SUSTAINABLE MODEL FOR EYE HEALTH IN KENYA 138 views0 applications

Assignment: Establishing the cost of an Operational Eye Unit

1. Introduction

The Fred Hollows Foundation (The Foundation) is a secular non-profit public health organization based in Australia, which was founded in 1992 by eminent eye surgeon Professor Fred Hollows. The Foundation focuses on strengthening eye health systems and the treatment and prevention of avoidable blindness caused by Cataract, Trachoma, Diabetic Retinopathy, and Refractive Error. The Foundation operates in more than 20 countries across Australia, The Pacific, South and Southeast Asia, and Africa. The Foundation was named The Australian Charity of the Year 2013 in the inaugural Australian Charity Awards.

The Foundation began working in Kenya in 2004. The Foundation work in partnership with the Ministry of Health at both national and county levels, Community Based Organizations and private hospitals to deliver high quality eye health services. The Foundation in collaboration with Ministry of Health – Ophthalmic Services Unit seeks the services of a consultant to coordinate the Eye Care Situations Analysis in Kenya using the WHO Eye Care Situational Analysis Tool (ECSAT).

2. Background to Eye Care Situation in Kenya

The Sustainable Model of Eye Health Financing (SMEHF) project aims to reduce avoidable blindness in Kenya by enhancing equitable access to eye health services in seven counties. The project leverages existing public health financing mechanisms in line with the global and Kenya goals of Universal Health Coverage (UHC). The project aims to supporting ongoing health financing reforms, and support partners in tracking of revenue generated by health providers from various sources of financing, distribution and allocation for eye health services. The goal is to enable more patients, especially vulnerable groups, to access affordable eye care services. While also ensuring that facilities manage resources efficiently for sustainable eye health financing.

The project will ensure the implementation of eye health financing in alignment with national health financing policies, and legal frameworks, and the specific contexts and systems of each county. This will be achieved through objectives which include strengthening the institutional capacity of facilities, enhancing revenue generation, promoting efficient resource management, and upgrading eye units and workforce skills.

The project aims to realise the following specific outcomes.

1. Community members, service providers, and hospital management team (HMT) are aware of the SHI ophthalmic benefit package and claims management.
2. vulnerable populations (Women, Elderly and poor households) are protected via health insurance and are utilizing it for eye care services.
3. Performance based contracting and payment financing mechanisms are functioning at provider level and lessons are being learnt and applied from this new approach.
4. Equipment and commodities are sustainably available at partner facilities**.**
5. Strengthened Leadership, Governance and Evidence for Sustainable Eye Health Service
6. High-Quality cataract surgeries are delivered consistently across partner facilities and outreach programs.

3. Purpose of The Consultancy

This consultancy is being commissioned by the Fred Hollows Foundation to establish the cost of an eye unit based on the Standards of Opthalmic Care of the Ministry of Health in Kenya.

The purpose of the consultancy is to:

1. Conduct a needs assessment of a functional eye unit at (Level 4 and 5) eye clinic at level 3 and eye health services at level 2 in the counties of Makueni, Meru and Kisumu (In total 5 facilities will be assessed in 3 counties) and form basis for costing as per the Standards of Ophthalmic Services for Kenya).
2. Establish the cost of a functional eye unit at (Level 4 and 5), eye clinic at level 3 and eye health services at level 2 as per the Standards for Ophthalmic services of the Ministry of Health, Kenya.

The consultancy entails utilizing the available data on eye health facilities, reports on eye care situation, and ophthalmic services documents. The consultant will work closely with County Health Management Teams in Meru, Makueni and Kisumu to assess current needs of five eye health facilities and allocate costs associated with establishing a functional eye unit at levels 4 & 5 as well as an eye clinic at level 3 and eye health services at level 2 as per the Standards of Ophthalmic Care in Kenya. The aim is to establish current state of existing facilities and total cost of a functioning eye unit for effective planning and establishment of such facilities.

4. Scope of the Consultancy and Key Questions

Scope of the assignment:

The consultant is required to perform the following functions at minimum:

• Use county specific Eye Care Situation Analysis Tool (ECSAT) reports and facility assessment findings to establish the current state of eye care facilities in two counties
• Utilize the Standards for Ophthalmic Services document of the Ministry of Health, Kenya (copy to be provided) and other relevant official reference documents of the Ministry of Health to identify and cost ingredients associated with establishing an eye unit or eye clinic at various levels.
• Collaborate with the three counties to establish cost of a functional eye unit.
• Identify costs associated with improvement of existing eye care units or clinics in surveyed counties.
• Develop a report indicating the cost associated with establishing and operating a functional eye unit or eye clinic.

Key guiding questions:

• What is the current situation of eye care facilities in the counties of Meru, Makueni and Kisumu)?
• What is the cost of establishing a functional eye unit at levels (2,3,4 and 5) as per the guidance provided in the Standards for Ophthalmic Services of the Ministry of Health, Kenya?

Specific questions:

To address the two primary guiding questions, in consultation with FHF team, the consultant will formulate additional targeted questions to effectively gather the necessary information.

5. Approach

A). Situational Analysis and costing

The consultant is expected to design an appropriate methodology for this assignment. In addition, the consultant is expected to;

1. Review relevant literature and documents including (grey literature, reports and peer review literature) on situational analysis of standards of ophthalmic care and identify any gaps in relation to the Kenyan Standards of Ophthalmic Care.
2. Conduct interviews with relevant personnel at the selected three counties on costs of establishing a functional eye unit.
3. Conduct a survey at five eye care facilities in the three counties to gather information about the current state of existing eye care facilities and associated costs.

