WHO QualityRights Tool Kit Intervention in Lebanon
The tool kit was implemented in 2 private facilities providing in-patient mental health services in Lebanon. The core elements of the intervention included:
- Establishing a national team of assessors
- Building capacities within the national team to assess health facilities using the WHO QualityRights tool kit
- Adaptation of the tool kit to the Lebanese context
- Assessment of the quality and human rights aspects of mental health services in the two facilities
- Development of improvement plans with the facilities
1- Assessment and management teams
As a first step, an assessment team was established bringing together members from different disciplines namely public health, social work, mental health, human rights advocates and others. In addition, the assessment team included persons with lived experience in mental health. A project management team was also set up to steer and monitor the implementation of the project.
2- Project plan
The project plan covered the detailed planning and scheduling required for the development and implementation of the project, ranging from the training of the assessment team, the logistics of carrying out the baseline assessments of facilities, the adaptation workshop, and the development of facility-based improvement plans.
The management team met on a weekly basis and coordinated the project plan with the WHO team in Geneva as well as an international expert who implemented the tool kit in India.
3- Capacity building of assessment team (initial and refresher training)
An initial three-day training was conducted in March 2017 preceded by an online QualityRights module. The training was conducted by two international experts; one having developed sections of the tool kit; and the other one having implemented the tool kit. This training included field visits and onsite application in two facilities providing mental health services. Another two-day refresher training was conducted in November 2017 prior to the baseline assessment. The same international expert who has experience in implementing the tool kit supported this refresher training. This training included simulations and applications on how to use the tool kit in Arabic.
4- Adaptation workshop
Preceding the refresher training in November, an adaptation workshop was conducted with the assessment team. The aim was to identify and address challenges in asking the questions in Arabic from the translated tool due to differences in Arabic dialects. The output of this workshop was a document with suggested changes to the Arabic terms and the question formulation.
5- Baseline assessment
A baseline assessment of the two facilities providing mental health services was conducted using the WHO QualityRights tool kit in November 2017 to measure the degree to which these facilities meet the standards and criteria in the 5 themes of the tool kit.
The assessment team was split in two groups, each covering a facility. The assessment was conducted by the assessment teams, with the assistance of an international consultant who has expertise in implementing the tool kit. One of the facilities was visited over two days and the other facility was visited over one day. Based on the tool kit’s assessment methodology, interviews were conducted with service users, family members/carers, and staff, in addition to the review of the facilities’ documentation and general observations.
6- Rating and reporting
Each assessment team conducted a debriefing session and shared notes after each day of assessment. Following completion of the assessments, each assessment team met over four non-consecutive days in order to discuss the findings, agree on the rating, and propose recommendations for action. The facilities’ reports were finalized by the management team.
7- Improvement plans
A meeting was conducted with each facility to discuss the initial findings of the assessment. The report was shared with each facility for review and feedback. A session was planned with each facility’s team in order to develop improvement plans.
The overall communication objective is to highlight the importance and impact of scaling up quality and human rights in mental health services. Following the next phase of the project, dissemination of information will be interactive, engaging with the target populations, and involving policy makers, legal representatives, and human rights NGOs.