideas are important.
• The research team will adhere to the Save the Children Child Safeguarding, Data protection and Privacy policies that are required throughout all project activities.

Ethical Consideration:

• Benefits/Harms: This research will focus on primary data collection from survey and interview. The process may expose children to secondary victimization (such as trauma, distress, anxiety, and loss of self-esteem) through the questions that trigger their memories of abuse and exploitation they experienced in the past. To avoid such harms, the researchers should avoid unnecessary questions related to violence, abuse, and exploitation that children encountered in the past, also the use of secondary data should be collected and reported in an ethical manner that will not expose children to harms. Furthermore, the research team will be trained on psychological first aid (PFA) to detect stress and provide initial support and refer to appropriate support.
• Consent/Assent: The researcher shall obtain children’s assent and youth’s consent. The children’s assent form must be written in the age-appropriated language. The linguistic ability must be taken into consideration. The consent/assent can only be given if the participants are informed about and have an understanding of the research. It must be given voluntarily without coercion and it may be withdrawn at any stage of the research process. Due to sensitivity of obtaining parental consent from children with diverse SOGIESC may be challenging as the children may not disclose SOGIESC information to parents or are not accepted, it is recommended that parental consent could be waived in this research.
• Privacy/Confidentiality: The researcher shall not disclose children’s names, families, address and personal information in the report and research dissemination. All of the children’s data shall remain anonymous.
• Non-discrimination: all children must be respected and participate in this research at their will. All researchers must oblige to guarantee that participation of children is exercised without discrimination of any kind of sex, gender, sexuality, language, religion, ethnicity, legal or social status.
• Child safeguarding and Research risk analysis:

o              Anti-harassment and PSEAH

o              Reporting and complaint mechanism

Timeframe:

The research aims to present deliverables within 11 months from September 2021 to July 2022. (3 months preparation, 3 months data collection, 5 months data validation/analysis/report writing)

4.             DELIVERABLES

The research deliverables and timeframe are outlined below.

Key deliverables	Timeframe	Remark
The research team is contracted and commences work	September 2021
Preparation Phase
The research lead and Save the Children will formulate the research working committee to design, review, and monitor the implementation of the research, and to provide solution and suggestions along the way, including ethical concerns and safeguarding protocols	September 2021	In the research working committee, SCI side will be HEARTS project officer and Technical Expert.
Phase 1: Inception Phase
The research team will conduct initial desk research and tool development. The summited inception research report will include: Research objectives and research questions Description of methodology, data collection tools, sampling considerations, and geographical locations Limitations and challenges of research and management plan Key deliverables, milestones and timelines Ethical and Safeguarding protocols for engaging with children and other vulnerable groups Logistical or other support required from Save the Children   Once the report is finalized and accepted, the research team must inform and submit a request for any change in strategy or approach to the HEARTS Senior Project Officer.	October 2021	All of the items will be reviewed by SCI ethics and Thai-national ethics committee affiliated (i.e. Thammasat University)
Feedback by SCI and Thai-national ethics committee
Approval of Inception Report and data collection tools		Ethics review
Phase 2: Data Collection and Analysis
The research team officially convene the research in accord to approved plan. It is expected that the research team will meet and provide short updates to the research working committee in a timely manner. Field work plan and logistical arrangements Translation of tools Data collection Data analysis	December 2021	The research team will be introduce to local CSO partners and youth groups to coordinate/engage in data collection.
Phase 3: Reporting
Preliminary findings presentation and data validation with SCI and relevant stakeholders Summary of Interim findings	May-June 2022	The research team shall present the data to be validated. In data validation, representations from children and CSOs should provide their opinions.
First draft of report including the following elements:   Executive summary Background description and context relevant to the research Scope and focus of the research Overview of the research methodology and data collection methods, Findings aligned to each of the key research questions Specific caveats or methodological limitations of the research Conclusions outlining implications of the findings or learnings Recommendations Annexes (Research TOR, Inception Report, Research schedule, List of people involved)   The report should be approximately 30 pages for each language with executive summary.	July 2022	The first draft of full report shall include findings and recommendations. See research report section for report guideline.
Final version of report	August 2022	Final version of report
Phase 4: Report Dissemination
Save the Children aims to disseminate and promote this research publicly. The researcher is expected to join SCI in the media and policy maker engagement session. Joint media engagement session Online webinar to share research findings	September 2022

Budget and Approximate Cost Breakdown:

The budget range for this research is 800,000 - 1,200,000 Thai Baht.