   B). Consultative Workshops

   4. Validation workshop: Conduct an analysis of data and share initial findings for validation with identified county stakeholders and Fred Hollows Foundation team and incorporate feedback before completing final report.

   C). Prepare final report

   Based on feedback from consultative sessions, consolidate a report with a summary of;

4. current state of eye unit or eye clinics in the selected three counties.
5. cost of establishing an eye unit as per Kenyan Standard of Ophthalmic care at the various levels (2,3,4,5) of care.

The consultant will be required to observe the quality and ethical standards as set out in The Foundation’s Evaluation Policy and Handbook.

Deliverables

1. Completed inception report with timelines and budget, approved by FHF
2. Completed data collection tools, approved by FHF
3. Completed interviews and data collection with relevant stakeholders
4. Completed planned validation workshops with relevant stakeholders as agreed with selected counties and The Foundation.
5. Submit draft and final report of the consultancy assignment
6. A summary PowerPoint slides deck of the key findings.

Schedule

The costing consultancy exercise is expected to last 27 working days encompassing data collection, validation and reporting.

Activity and Timeline

Consultant identification and onboarding (Advert, shortlists, interviews and contracting completed)

22nd August

Submit a draft inception report/ with clear timelines and budget

25th August

Consultancy initiation meetings with identified partners

By 29th August

Identification of key stakeholders for interviews

Finalise data collection tools in consultation with FHF

3rd September

Presentation of draft findings report

25th September

Input findings into the draft report

Final reports completed and disseminated to counties and copy submitted to FHF

30th September

A summary of findings on PowerPoint slides submitted to FHF

8th October

Consultants Team & Qualifications

Essential requirements

• Degree or master’s in economics, Health Economics/Financing, public health, international development or related fields
• Experience conducting costing studies
• Considerable experience in participatory approaches to research, gathering data and synthesizing the perspectives of various stakeholders
• Experience in strategic planning processes, public health and health services management
• Demonstrated understanding of eye health programming and emerging global public eye health issues
• Familiarity with various global, regional and local policies and instruments on provision of eye care services
• Demonstrated ability to lead consultative stakeholder engagements and generate quality reports
• Understanding of Kenyan health system and eye care context
• Experience of evaluation in private and public health sectors; and
• Understanding of eye health service delivery in Kenya

Management and Logistics

This consultancy has been commissioned by FHF, Kenya country office. The assignment will be coordinated by the Project coordinator supported by Health Financing Advisor and the Monitoring and Evaluation team from the Fred Hollows Foundation.

Person and Responsible for:

Project Coordinator

• Provide support to consultant to engage with selected partners as needed and to establish a core implementation team of the consultancy.
• Coordinate meetings with selected teams
• Support consultant entry into selected counties/ partners

FHF Kenya Country Director

• Approve TORs and budget for the project/consultancy
• Approve project plan and signing consultancy agreement
• Approve final consultancy report

Selected Partners (Counties)

• Facilitate letters of introductions and consultants’ access to selected hospitals
• Participate in interviews and workshops as planned by the consultants

Lead Consultant

• Develop clear implementation plan for the assignment, carry out field work, develop draft and final report and share findings and actions with relevant stakeholders
• Maintain regular communication with selected counties/ partners and update FHF on the project progress.
• Work according to appropriate professional and ethical standards; and FHF policies including child protection

Health Financing Advisor and Monitoring and Evaluation Manager

• Provide technical input throughout implementation phase and report writing

Procurement and Logistics Manager

• Provide support during contracting period.

CONFIDENTIALITY

The consultants agree to not divulge confidential information to any person for any reason during or after completion of this contract with The Foundation. Upon completion or termination of this contract, the evaluator/s undertake to return to The Foundation any materials, files or property in their possession that relate to the business affairs of The Foundation. The consultant is responsible for safety, security and administration of primary and secondary data collected from FHF or otherwise.

Intellectual Property

All intellectual property and/or copyright material produced by the evaluator/s whilst under contract to The Foundation remain the property of The Foundation and will not be shared with third parties without the express permission of The Foundation. The evaluator/s are required to surrender any copyright material created during the term of the contract to The Foundation upon completion or termination of the contract.

Safeguarding People

The Fred Hollows Foundation is committed to ensuring that its activities are implemented in a safe and productive environment which prevents harm and avoids negative impacts on the health and safety of all people, particularly children, vulnerable people, and disadvantaged groups. The Foundation has a zero-tolerance approach to sexual exploitation, abuse, and harassment of any kind. All personnel including contractors/consultants are expected to uphold and promote high standards of professional conduct in line with The Foundation’s Safeguarding People Policy including Code of Conduct. Contractors/consultants will be expected to sign and adhere to The Foundation’s Safeguarding Code of Conduct and provide any background checks as required.

INSURANCE

Any consultants involved in this evaluation will be required to have in place insurance arrangements appropriate to provision of the requirements in this Terms of Reference including travel insurance.

Ethical and other Considerations

The evaluator and evaluation team are expected to maintain high professional and ethical standards and comply with The Foundation’s Research and Evaluation Policy. The Foundation is committed to ensuring a safe environment and culture for all people, including children, with whom we come in contact during the course of our work. All members of the evaluation team will be required to comply with The Foundation’s Safeguarding People Policy and sign the Safeguarding Code of Conduct.