(ToR) for Final Evaluation of: “Strengthening Ophthalmic Care in the Regions of Addis Ababa, Oromia, SNNP, and Amhara in Ethiopia” Project

Terms of Reference (ToR) for Final Evaluation of: “Strengthening Ophthalmic Care in the Regions of Addis Ababa, Oromia, SNNP, and Amhara in Ethiopia” Project

 

Background

Cheshire Ethiopia (CE) is a registered Non-Governmental Organization (NGO) dedicated to the rehabilitation of children and youth with disabilities since 1962. Re-registered in line with proclamation No. 1113/2019 by the Federal Democratic Republic of Ethiopia Agency for Civil Society Organizations, CE provides comprehensive rehabilitation services to persons with disabilities (PwDs) at the federal level.

CE aims to increase access to quality and comprehensive rehabilitation services for children with disabilities and their families inclusively. CE’s services are decentralized across four strategically located underserved regions in Ethiopia, providing Institutional-Based Rehabilitation Services, Mobile Outreach Services, Community-Based Rehabilitation (CBR), and fostering partnerships and collaboration. The organization operates five rehabilitation centers and several Community-Based Inclusive Development (CBID) programs.

This Terms of Reference (ToR) is intended to recruit a qualified consultant firm to undertake the final evaluation of the project titled “Strengthening Ophthalmic Care in the Regions of Addis Ababa, Oromia, SNNP, and Amhara in Ethiopia,” facilitated by CBM and funded by BMZ and SDL, which has been implemented over the last three years.

 

General Objective

To conduct a comprehensive final evaluation of the project “Strengthening Ophthalmic Care in the Regions of Addis Ababa, Oromia, SNNP, and Amhara in Ethiopia” to assess the overall performance, effectiveness, efficiency, impact, relevance, and sustainability of the project’s interventions, and to provide actionable recommendations for future ophthalmic care projects and programs.

 

Specific Objectives 

The final evaluation aims to:

• Assess the relevance, effectiveness, efficiency, impact, and sustainability of the project’s interventions.
• Determine the extent to which the project has achieved its stated outputs and outcomes.
• Identify lessons learned and best practices for future ophthalmic care projects.
• Provide actionable recommendations to CE, CBM, BMZ, and SDL for enhancing similar future interventions.

Scope 

The final evaluation will assess the overall performance of the “Strengthening Ophthalmic Care in the Regions of Addis Ababa, Oromia, SNNP, and Amhara in Ethiopia” project, covering its implementation over the past three years. The evaluation will focus on the following key areas:

Geographic Coverage:

• Assess project activities in all target regions: Addis Ababa, Oromia, SNNP, and Amhara. This includes visits to key sites where services were delivered and activities were implemented.

Programmatic Components:

• Evaluate all project activities, including medical supply procurement, outreach services, surgical interventions, school-based eye care, capacity building, community awareness, advocacy efforts, and the establishment of referral linkages with government and community health facilities.

 

Evaluation Themes:

• Relevance: Determine how well the project aligned with the needs of beneficiaries and local priorities.
• Effectiveness: Measure the achievement of project outcomes, such as improved access to eye care services and capacity building.
• Efficiency: Assess resource use, including financial, human, and material, for delivering planned activities.
• Impact: Identify changes brought by the project, both positive and negative, intended and unintended, on the target populations.
• Sustainability: Evaluate the likelihood of continued benefits and the long-term sustainability of project outcomes.

Stakeholder Involvement:

• Engage a diverse range of stakeholders – including beneficiaries, healthcare providers, CE staff, partners (CBM, BMZ, and SDL), government officials, and community members – to gather insights and perspectives on project implementation and outcomes.

Time Frame

Cover the entire duration of the project from inception to completion over the last three years, analyzing progress, achievements, and any changes in context or scope.

Results Assessment

The final evaluation is expected to assess the achievement of key project targets, such as:

• The establishment and effectiveness of an efficient referral system, including the referral of school children, to ensure timely access to eye care services.
• The establishment of an eye unit and the strengthening of access to quality eye care services within the targeted regions.
• Review the capacity-building efforts for health professionals, specifically evaluating how their ability to provide quality eye care services has been enhanced.
• Examine whether the eye ward is fully equipped with the necessary tools and equipment for treating visual impairments and is operational as intended.
• Verify if people were screened for eye problems during outreach activities and evaluate the effectiveness of the screening processes.
• Assess the referral system’s effectiveness in ensuring that 9,000 people with visual impairments were directed to appropriate eye care and treatment services.
• Evaluate the successful completion of 4,500 cataract surgeries and the processes that ensured quality surgical outcomes.
• Review the establishment, furnishing, and functionality of the optical workshop, ensuring it meets the project’s objectives.
• Assess the training of eye unit staff members in monitoring the outcomes of cataract surgeries and the implementation of annual cataract audits to maintain high standards.
• Confirm whether pairs of glasses were prescribed and provided to individuals with low vision and assess the quality and appropriateness of these prescriptions.
• Evaluate the establishment and effectiveness of the outreach system, including the completion of outreach activities by the end of the project.
• Review the training provided to community health workers and school staff on identifying and referring individuals with visual impairments for appropriate treatment.
• Assess the strengthening of regional technical working groups on eye health (TWGs), led by the health offices of the target regions.
• Evaluate whether primary health care providers have gained the necessary skills to adequately treat eye problems or refer patients appropriately.
• Review the establishment of a referral network among 30 state health system structures (hospitals, health centers, and health posts) through signed Memorandums of Understanding (MoUs).

Methodology

The consultant is expected to propose a comprehensive methodology that includes, but is not limited to:

• Desk review of project documents, progress reports, and related materials.
• Qualitative and quantitative data collection through surveys, interviews, focus group discussions (FGDs), and site visits to project locations.
• Consultation with key stakeholders, including CE staff, local health authorities, community members, and beneficiaries.
• Triangulation of data to ensure validity and reliability of findings.

 

Deliverables

The consultant will be expected to deliver the following:

1. Inception Report: Detailing the evaluation design, methodology, data collection tools, and work plan.
2. Draft Evaluation Report: A comprehensive report covering all aspects outlined in the ToR.
3. Final Evaluation Report: Incorporating feedback from CE, CBM, BMZ, SDL, and other stakeholders. The report should include an executive summary, methodology, findings, conclusions, and actionable recommendations.
4. Presentation of Findings: PowerPoint presentation summarizing key findings, lessons learned, and recommendations to be presented to CE and stakeholders.

Duration of the Assignment

The evaluation is expected to be completed within a period of 45 days from the date of signing the contract. The consultant will submit a detailed work plan as part of the inception report.