DEVELOPMENT OF EMBU COUNTY EYE HEALTH STRATEGIC PLAN

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 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 Embu County Department of Health – Ophthalmic Services seeks the services of a consultant to coordinate development of an eye Health Strategic Plan for Embu County. In this regard, the Embu County Government (ECG) seeks to develop a county eye health strategic plan, to inform decision-making for eye health service provision in the county.

2.Background to eye care situation in Kenya

A recently concluded Rapid Assessment of Avoidable Blindness (RAAB) study in Kenya estimated that 136,869 people in Embu County have visual impairment, and that the degree and magnitude of visual impairment is high. Untreated cataracts and glaucoma were found to be the main causes of blindness, while uncorrected refractive error and untreated cataracts accounted for the majority of the moderate visual impairement. The burden of visual impairment is high, with one in every five persons aged 50 years and above suffering from some form of visual impairment with 5,041 already blind. Eighty percent of the causes of blindness and visual impairment are either treatable or preventable.

According to the same RAAB study, refractive error coverage is very low, with only 3.5% of those aged 50 years and above accessing spectacle correction. Further, only 36% of those requiring sight-restoring cataract surgery have accessed the service, of which 4 in every 10 patients had good outcome. The study also established that cost, low felt need, and lack of awareness about treatment options were the main barriers to accessing cataract services in Embu County. With a lean workforce of only one ophthalmologist for a population of 701,892, coupled with lack of optometrists and inadequate financing of eye services, access to quality eye care services in Embu County is significantly hampered.

Given this evidence, the study proposed the development of an eye health strategic plan to address the high burden of eye diseases. An eye plan provides priorities to addressing the burden of eye diseases in the county. The eye plan provides opportunities for county governments to consider budgeting and resourcing eye care services.

3. Purpose of the consultancy

This consultancy is being commissioned by the Fred Hollows Foundation on behalf of Embu County Department of Health with a purpose of developing an eye health strategic plan for the county. The consultant will liaise with the National Ministry of Health to obtain already collected Eye care Situational Analysis (ECSAT) data to generate background information for planning eye care services at the county levels.

4. Scope of the consultancy and key questions

The specific objectives of this assignment will be to:

• Conduct detailed literature review on eye health in the country and at Embu County level.
• Consolidate all the relevant data and information required for the development of an inclusive eye health strategic plan.
• Establish the status of inclusive eye health in Embu County while liaising with national Ministry of Health on already collected WHO ECSAT information and collect this when it is missing.
• Lead the workshops for drafting the eye health strategic plan.
• Seek consensus on priority needs.
• Develop and disseminate an eye health plan using agreed upon format.

5. Approach

The consultant/consulting firm is expected to adopt a participatory, evidence-based, and inclusive approach to develop the Strategic Plan for Inclusive Eye Health. The approach should include, but not be limited to, the following key steps:

• Situation Analysis: Conduct a thorough review of existing policies, programs, and data related to inclusive eye health through desk reviews and gap assessments. Data from ECSAT will be key.
• Stakeholder Engagement: Develop and implement a stakeholder engagement plan to ensure active participation from all relevant groups, eg Department of Health, Ministry of Education, TSC, NGAO, DPOs and county leadership.
• Data Collection: Employ tools such as surveys, interviews, and participatory workshops to gather insights on current challenges and opportunities.
• Workshops and Consultations: Facilitate workshops to validate findings, set strategic priorities, and co-develop the strategic plan with stakeholders.
• Apply relevant analytical tools (e.g., SWOT analysis, PESTEL analysis, Theory of Change) to assess the current state of inclusive eye health services and inform strategic priorities.
• Alignment with Policies and Standards: Ensure the strategic plan aligns with national health strategies, WHO guidelines, and international best practices for inclusive eye health.

Deliverables

• Inception Report outlining the methodology, detailed work plan, and timelines.
• A summary of the situational analysis report.
• Report on the process including stakeholder consultations and workshops.
• Hold consultative forums to seek consensus.
• A five-year strategic plan including results, resources and monitoring framework.
• Presentation Materials for dissemination and advocacy, including slide decks and summary briefs.

Schedule

This assignment is expected to be carried out for a period of 20-days. The consultant will develop a provisional work plan for undertaking this work within the stipulated period.

Activity

-Inception meeting and agreement on methodology and work plan.

Day 1-2

-Conduct situation analysis and desk review in collaboration with Embu County while liaising with national Ministry of Health on already collected WHO ECSAT information and collect this where it is missing.

Day 3 -7

-Data analysis and preparation of the situation analysis report.

Day 8-10

-Development of the draft Strategic Plan, including setting strategic objectives and proposed interventions in collaboration with department of health and other stakeholders involved in inclusive eye health.

Day 11-17

-Facilitate validation workshop to review the draft strategic plan with stakeholders.

Day 18-21

-Incorporate feedback and finalize the Strategic Plan.

Day 22-24

-Develop the Monitoring and Evaluation (M&E) framework and presentation materials.

Day 25-29

-Submission of the final Strategic Plan, M&E framework, and presentation materials.

Day 30

Consultants team & qualifications

• At least a master’s degree in a relevant field in planning, public policy, development studies, public health or related fields.
• At least five years professional experience in strategic planning and management.
• Prior working experience in health programs and specifically eye health is desirable.
• Demonstrated experience in working with government partners and other stakeholders in public sector development programs especially in capacity development.
• Evidence of having undertaken similar assignments.
• Experience in research, policy development, management and programming in related work.

Skills and competencies:

• Ability to work with minimal supervision.
• Must be result-oriented, a team player, exhibiting high levels of enthusiasm, tact, diplomacy and integrity.
• Demonstrate excellent interpersonal and professional skills in interacting with government and development partners.
• Skills in facilitation of stakeholder engagements/workshops.

Management and logistics

The development of Embu County Eye Health Strategic Plan 2025- 2029 is being supported by The Fred Hollows Foundation Kenya. The Consultant will work closely with Embu County department of Health services and Vision Impact Project for Inclusive Eye Health project staff to ensure delivery of the Strategic Plan.

Person- FHF Kenya Country Director

Responsible for:

-Approve and sign of consultancy agreement.

-Sign of approved strategic plan.

Person- FHF Kenya Programs Program Manager and designated focal person

Responsible for:

– Provide support to consultant to engage with MOH and county as needed and to coordinate logistics for development of the eye plan.

-First level approval of the strategic plan.

Person- FHF Kenya M&E Manager

Responsible for:

-Approve final Terms of reference.

-Approve strategic plan.

Person- Embu County Ministry of Health

Responsible for:

-Coordinate stakeholder engagements.

-Facilitate letters of introductions and consultants’ access to relevant government entities.

-Provide county level data and reports as required for the assignment.

Person- Lead Consultant

Responsible for:

-Develop clear implementation plan for the assignment, carry out field work, develop draft situational analysis report and share findings and actions for planning eye care; proactively engage with stakeholders on development of strategic plan; hold consultative workshops for presentation of findings and validation of priority actions.

-Present high-quality final reports as per terms of reference.

-Maintain regular communication with county health teams and FHF on the project progress.

-Work according to appropriate professional and ethical standards; and FHF policies including child protection.

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 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.