External Evaluator for the Baseline study

Lusaka, Zambia, Consultancy N/A

Orbis International is a nonprofit organization that works in Africa, Asia, Latin America, and the Caribbean. Our vision is to transform lives through the prevention and treatment of blindness. Without network of partners, we mentor, train and inspire local communities so they can save sight in their communities.
In Zambia, Orbis is a partner of the Ministry of Health and provides technical support to eye care teams to provide quality eye care in Lusaka, Copperbelt and Northwestern provinces.
Orbis seeks the services of a legally registered and qualified individual external evaluator to conduct a Baseline study for the “Strengthening Eye Health Capacity and Care in Lusaka, Copperbelt and Eastern provinces” project.
The consultant must have a license and Taxpayer Registration Certificate to justify the 15% withholding tax deduction or willing to have 15% of the overall payment retained with Orbis International Zambia as withholding tax and ultimately paid to the Zambia Revenue Authority.
If eligible, please submit your interest and technical and financial proposal in response to the TORs below by email within 7 working days of this announcement to the address seen below. The closing date for receiving the applications is close of business, 18th March 2022.
Interested applicants can look at the detailed Terms of Reference (TOR) attached to this advert and send their application to [email protected], copying in [email protected]
The successful consultant will be notified by 25th March 2022.
Orbis International Zambia reserves the right to reject any or all bids and proposals.
Orbis International Zambia
15 Kabulonga Road, Kabulonga, Lusaka.
Tel +260 211 265902/ Mobile 0763590963 | Zambia.
TOR for Baseline study
Project Title: Strengthening Eye Health Capacity and Care in Lusaka, Copperbelt and Eastern provinces project
1. Introduction and Background
1.1   Introduction:
These Terms of Reference (TOR) outline relevant details for Orbis International Zambia to hire a consultant to lead a Baseline study of the Strengthening Eye Health Capacity and Care in Lusaka, Copperbelt and Eastern provinces project.
Orbis International is a non-aligned, non-profit, global development organization on a mission to transform lives through access to quality eye health. To achieve its mission, it builds the capabilities of its partners through education and training, eye care management systems development, technical and financial support, and research. Orbis International (OI) manages four global programs – a Flying Eye Hospital, Hospital Based Programs, Fellowships, and Cybersight – and has country programs in Asia, Africa, Latin America, and the Caribbean.
Orbis International Zambia (OIZ) is branch of OI which was established in 20160 and works in partnership with the Ministry of Health. OIZ’s mission is to transform lives through the prevention and treatment of blindness and a vision of networking with partners, mentor, train and inspire local teams so that they can save sight in their communities. In Lusaka Province, Orbis works across all levels of eye health throughout the province’s six districts with a focus to support the University Teaching Hospital (UTH)-Eye Hospital’s priority capacity and equipment needs to ensure it has the infrastructure, operational capacity and staffing to provide comprehensive and equitable adult and pediatric eye health care services. Orbis has also employed learnings and proven models from previous work in Zambia to roll out community awareness and primary/district level capacity strengthening interventions in Lusaka province.
1.2   Background:
OIZ, with the support from the David and Molly Pyott Foundation, implemented a project called Strengthening Eye Health Capacity and Care in Lusaka that supported UTH-Eye Hospital to improve the structure of their residency program and enhance faculty capacity building through trainings and fellowships. UTH was also supported with equipment and consumables.  In its last year of implementation, the project extended the support to the district hospitals and 1st level hospitals, supporting them with training, equipment, drugs, and outreach services. This project was originally planned to end in December 2021, but an extension of three months was given to end in March 2022.
Towards the end of the project, funds were sourced from the same donor to have a phase II project where the services will continue for UTH eye hospital and the districts within Lusaka province. The support will be scaled up to Copperbelt and partly Eastern province. This study is meant to document the baseline at which the phase II project will start from. This will be the basis for setting targets in the new project and be used as a measure to assess the achievements.
2.1 Project goal: Improved quality and comprehensive eye heath care for all in Lusaka, Copperbelt and Eastern province
1.2 Project objectives:
a) To Improve human resources for eye health (HReH) increasing the number adequately skilled ophthalmology graduates and other eye care professional (tertiary to health center level)
b) To develop sustainable eye care services and systems improving clinical and operational capacity to provide comprehensive quality adult and pediatric ophthalmology services.
c) To increase demand for eye health services and investments in primary eye care
d) To improve enabling environment for the implementation of eye health policies in Zambia
2.3 Target population and project sites:
The beneficiaries are from the three provinces namely Lusaka, Copperbelt and Eastern province.  The University Teaching Eye Hospital, Levey Mwanawasa Teaching hospital, Kitwe Teaching Eye Hospital and Ndola Teaching Hospital are the highest referral hospitals in the country. The targeted beneficiaries of the project are both the residents and the faculty being capacity built while at the same time those that come to seek eye health services at these facilities. Being referral hospital, patients from all over the country are seeking eye health services. Patients are being referred from district hospitals and 1st level hospitals from within district in these provinces. Further, the residents go to their placements at Chipata general hospital and in turn they will offer services to the surrounding communities and those referred to the hospital.
Project Sites