• All research activities of the researchers (this include the professional fee, admin/logistic cost on the researchers’ part, and the research advisors’ professional fee)
• Design and published research in digital format
• Organize online webinar to share research findings and recommendations

5.             REPORTING AND GOVERNANCE

The consultant will report to the SCI HEARTS Senior Project Officer. Additional technical advice will be provided by the Child Protection Technical Advisor, and technical team from Save the Children members. Save the Children should approve all plans and documents developed by the consultant.

The lead consultant is to provide reporting against the research plan. The following regular reporting and quality review processes will also be used:

• Regular email at least once every two weeks to the SC HEARTS Senior Project Officer documenting progress, any emerging issues to be resolved and planned activities for the following weeks.
• The consultant will hold a meeting with the project team and CSO partners to discuss the preliminary findings of the research.

A draft research report should be submitted for feedback and comments in English. The report should be written in English and Thai. The report should be approximately 30 pages with executive summary (appendices not included). The final report will comprise the following contents:

• Title, date, month, and year of the report, name(s) of author(s)
• Acknowledgement
• Contents
• List of Acronyms
• List of Tables
• Executive Summary
• Background of the research and context
• Background of research population and geographic area
• Introduction
• Literature Review
• Research methodologies
• Research findings
• Conclusion highlighting risk factors and protective factors that impact mental health outcomes of children and youth with diverse SOGIESC
• Recommendations that include children’s voice to enhance their resilience, as well as highlight preventive and protective factors through policy changes and implementation
• Annexes

o              Research TOR

o              Inception report including work plan and budget

o              Research framework and tools

o              List of people involved – including list of ethics committee

o              Raw data

The researcher will revise the report according to the agreed feedback and comments.

6.             EVALUATION TEAM

To be considered, the Evaluation team members together must have demonstrated skills, expertise and experience in:

• Masters’ degree in Social sciences, psychology, gender studies or relevant area to the project.
• Proven experience designing and conducting high quality research. Proven ability and track record conducting ethical and inclusive research with vulnerable populations while ensuring rigorous ethics, integrity, and safeguarding
• Demonstrate knowledge in SOGIESC, preferably with experience in conducting SOGIESC-related research
• Thai or international consultant who has experience working in Thailand with work permit
• Ability to work independently and meet tight deadlines
• Language proficiencies required include: English and Thai; kindly include a clear plan for language proficiencies in the team and/or translators included in the team
• Flexibility to travel (if needed)

There is a high expectation that:

• Members (or a proportion) of the research team have a track record of working together.
• A team leader will be appointed who has the seniority and experience in leading complex research projects, and who has the ability and standing to lead a team toward a common goal.
• The team has the ability to commit to the terms of the project, and have adequate and available skilled resources to dedicate to this research over the period.
• The team has a strong track record of working flexibly to accommodate changes as the project is implemented.

Applications for the consultancy should include:

• Expression of interest: stating candidate skill and experience suitable for the consultancy (max 2 page)
• Technical and financial proposal: Outline of evaluation framework and methods, proposed timeframe, work plan and budget (max 4 pages; applications over limit will be automatically excluded).
• CV of proposed individual/s and one piece of evidence of similar evaluation carried out previously
• Provide at least 2 research samples in Thai or English led by the leading consultant on the assignment

If you are interested in this research, please submit a proposed plan for research design and implementation with detailed schedule and proposed budget (consultant fee and all proposed expenses including translators if lead candidate is international consultant)

Contact : tha_procurement_bkk@savethechildren.org

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ที่ปรึกษา / Consultant