Tenders are invited for Theory Based Evaluation for Non-Communicable Diseases (NCD) Programme. Closing Date: 20 Feb 2026 Background The global burden of non-communicable diseases (NCDs) is increasingly recognized as a priority in humanitarian response. Humanitarian crises disrupt essential services, aggravate NCD complications, and heighten risks for displaced populations and vulnerable host communities. Yet robust evaluation of NCD interventions in crisis contexts remains rare, limiting our ability to determine what works, how, for whom, and under which conditions. To address these challenges, the Danish Red Cross (DRC) and local partners have launched the Collaborative Action for Resilient NCD Care in the MENA region (CARE), which will cover Lebanon and Syria from 2025 to 2028. CARE is an integrated programme, supported through two complementary funding streams: Novo Nordisk A/S (NN A/S): Focusing on scaling NCD service delivery in Syria and Lebanon, contributing to regional/global learning and advocacy. Novo Nordisk Foundation (NNF): Supporting service delivery and community-led prevention in Lebanon, with a strong emphasis on peer-support groups (PSGs) and global learning. The NCD CARE programme is implemented by the Danish Red Cross (DRC) in partnership with the Lebanese Red Cross (LRC), Palestinian Red Crescent Society in Lebanon (PRCS-L), Syrian Arab Red Crescent (SARC), and academic partners including the London School of Hygiene & Tropical Medicine (LSHTM) and the Lebanese University (LU), aims to advance sustained and equitable NCD care in humanitarian settings. The programme is structured around three mutually reinforcing pillars: Scaling NCD service delivery through PHCCs operated by LRC in Lebanon and SARC in Syria. Strengthening community-led prevention and self-care through Peer Support Groups (PSGs) and health awareness and education initiatives. Generating global evidence and advocacy through operational research and learning hubs. Rationale CARE combines health system strengthening, community mobilisation, and evidence generation in volatile settings. Standard monitoring captures reach and outputs but does not unpack how and why outcomes occur. The main objectives of the evaluation are: Examine not only what outcomes occur and how much but also how and why, for whom, and under what circumstances. Provide continuous learning throughout the remaining three years of the programme. Generate actionable evidence to inform programme adaptation and global policy. Capture synergies across both funding streams (NNA/S and NNF), while recognizing their distinct geographic and thematic contributions. Strengthen the Red Cross Red Crescent Movements leadership in generating global evidence on NCDs in emergencies. Purpose The impact from models of care for NCDs in humanitarian settings is important to document but is rarely done and even more rarely disseminated. This makes it difficult to determine what works, how, where and why. This is even more problematic as evaluation of effect and implementation of community-based interventions driven by community health volunteers and interventions at primary care level to provide quality care are considered top priorities for research on NCDs in humanitarian settings. In response to this gap, the Danish Red Cross is commissioning a theory-based evaluation, drawing on realist principles, for the Collaborative Action for Resilient NCD Care in MENA programme. The evaluation will use a realist approach to explore how and why the NCD interventions work (or do not), for whom, in what respects, over what duration, and under what circumstances. The aim is to generate actionable learning to inform programme adaptation and strengthen the global evidence base on NCD care in humanitarian contexts. The purpose of this evaluation is to: Develop the theory of change for the programme based on the learning and adapt the ways of working by leveraging incoming evidence of what works, for who and in what contexts. Support accountability and learning by documenting outcomes and unpacking causal pathways. Generate evidence for global advocacy, showcasing the effectiveness of Red Cross and Red Crescent (RCRC) models of NCD care in humanitarian contexts. 2. Objective Assess the outcomes of NCD models of care implemented under the two first CARE programme pillars. Identify mechanisms through which outcomes are achieved and the contextual factors that shape them. Examine for whom the programme is effective, and under what conditions. Document unintended or adverse outcomes. Translate findings into global learning and advocacy. 