UTH Eye Hospital, Levy Mwanawasa Teaching Hospital, Kitwe Teaching Eye hospital and Ndola Teaching Hospital: responsible for training residents, coordinating the outreach activities and the performance of static services and in the district facilities during outreach camps.
1st level hospitals: responsible for initial screening of patients as they receive referrals from the health posts. They also carry out community outreach screening and treating those that don’t need to be referred to the tertiary hospitals.
District hospitals (secondary level): deliver primary eye care and carry out outreach screenings in the community, and coordinates activities of the local Health Posts and Health Centers.

2.4 Project duration: January 2022 to December 2024.
2.5 Project partners: The Project will partner with Ministry of Health at all levels of implementation. Orbis Zambia has a Memorandum of Agreement (MOA) with the Ministry of Health which facilitates implementation of activities at all levels of the health structure hence the project will implement through the Ministry of health structures and staff. The facility staff will offer the eye health services while the project will offer support in capacity building and systems strengthening through equipment and consumables support as well as financial support for outreach activities and referrals.
2.6 Project strategy and approach:
With support from the David and Molly Pyott Foundation, Orbis will implement key strategic interventions to ensure that:
1. The tertiary hospitals deliver a high-quality residency training program that results in increasing numbers of competent ophthalmology graduates.
2. The UTHs Eye Hospital have improved clinical and operational (i.e., structures, workflow efficiencies, sustainability) capacity to provide comprehensive quality adult and pediatric ophthalmology services.
3. Demand for, and uptake of services by communities in Lusaka province.
4. National eye health issues are prioritized and promoted through robust engagement with key influencers, including national, regional, and local government officials, civic leaders and other community-based NGOs working in the region.
2. Objectives and Outcomes of the Baseline study
3.1 Baseline study objectives:

Establish baselines for the phase II target formulation on the project indicators.
Establish profiles for the facilities that will be supported in the phase II project
Identify opportunities for improvement from the phase I project.
Make recommendations which can inform strategies for the phase II project.

3.2 Baseline study outcome:
This study is meant to document the benchmarks against which achievements in the Phase II will be measured. The outcome of the study is to generate information and recommendations Orbis can use to improve the effectiveness and efficiency of the phase II project and/or the design of such future projects with similar goals and objectives.
3.3 Baseline study deliverables:
1. An inception package, outlining:
a. Study design and methodology. In the methodology section, detail:

Study approach
data collection tools and organization
sampling procedures
quality assurance
data analysis
ethical considerations

b. Work-plan
2. A presentation to Orbis International Zambia highlighting significant findings and draft recommendations before the end of field work.
3. A draft report to be reviewed and commented on by Orbis International Zambia.
4. A final report of maximum 40 pages, excluding annexes, but including an executive summary of maximum two pages.
5. A power-point presentation of the main findings, conclusions, and recommendations, suitable for Orbis International Zambia to use in presentation to stakeholders.
3.3.1 Structure of the final report
The report should be written in English and include the following sections:

Table of contents
Executive summary
List of abbreviations
Background: overview of project, strategy, and activities
Methodology: methods, limitations
Findings: Baseline on indicators and other qualitative project dimensions
Annexes: TOR; data collection tools; lists of interviewees, documents reviewed, sites visited; and disclosure of any evaluation team member’s conflict of interest, etc.

