Tenders Are Invited For Mid Term Evaluation: Strengthening Systems For Eye Health Project In Rwanda.

Tenders are invited for Mid Term Evaluation: Strengthening Systems for Eye Health Project in Rwanda. Location: Kigali Deadline: Thursday, 13/11/2025 23:59 Evaluation TERMS OF REFERENCE STRENGTHENING SYSTEMS FOR EYE HEALTH PROJECT IN RWANDA SEPT 2023 JUNE 2027 MID TERM EVALUATION Introduction The Fred Hollows Foundation (The Foundation) is a secular non-profit public health organisation 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. Since 2006, The Fred Hollows Foundation (FHF) has partnered with Rwandas Ministry of Health to deliver eye care services. Initially focused on rural districts in Western Province (Zones 5 and 6), FHF expanded its reach between 20132016 to cover 22 public hospitals nationwide. This expansion included integration with primary eye care, specialist upgrades, surgical outreach, optometry development, and ophthalmology scholarships. In 2017, FHF launched the Rwanda Integrated Eye Health Sector Development (RIEHSD) project (20172021) to support improved cataract surgical output and integration into the national health system. From July 2019, the service delivery component transitioned into Rwandas Performance-Based Financing (PBF) model. There was recognition that though PBF would lead to a few health systems reforms, it would not of itself robustly address all the systemic bottlenecks affecting eye health service delivery in Rwanda. To address these systemic gaps, FHF initiated the complementary Strengthening Systems for Eye Health in Rwanda project (20232027), combining supply and demand side interventions. Project background The project is designed to address systemic gaps in Rwandas eye health sector identified in FHFs strategy. It complements the Performance-Based Financing (PBF) initiative by using a Health Systems Strengthening (HSS) approach to improve efficiency and sustainability. Key goals include increasing the number of skilled eye health professionals (especially ophthalmologists), raising the cataract surgical rate, and enhancing surgical quality. The project strengthens leadership, coordination, and supply chain systems, while addressing shortages in equipment, consumables, and maintenance expertise. It also tackles gaps in evidence and research for eye health programming. Strategic partnerships with RIIO, ROS, CBM, OneSight, National NGOs/CBOs and others are central to achieving inclusive and equitable outcomes, especially for women, men, persons with disability and other vulnerable groups. Operating across all 30 districts and the national Ministry of Health, the project has aimed to build a sustainable foundation for long-term eye health improvements through policy support and coordinated action. This project is supported by funding from The Fred Hollows Foundation and the Australian Governments Department of Foreign Affairs and Trade (DFAT). The Fred Hollows Foundation gratefully acknowledges the support from the Australian Government through the Australian NGO Cooperation Program (ANCP). Expected Outcomes and Outputs This project intends to achieve the following outcomes and outputs. Outcome 1: Strengthened eye health leadership and coordination at the district and national levels to drive effective eye health planning and budgeting. Output 1.1 Strengthened coordination between govt, NGO and private stakeholders towards realisation of the outcomes and targets in National Strategic Plan for Eye Health Output 1.2 Evidence from Cataract Surgical Business Case informs amount of CBHI reimbursement for cataract surgeries Output 1.3 Robust systems established to ensure eye health still functioning through PBF model following conclusion of the PBF project. Outcome 2:Human resources for eye health are trained, well equipped for productivity and quality, and appropriately deployed for effectiveness in service delivery. Output 2.1: Capacity of cataract surgical teams is strengthened and functioning optimally at hospital level. Output 2.2: Resident in ophthalmology students is trained and posted to target hospitals to effectively provide ophthalmic services including cataract management. Output 2.3: Systems and processes for cataract surgical quality assurance are established and institutionalized (including advocacy for productivity and quality in training) Output 2.4: Human resources for eye health planning for effective deployment and retention of skilled eye health workers is in place. Outcome 3:A strengthened, reliable and sustainable supply chain for eye health commodities and equipment is functioning optimally and independently procuring eye care equipment and consumables. Output 3.1: Output 3.1 Rwanda Medical Supply (RMS) independently coordinates, procures and ensures