Strengthening Vision 2020 Eye Care programmes in the northern provinces of Zimbabwe as well as urban tertiary eye care centres in Harare and Bulawayo

Mid-Term Review (MTR)

Terms of Reference

Background

The project which is being implemented in partnership with Zimbabwe Council for the Blind (ZCfB), CBM and the Ministry of Health and Child Care. CBM enjoys a long-standing relationship with Zimbabwe Council for the Blind (ZCfB) spanning over three decades. The project is being implemented in 5 out of Zimbabwe`s 10 Provinces reaching out to over 5,751,829 (2012 National census). The support with primary eye care is being provided in 3 Northern Provinces which are: Sakubva Eye Hospital (Manicaland), Marondera Eye Hospital (Mashonaland East), Norton Eye Hospital (Mashonaland West), while support of tertiary eye care facilities is being provided in 2 additional Provinces namely: Sekuru Kaguvi Eye Hospital (Harare) and United Bulawayo Hospital – Richard Morris (Bulawayo).

Currently there are 3 CBM supported Vision 2020 eye units in the Northern part of Zimbabwe which are: Sakubva Eye Hospital (Manicaland), Marondera Eye Hospital (Mashonaland East) and Norton Eye Hospital (Mashonaland West). All these Provinces share similar features with about 80% comprising rural population and the rest falling under the urban sector. The support of tertiary centres aims at further strengthening paediatric ophthalmology that was established with support from CBM in both hospitals. The project seeks to increase access to quality adult cataract surgery as well as unveiling affordable eye care services to the overall population.

The overall objective of the programme is to reduce avoidable blindness and visual impairment in all age groups in Mashonaland East, Mashonaland West, Manicaland, Harare and Bulawayo provinces.

The project aims to reduce avoidable blindness by providing regular and affordable eye health care services for adults and paediatric clients in Mashonaland West, East, Harare, Manicaland and Bulawayo provinces by 2020. (specific objective)

The programme encapsulates this through the following core result areas, namely:

Perform 4500 cataract surgeries in Mashonaland West Province
Training of eye health personnel in Mashonaland East, Mashonaland West and Manicaland Provinces
Perform 2350 cataract surgeries in Manicaland Province
Perform 2550 cataract surgeries in Mashonaland East Provinces
Support provision of paediatric and adult surgery at SKH
Support provision of spectacles to 30 000 clients in Mashonaland East, Mashonaland West and Manicaland Provinces
Support provision of low vision services at SKH – children eye unit
Support paediatric surgery at UBH – children’s eye unit
Support to coordination and administration in 5 provinces

Purpose, Objectives and Scope of the review.

Council for the Blind Zimbabwe seeks the services of a consultant to conduct a Mid-Term Review of the Strengthening Vision 2020 Eye Care programmes in the northern provinces of Zimbabwe as well as urban tertiary eye care centres in Harare and Bulawayo.

The MTR is intended to provide ZCfB and its partners (CBM and MoHCC) with an analysis of the status of the programme’s implementation, its achievements and challenges mid-way through its implementation and to produce evidence on the project’s effectiveness to inform improvement for the rest of the project’s lifetime. This review aims to assess the sustainability of the work that has been done so far and provide recommendations to local stakeholders about what needs to be done to consolidate/continue any gains (in terms of eye health services) made through this project.

The objectives of the mid-term review are to:

Reflect on the relevance, overall strategy and achieved results of the programme as well as to identify any strengths and weaknesses;
Inform improvements to the programme and its implementation;
To establish lessons learnt and identify future challenges to programme implementation.

Mid-term Review Team

The Mid-term Evaluation Team will comprise one external consultant, one ophthalmology expert, the Director and Project officer from CFB Head office and CBM country office Representative. The external consultant will act as the Team Leader and is responsible for the planning and delivery of the evaluation, and reports and recommendations. The project team of CFB will provide necessary support to provide context, documentation and will coordinate the field visit schedule.

Methodology

The underlying methodology for the proposed review is to: (a) obtain the relevant information from multiple sources - both primary and secondary, in the most cost-effective and realistic way, and (b) validate findings through triangulation. In order to deliver on this assignment, a mix of both qualitative and quantitative tools should be utilized to collect the data. The principles underpinning the evaluation will be independence, transparency, collaboration and direct participation with beneficiaries, key stakeholders and involvement with programme partners. The inclusion of persons with disabilities is a priority for CBM funded projects including the ability of said persons to access eye care services. Principles of disability inclusion should therefore be used throughout the assignment, meaning that part of the review team may be persons with lived experience of disability and that all methods applied shall be inclusive of persons with disabilities. This might make necessary the provision of reasonable accommodation (locations, accessibility, translations e.g. to sign language etc.).

The Review should include the following:

Desk review of all relevant project documentation and other materials such as the project design document (PDD), annual work plans, monitoring and evaluation framework, project and program reports, VISION2020 program guidelines, annual reports, policy documents and national and provincial level strategy documents.
Interviews and discussions with relevant personnel from CFB, project partners and other relevant stakeholders.
Site visits to selected partner hospitals and clinics, including discussions with eye doctors and nurses.
Site visits to selected communities, including discussions with Commune and Village Health Workers, School teachers, students and patients.
Brief verbal reporting after field trips to the Director CFB and CBM Country Manager to present lessons learned, findings and recommendations.
Submission of a final evaluation report, reflecting comments and feedback received.

Roles of the Consultant

Submit a proposal detailing proposed approach, cost and timelines for the MTR.
Participate in the inception meeting with ZCfB and CBM.
Develop data collection tools in consultation with ZCfB and CBM.
Collect data from identified sources.
Present findings to relevant stakeholders.
Develop and submit MTR report.

Roles of ZCfB and CBM

Finalise TORs for the review, select most appropriate consultant/s, manage contract and payment.
Provide relevant literature for desk research.
Organise appointments for interviews with partners.
Provide input into the development of MTR tools.
Approve final report and other deliverables.

Deliverables:

The expected outputs of the MTR are:

A comprehensive MTR report outlining the context, achievements, challenges and recommendations for the Strengthening Vision 2020 Eye Care Programme incorporating stakeholder input from the interviews. The CBM template for final evaluation reports shall be used (to be provided upon contract signature).