SKILLS ASSESSMENT FOR EYE HEALTH WORKERS IN JOORTH AND MTRH

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. It operates in more than 20 countries across Australia, The Pacific, South and South-East Asia, and Africa. The Foundation was named The Australian Charity of the Year 2013 at the inaugural Australian Charity Awards.

The Foundation began working in Kenya in 2004, partnering with the Ministry of Health (MoH) to deliver comprehensive eye health care in the three hitherto districts (now counties) of Nakuru, Homa Bay, and Migori, evolving to eventually cover 13 counties based on the needs identified in the National Plan for Blindness Prevention (NPBP). Working in partnership with the MoH, The Foundation strives to improve access to high-quality eye health services through community empowerment, development of appropriate infrastructure to enhance coverage of effective eye health programs, and improvement of the quality of eye health workforce education and training through capacity strengthening of health professional training institutions.

Project Background

The Comprehensive Eye Health project has the overarching goal of contributing to the reduction of the prevalence of blindness caused by cataract, Glaucoma and diabetic retinopathy in Kenya.The project seek to increase equitable access to eye health services in Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTH) in Kisumu County and Moi Teaching and Referral hospital in Uasin Gishu county. This is done by strengthening the capacity of the health system to provide high quality cataract, glaucoma, and retinal eye health services across the patient pathway, to improve patient eye health outcomes for poor and vulnerable communities.

The two counties were identified as a pilot to the partnership between Novartis and The Fred Hollows Foundation in Kenya. The project will address gaps identified in the counties that include Low eye health literacy which is a result of inadequate integration of eye health into the health system hence patients missing critical opportunities for early detection, referral and treatment: Fragmented patient pathway and weak service delivery capacity leading to situations where people who are identified as needing further screening, monitoring or treatment by an eye health specialist, often do not seek or reach the services they need: Lack of skilled human resources for eye health where they are needed: Poor patient outcomes that has been impacted by late detection of disease, people’s inability to return to secondary and tertiary services multiple times for ongoing treatments, and the high cost of complex and long-term management mostly for glaucoma and retinal diseases. Lastly, weak enabling health systems that hinder adequate planning and resourcing for eye health commodities.

The project aims to realize the following specific outcomes.

• Strengthened eye health literacy and service-seeking behavior through improved integration into community health care and effective eye health referral pathways.
• Improved access to qualitycataract, glaucoma, and diabetic retinopathy services at all levels of care.
• Increased availability of eye health supplies and commodities through the implementation of enabling policy and stronger supply chain management.
• Improved leadership and governance for better planning and resourcing for eye health.

Purpose of the Assessment

The purpose of this assessment is to determine the skills and knowledge levels of the eye health workers in JOOTRH and MTRH. The assessment will provide a clear picture of eye health workers’ skills and expertise, and any skills gaps. A detailed analysis of the skills for eye health workers will help in creating focused training plans that overcome skill gaps within the eye health teams. With the assessment data, the decision-makers can allocate the right resources for capacity building for eye health workers.

Scope of the Assessment

The assessment will focus on the following.

• Identification of various eye health workers and their roles at JOOTRH and MTRH
• An assessment of general ophthalmic skills among different cadres eye care workers
• An assessment of specialized ophthalmic skills in disease areas such as DR and Glaucoma
• An assessment of proficiency in the identification and use of eye care equipment
• Identification of skill gaps and impact on eye health service delivery
• Identification of training needs and develop a program

Approach and Methodology

FHF Kenya will select a consultant/institution to conduct the skills assessment for eye health workers. The selected consultant will be required to prepare a detailed research methodology in collaboration with FHF Kenya. The consultant will be required to propose the right methodology for the assessment and data collection methods including quantitative and qualitative data collection, desktop literature reviews, and key informant interviews.

Deliverables

The following deliverables are expected from the consultant in completing the assignment:

• Detailed skills assessment plan and methodology including timelines
• An inception report.
• Completed data collection tools for the assessment
• Presentation and validation of findings and recommendations
• Draft and final assessment reports including summary report summarized slide decks for dissemination of findings.
• Raw data collected/generated during the assessment provided in an agreed format. Interview transcript shall be compiled and labeled. A backup of raw data shall be provided on flash/hard drive.

The Foundation will provide the following:

• Focal person to support in undertaking the assignment
• Provide documents required for desk review.
• Give feedback on the assessment plan and methodology
• Provide feedback on draft data collection tools, reports and other deliverables.
• Support coordination between the consultant and partners during the entire assessment activities.

Schedule

The assessment is expected to start in March 2023 for an estimated duration of 20 working days. This will include desk reviews, fieldwork, interviews, and report writing and final presentation to FHF. Data collection will take place specifically in the two facilities i.e. Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu and Moi Teaching and Referral Hospital, Eldoret. A detailed plan of key assessment events will be discussed and agreed with the consultant.

Evaluation Team and Qualifications

The skills assessment will be contracted to an independent and experienced consultant or team who will work closely with The Foundation staff in the design and implementation of the exercise. The Foundation seeks to engage the services of an independent individual or registered organization, that have following experiences and expertise in eye health human resource skills assessment.

At least a Master’s Degree in Ophthalmology, Public Health or related health sciences.

• Demonstrated experience in skills assessment for eye health workers including health systems assessments.
• Experience in the development and use of quantitative and qualitative data collection tools and assessment methods.
• Strong knowledge and experience working with the Kenyan health care systems and overall understanding of Kenyan health sector policies, especially on human resources for eye health.
• Strong analytical skills
• Ability to work independently, proactively seek information and manage feedback and input.
• Excellent spoken and written communication skills in English

The following additional skills and experience are highly desirable:

• Knowledge and experience in eye health and a sound understanding of programs and strategies relating to eye health in Kenya

Confidentiality

The evaluator/s agrees 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 work of The Foundation. The consultant will be 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 copyrighted 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 that 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.