3. Study Scope, Questions, and Methodology
4.1 Scope of the evaluation:
This study will set January 2022 as the baseline period and a reference point for all achievements in the Phase II project, and the evaluator is expected to:

Outline the baseline study design and methodology including data collection instruments and detailed work plan.
Collect, compile, and analyze the data.
Produce draft and final baseline report.
Present the main findings, conclusions, and recommendations to Orbis Zambia and partner institutions.

The study will cover all the sampled districts which will be a representative of the 7 districts including 1st Level hospitals in Lusaka and the health centers where the phase I project was working in as mentioned above. Further, the phase II project will cover Copperbelt and Eastern (Only Chipata General Hospital). The study will need to establish the baseline on the phase II indicators in these areas. The evaluator should look at the last three years’ data to establish a trend have a good basis of setting targets for the phase II project.
4.2 Study questions:
1. How was the actual data flow in Phase I project? What were the challenges in Phase I and proposed solutions for Phase II? What were the original data sources for Orbis core & non-core indicators?
2. What are the starting points in terms of figures and percentages on both quantitative and qualitative indicators of the phase II project? (Note that the project indicators will be given to the consultant)
3. What is the capacity of the facilities where the project will be supporting (Level of care, catchment population, average patients seen and conditions/month, number of ophthalmic staff, equipment etc.)?
4. Those facilities that are using smart care software, how is the data flow before being entered in HMIS system? How are these applications being used by the government and how Orbis can tap from them? How useful were these tools in Phase I and how can we utilize them better in Phase II?
5. How is the patient flow currently in the facilities? What are the challenges and proposed solutions?
6. How is the ophthalmic staffing in the facilities?
7. How was the patient load (by Ophthalmic cadre and by gender) at the eye health facilities in Phase I? What were the challenges in phase I and proposed solutions for Phase II?
8. How was the patient flow between different departments/units at health facilities in Phase I? What were the challenges in phase I and proposed solutions for Phase II?
9. Was there a referral system in place in Phase I? If yes, please explain and how? What were the challenges in Phase I and proposed solutions in phase II?
10. Was there a quality assurance system in place at partner hospitals in Phase I? If yes, please explain? If not, why?
11. How are the facilities equipped with Ophthalmic equipment? Please list out name, number, and status (i.e., functional/ needs minor maintenance / needs major maintenance/ can’t be maintained and hence not functional at all)
12. How well are the facilities supplied with eye health drugs from the Ministry in Phase I and what medication comes to the health centre? What were the challenges in Phase I and proposed solution in Phase II?
13. Who were the partners supporting the facilities in Phase I? How was Orbis relationship with these partners? Are there new partners in Phase II?
14. How visible was Orbis in Phase I compared to other eye NGOs.  What were the challenges in Phase I and proposed solutions for Phase II?
15. What are the recommendations for a revised project with the same focus?
Please note that this information should come from data over the three years’ period.
4.3 Baseline study methodology:
The consultant is expected to design an appropriate methodology to answer the study questions. The methodology and data collection tools will be finalized in consultation with Orbis. Typically, the consultant is required to travel to project sites and have face-to-face discussions with various project stakeholders to gather required information. Currently the COVID-19 pandemic has reduced, and the consultant will have contact meetings with respondents.
The methodology should include:

A. Review of secondary data including but not limited to the project plan; M&E operational plan, data collection instruments, quarterly and annual progress reports; financial reports; medical/hospital data; and event reports, case studies, and special assessments/surveys. Retrieve core indicator data directly from the HMIS/records and analyse to unearth trends in volume of patient services provided (e.g., # of patient visits, # of surgeries performed, referrals, Ophthalmic drugs received by the facilities etc.) from partner hospitals, as well as validate data that has already been reported.
Collect and analyze data from eye health facilities.

B. Generate primary data via methods such as the following:

Interview health facility staff, management, and other key informants
Consult with relevant Orbis staff.
Conduct partner and beneficiaries’ satisfaction surveys using Orbis tools.

