This service is part of the preparatory study for the project to rebuild the Melsisi health centre and provide support for its reopening. For Axis 5 " support programme for the reopening of the health centre ", the expected deliverables are described below:

3.    Deliverable 1: Methodological proposal, detailing the working approach, the tools, the methodology envisaged and the detailed work schedule.

2.    Deliverable 2: The project's medical and organisational guidelines report. In particular, this deliverable must

• Confirm the health project and the health centre's strategic orientations with the authorities, in order to define the health care offer according to the needs of the population, the local environment and the positioning of the health centre in its area. The project will have to identify the health priorities to which the centre will contribute by integrating the resources and skills available.
• In view of the site's remote location, the telecoms aspect will also need to be taken into account, particularly the use of e-health as a means of improving access to care. This section will identify possible and desirable cooperation with other healthcare facilities.
• Confirm with the authorities the size of the centre and the resources required to meet the centre's expected activities.
• Identify the consequences for patient flows and the organisation of activities (prevention, care) where appropriate.

3.    Deliverable 3: A report on the actions to be taken to ensure the sustainability of the project, the governance plan and the operating budget for the facility at the end of each phase:

• Identify who will benefit from the project in the sense of: the project owner on the one hand and the operator on the other, and carry out an assessment of the operator's strengths and weaknesses (proposing corrective measures); and propose, in the light of these elements, an appropriate operating mode between the project owner, the operator and potential stakeholders and possible ways of strengthening them.
• Propose adjustments to the mode of governance, both functionally and contractually;
• Analyse the structure's existing financial data (annual budgets, balance sheets and certified accounts), which will enable the risk to be assessed in relation to the long-term viability of the operation;
• Propose a budget that takes into account the attendance and use of health services and other public health services, whether or not they are subsidised by the State or other partners (surveillance, vaccination, prevention campaigns, etc.); and that guarantees the correct distribution of income and expenditure between the project operators;
• Ensure consistency between the human resources available, their skills and the size of the infrastructure;

4.    Deliverable 4: The proposal report for technical support for the opening of the centre should include technical assistance for the health centre's manager and health professionals, in order to optimise the sustainability of the project. The study will have to size this technical assistance according to the needs identified, while taking into account the constraints linked to transport costs and local living conditions.

This technical support programme for the opening, aimed at the establishment's teams, should make it possible, among other things, to:

• Ensure a good match between the skills of the teams, the needs of the population and the priority activities expected;
• Proposals to make the centre and the island more attractive to healthcare professionals and, more generally, to improve territorial coverage in terms of healthcare professionals.
• Updating the establishment's statutes and regulations (taking care to address gender issues);
• Training in governance issues and tools, if necessary;
• Training in maintenance issues;
• Training/changes in organisation, if necessary;
• In addition to the transmission of epidemiological and health data, telemedicine support may be envisaged as part of the healthcare provision, and will therefore require an appropriate communication system (VSAT or other);