In February 2025 UNFPA initiated cooperation with UNDP to support the implementation of the Global Fund Tuberculosis (TB) grant in Turkmenistan to strengthen the Gender and Reproductive Health (RH) response in the Exit of National TB programme of Turkmenistan, requiring strengthened support systems.

Psychosocial support is crucial for TB patients and their families, significantly improving treatment adherence, mental well-being, and overall outcomes. At the same time this support needs to acknowledge and address the unique emotional and psychological challenges faced by individuals due to their gender roles and societal expectations. For example, women may face increased stigma, domestic responsibilities hindering treatment access, or economic dependence that exacerbates stress. Men may struggle with perceived loss of masculinity or reluctance to seek help due to societal pressures.

In July 2024, UNFPA signed a Memorandum of Understanding with the National Red Crescent Society of Turkmenistan to provide psychological counselling and case management support to women and girls with a focus on gender-based violence. Following the signing, the services were launched in 5 regions of the country and Ashgabat city.

Within this initiative UNFPA will hire an international consultant to train psychologists in the Family Support Services in 5 regions and Ashgabat city, as well as a psychologist based at the CSO Keyik okara to provide psychosocial counselling to the target population integrating gender responsive approach.

(Description of services, activities, or outputs)

3-day training of psychologists in the Family Support Services in 5 regions and Ashgabat city, as well as a psychologist based at the CSO Keyik okara to provide psychosocial counselling to TB patients and their families:

1. Desk review, preparation of training agenda, materials and presentations – 3 days
2. Country mission and training – 3 days
3. Consultancy report and recommendations – 1 day

The training will address the following areas of counselling:

Mental Health Challenges: TB and its treatment can lead to anxiety, depression, and other mental health issues. Psychological counseling helps patients and their families cope with these challenges and improve their mental well-being.

Improving Treatment Adherence:
TB treatment is long and complex, and psychological support can help patients and their families stay motivated and adhere to their treatment plan.

• This part requires knowledge of adherence concept, types of non-adherence and the approaches to them; early identification of risks for non-adherence; development of individual adherence building plans; management of non-adherence due to various reasons, such as side effects of anti-TB treatment, personality characteristics, social isolation etc; management of non-adherence in specific patients, such as having drug/alcohol addiction problems, ex-prisoners, lonely patients; and returning defaulted patients to treatment.
• Reducing Stigma and Isolation:
  TB can lead to social stigma and isolation, which can further exacerbate mental health problems. Counseling can help patients and their families address these issues and build a supportive network.
• Empowering Patients:
  Counseling empowers patients and their families to take an active role in their treatment and recovery.
• The following types of counseling will be addressed in training:
  • Individual Counseling: One-on-one sessions with a trained counselor to address specific concerns and challenges.
  • Group Counseling: Support groups where patients can connect with others and share their experiences.

• The following key areas will be addressed in training for counseling:
  • Health Education: Providing accurate information about TB, treatment, and prevention.
  • Treatment Adherence: Encouraging patients to take their medication as prescribed and attend follow-up appointments.
  • Emotional Support: Providing a safe space for patients to express their feelings and concerns.
  • Stress Management: Teaching patients coping mechanisms for managing stress and anxiety.
  • Social Support: Connecting patients with social support networks and resources.

Deliverable 1: Desk review of available materials and developed agenda and training materials including presentations and recommendations for a 3-day training on providing psychosocial support for TB patients and their families by April 29, 2025;

Deliverable 2: Country mission, facilitation of the training and travel report on the mission. By May 20, 2025

Deliverable 3: Final report with finalized presentations and recommendations for future interventions in providing psychosocial support for TB patients and their families – by May 30, 2025

• At least a Master’s Degree in Public Health, Medicine, Epidemiology, Psychology or equivalent OR Bachelor’s degree with additional two years of the relevant experience;
• Excellent knowledge and at least 5 years of proven experience in providing psychological adherence counselling to TB patients in public, private or non-governmental organizations;
• Experience in the development/adaptation of tools and training materials for adherence counselling (questionnaires, manuals, handouts, etc).
• Excellent Russian speaking and writing skills required;
• Strong analytical and facilitation skills;
• Effective communication skills.