4.4 Selection of sites or partners for the baseline study:
The consultant is required to sample some sites using a method that will help select a representative sample of the total sites. The project is implemented in urban, peri urban and rural districts. This therefore means the health facilities are at different levels. Some districts have ophthalmic staff and others don’t have and this should be considered during sampling. The following factors should be considered while sampling.

Service delivery level (e.g., primary, secondary, or tertiary)
Geographical representations (e.g., rural vs. urban)
Facilities with Ophthalmic staff (Ophthalmologists, Ophthalmic Clinical Officers and Ophthalmic Nurses)

The following sites are the project implementation areas.
Provincial HQ
Primary, secondary & Tertiary
Ophthalmologists, OCO & ONs
Primary & Secondary
Primary & Secondary
Primary & Secondary
Primary & Secondary
Primary & Secondary
Ophthalmologists, OCO & ONs
Ophthalmologists, OCO & ONs
Eastern Province
Ophthalmologists, OCO & ONs
4.  Timeline and Tasks
Time frame
TOR shared with potential consultants
11th March, 2022
Proposals received from interested consultants
18th March, 2022
Consultant selected
25th March, 2022
Study design and tools developed
30th March, 2022
Inception meeting
4th April, 2022
Virtual consultation, key informant interviews, and secondary data analysis completed
11th April, 2022
Primary data analysis completed, and draft report submitted
28th April, 2022
Findings presented by the consultant
29th April, 2022
Orbis feedback on draft report provided
6th May, 2022
Final report submitted
13th May, 2022
5.       Expected Competencies of and Selection Criteria for the Consultant
6.1 Expected Competencies of the Consultant
The consultant should have:

At least a master’s degree in the field of public health/medicine/development studies/social science or other relevant discipline.
Experience in research and evaluation in health systems, public health, community health, community development, and eye health care services
Professional familiarity with hospital settings
Strong methodological skills in the development and implementation of data collection tools, data management, and analysis
Excellent written English and report writing skills
Oral and written proficiency in the local language

6.2 Evaluator Selection Criteria
Weight in Points
Technical proposal
Personal/Organizational Background
Relevant academic qualification (e.g., ophthalmology, public health, M&E, etc.)
Relevant experience (e.g., evaluation/ research/ survey in eye health)
Team (preferred over an individual evaluator)
Proposal Developed by Consultant
Proposed methodology
Proposed data management and analysis plan
Structure and presentation of proposal
Work plan/ time frame
Financial proposal
Proposed budget
Grand Total
Technical proposals must earn at least 52.5 points (75%) to be considered.
6.       Submission Checklist for Proposal
The consultant will submit a detailed proposal. The proposal must describe the methodology, tools, and analysis plan in detail. The proposal should be divided into two parts: technical and financial. The financial proposal will include the study’s estimated cost and list the consultant’s daily rate. The technical part will contain the following sections:
Background of the study company or organization
Detailed study methodology
Detailed work plan/timeframe
Consultant’s CV listing relevant experience
Proposals will be subject to a price and quality comparison.
7. Payment Schedule
1st installment (40%) will be made upon signing of the contract.
2nd installment (40%) will be made upon submission of first draft.
3rd installment (20%) will be made upon submission of final report.
8. How to Apply
Interested applicants are requested to summit proposal (technical and financial) and required documents on or before 18th March 2022 Application should be submitted via email to [email protected] copying in [email protected] Please mention “Strengthening Eye Capacity and Care II Baseline TOR” in the email subject line.
9. Considerations
10.1 Ethical Considerations:
The evaluation will respect human subjects’ considerations such as confidentiality of responses in interviews or discussions as well as any personal patient information (which will not include identifiers) and obtaining informed oral consent from patients participating in interviews or surveys.
10.2 Child Protection Policy:
The firm/individual shall comply with the Child Protection Policy of Orbis International. Any violation/ deviation in complying with Orbis’ child protection policy will result in termination of the agreement.
10.3 Binding:
All documents, papers, and data produced during the assessment are to be treated as Orbis property and restricted for public use. The contracted agency/consultant will submit all original documents, materials, and data to Orbis International Zambia.