availability of eye care equipment and consumables to all public hospitals Output 3.2 Public hospitals are procuring eye health commodities from RMS. Output 3.3 Cataract surgical equipment and consumables are provided to select public hospitals Output 3.4: Eye care equipment maintenance and repair capacities is increased Outcome 4. Planning and monitoring systems for eye health resourcing are routinised and used in decision making. Output 4.1: Accurate and reliable eye health data is available from the national HMIS and PBF systems and utilized by eye health decision-makers at national and local levels. Output 4.2: Evidence of eye health monitoring are generated at the national and district level Output 4.3: Robust monitoring, evaluation and research systems is in place and findings inform improved eye health programming. Outcome 5:Increased equitable demand for engagement with and accountability in eye health services is generated. Output 5.1 Gender and disability analysis, on access to eye care services conducted, and findings inform programming. Output 5.2: Improved knowledge of service providers in gender equity for sustainable eye health services Output 5.3: Gender and disability are mainstreamed to increase access to eye health for persons with disability Output 5.4 Community members are aware of eye health and the benefits of CBHI and actively seek services. Outcome 6: A public private partnership model is established for increased access to quality eye health services to the last mile. Output 6.1: Scoping for eye care delivery model, through adoption of government hospital by RIIO is carried out. Output 6.2: Support for newly posted ophthalmologists is continued through ROS to enhance skills for quality surgeries. Output 6.3: Partnership established with private sector for reduced cataract backlog. Project partners Ministry of Health (DG of Planning, Health Financing, and Information Systems) Ministry of Health Department of Clinical Services Rwanda International Institute of Ophthalmology (RIIO) Rwanda Ophthalmic Society (ROS) Rwanda Ophthalmic Clinical Officers and Cataract Surgeon Society (ROCOCS) Rwanda Medical Supply Ltd Local NGOs Eye health NGOs including CBM, One Sight and Delvicchio Rwanda Social Security Board (RSSB) University of Rwanda Rwanda Mens Resource Centre (RWAMREC) National Union of Disability Organisations of Rwanda (NUDOR) Purpose of the evaluation The overall objective of this mid-term review (MTR) is to identify the key successes and challenges in project implementation to date, identify factors which have contributed to the project successes, and areas of weakness that have impeded progress. The findings of the review will be provided to the Foundations Rwanda Team, Program Division and Ministry of Health in Rwanda, with recommendations to all stakeholders on addressing identified challenges and inform ongoing project plans and practices. This may include recommendations on variations to project design in order to improve delivery for the remainder of the project, to be discussed with the donor and implementing partners The primary intended users of the mid-term evaluation will be; FHF Rwanda Team Rwanda MoH Rwanda Ophthalmology Society (ROS) Rwanda International Institute for Ophthalmology Relevant eye health NGOs These teams are involved in program implementation either directly or indirectly by providing support and guidance. Equally, the evaluation will also be of relevance to the following secondary users International eye health sector NGOs The Australian Department of Foreign Affairs and Trade (DFAT/ANCP). Evaluation scope and key questions HSS is a national health systems initiative designed to deliver outcomes across all 30 districts. As part of the program, an Accelerate a Clinic pilot is being implemented to strengthen the capacity of four district hospitals to increase cataract surgeries, aligned with the cataract business case. This evaluation will assess progress across the six defined program outcomes. The following indicative evaluation questions will guide the assessment. However, the consultant is encouraged to expand or adapt the questions as needed to ensure a comprehensive and contextually relevant evaluation. Relevance To what extent are the six program outcomes and associated strategies aligned with the key barriers to eye health service delivery in Rwanda? Are there additional outcomes or strategic priorities that have emerged and should be considered during the remaining period of the project to enhance its relevance and impact? Effectiveness What progress has been made toward achieving each of the six program outcomes and outputs? To what ext Tender Link : https://www.jobinrwanda.com/job/evaluation-terms-reference-strengthening-systems-eye-health-project-rwanda