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Call for Proposals - External expert for activities for improvement of mental health and wellbeing of Roma and rural populations in North Macedonia



Title: External expert for activities for improvement of mental health and wellbeing of Roma and rural populations in North Macedonia

Reporting to: ESE, North Macedonia

Duration: Start August 2022, and should conclude by December 15th , 2022


To build capacity and technically support ESE professionals in creating tools that promote mental health and psychological wellbeing of the rural Macedonian population and Roma communities through non-medical approaches.


Co-develop a model of the local needs and resources that influence and determine the mental health of the rural Macedonian population and Roma communities from a non-medical perspective between ESE, CSOs and external experts.

Adapt assessment tools and build capacity of ESE to train professionals and providers to implement these tools for data collection, analyse the obtained data and make informed decisions led by community priorities.

Collaborate with ESE trainers in the development of mental health local action plans for rural and Roma populations in North Macedonia.


Mental health represents a neglected area in North Macedonia. One indicator for this situation is represented by the 19.7 mental health workers per 100,000 population, a very low figure compared tothe 80 from other European countries. Moreover, the mental health is still shrouded in stigma and discrimination, especially in small, closed, and marginalized Roma and rural communities. The community survey conducted in Roma communities by ESE in partnership with John Hopkins University, Baltimore USA, in 2017 indicated that 32% of Roma suffer from severe depression, while 44% suffer from mild depression. However, according to the Lancet Commission, poor mental health is strongly associated with social disadvantage in such a manner that these biomedicalsymptoms must be explained in the context of theunderlying complex, multilevel and multidetermined problems which are provoking them.

Roma and isolated rural communities face many issues regarding access to health, social and educational services, as well as poor infrastructure and living conditions. It has been widely recognized that the COVID-19 pandemic has aggravated these circumstances for many communities, as daily life stressors and isolation increased, social support networks weakened, and new barriers to accessing resources emerged. Many communities did not have the sufficient resources or previous living conditions to protect themselves from the virus, living in fear and abandonment.

Specific groups such as women and girls are more at-risk of experiencing mental health distress. According to the World Health Organization, gender violence is a leading cause of mental distress for women, and institutions have recognized the increased risk of gender violence. Specifically, women were at-risk of experiencing gender-based violence during the COVID-19 lockdown. Evidence shows that young Roma girls in various European countries are at-risk of school drop-out due to barriers to online schooling such as access to wi-fi, technological infrastructure and equipment. Gendered obligations within the community, such as family obligations during a crisis time, heightened this risk and the future of Roma women and girls. Roma people who also identify with other minority groups—for example LGBTQ community, religious or racialized groups—are at risk of experiencing mental distress, more vulnerability and invisibility due to the tensions created between feelings of shame, reconciliation, and pride of these identities early in life and during the life course. Special attention must be made to intersecting circumstances and identities and their influences on mental health. These findings show that marginalized, isolated and segregatedcommunities could be at risk of suffering similar constraints in the post-Covid times such as rural communities in impoverished countries.

The main target of this work is to develop useful insights to improve the mental health and psychological wellbeing from a non-medical approach in North Macedonian rural and Roma communities. ESE aims to develop culturally sensitive instruments, ensuring social determinants’ weight on mental health challenges in which Roma community members, and rural people are engaged in the process. Based on these findings the Roma CSOs, and CSOs working in rural areas will develop action plans for improvement of mental health through a non-medical approach.

Description of responsibilities


Scope of work

The external company/individual expert or consortium of experts will be expected to work under the direction of and in consultation with ESE. As a transversal action, the company/individual expert or consortium of experts will train CSOs on non-medical approaches to mental health data collection and analysis. Online training will be organized for capacity-building and to provide expert support within each of the following actions:

Action 1. To prepare a focus group questionnaire that aims to explore the multilevel (i.e., structural, organizational, and psychosocial) factors which have influence on mental health and identify key stakeholders within the communities.

Action 2. To co-design a survey with ESE and CSOs to identify and explore all the determinants from the local environment which have a positive or negative influence on Roma and rural people’s mental health in North Macedonia.

Action 3. To collaboratively analyze data between the company/individual expert or consortium of experts, ESE, CSOs and other key stakeholders.The external expert team will facilitate an online space to analyze existing data and identify themes, and other emerging data. The outcome of this workshop will provide ESE staff with a deeper understanding to prepare the research report.

Action 4.To review the prepared research report by ESE staff and to provide recommendations for its improvement. The company/individual expert or consortium of experts will provide critical feedback to the report and engage in dialogue with ESE staff.




Action 1
Questionnaire for focus group discussion designed
Action 2
Surveys developed
CSOs trained
Action 3
Workshop implemented to facilitate collaborative data analysis in preparation for ESE to prepare report
Action 4
Conducted review of the research report prepared by ESE



The  report will be developed by the staff of [CESPYD] who will receive the amount of €. 1.300 once the work is developed, and the report delivered.


Criteria for selection

The call is open for companies, individual experts or consortium of experts.

Following criteria will be assessed in the selection process:

- Experience with work on mental health, especially mental health of marginalized groups, including Roma.

- Experience in conducting quantitative research on mental health

- Experience in conducting qualitative research on mental health

- Experience in writing research reports and/or similar publication related to mental health.


Needed documents

- Letter of intent

- CVs of expert/s


Deadline for application

August 15th, 2022




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