3. Scope of Work The scope of this consultancy focuses on the DRC programme Collaborative Action for Resilient NCD Care in MENA (Syria and Lebanon), implemented in Lebanon by LRC and PRCS-L and in Syria by SARC. The evaluation will span the full duration of the programme and accompany its implementation through an embedded, iterative and adaptive evaluation process, starting from 2026. Thematic scope: activities supported through the CARE projects which include Primary Health Care Service delivery, PSGs/self-care, resilience of PHCCs, medicines and HIS strengthening (to be further specified following the inception phase). It is preliminary envisaged this process to focus on NCD services at the Primary Health Care facilities. Geographic scope: Selected target areas in Lebanon and Syria, with phased sampling approach allowing testing the capacity building and data collection and analysis processes. Locations will be agreed with the partner National Societies at the inception phase. Stakeholders: Danish Red Cross, Host National Societies, evaluation team and research partners. Evaluation Design, Methodology and Approach The evaluation will adopt a theory-based and realist-informed approach, grounded in understanding how, why, for whom, and in what contexts the programme contributes to intended and unintended outcomes. The evaluator is expected to adopt an iterative, participatory, context-sensitive, and theory-driven approach using multiple methods as appropriate. The final methodological approach and data to be used in the evaluation should be clearly outlined in the inception report and fully discussed and agreed between DRC, key stakeholders and the evaluators. Realist evaluation principles, particularly the use of ContextMechanismOutcome (CMO) configurations, will guide the evaluation design and data analysis to uncover what works, for whom, in what respects, under what conditions, and why. The evaluation is foreseen to adopt a theory-based, realist-informed approach: Theory of Change (ToC) refinement through participatory validation. Context Mechanism Outcome (CMO) configurations to analyse causal pathways. If relevant, link with Complementary frameworks (PRISM, RE-AIM) to assess reach, adoption, and sustainability. It will be departing from what data is already being collected including observation and program documentations. The detailed methodology of data collection will be determined during the inception phase. Iterative design allowing adaptation to shifting humanitarian contexts. Participatory learning cycles integrated with programme review mechanisms. The consultant(s) will lead the design and technically oversee / provide quality assurance throughout the operationalisation of a comprehensive, embedded evaluative process. This process will be aligned with programme cycles and learning needs, and will include the following elements: Analysis of the initial Theory of change and development of hypotheses Review and refine the existing Theory of Change, mapping key pathways of change across the two outcome areas, identifying weak evidence links to be further explored in the evaluation. Co-design and co-facilitate participatory ToC workshops involving programme stakeholders, including service providers and users - to articulate and validate initial programme theories, including provisional CMO configurations, to be refined through evidence over time. Establish the iterative evaluation framework and evaluation workplan Co-develop an evaluation framework that integrates theory-based and realist principles, including initial CMO configurations, prioritization of evaluation questions, identification of data sources and methods appropriate to context Develop a realistic and adaptive workplan for implementing the evaluative processes for the four-year period, in alignment with programme milestones, and specifying timelines, roles and responsibilities Validate the evaluation framework and workplan with stakeholders in a participatory manner, ensuring buy-in, contextual relevance, and feasibility. Support the coordinate and/or co-manage the theory-based impact evaluation for the agreed scope and methodology established during the co-design phase. On the basis of the agreed evaluation workplan, coordinate or co-manage evaluation activities during the programme cycle, in close collaboration with DRC, implementing partners, and research institutions. Plan, implement and perform the first iteration of data collection interrogating the programe theory and as per agreed evaluation focus. For evaluation activities under the direct responsibility of DRC or partners, and subsequent iterations of data collection, provide a structured handover and supporting tools (where possible and appropriate), perform regular checks on data quality and on the overall adherence to the agreed upon evaluation workplan, methodology and standards of rigor. Develop practical implementation plans for data collection, analysis, and synthesis in subsequent iterations of data collection. Support the integration of evaluation activities with ongoing monitoring systems where appropriate. Contribute to capacity building and evaluation ownership within the core evaluation team and partners. Co-facili Tender Link : https://reliefweb.int/job/4196516/theory-based-evaluation-non-communicable-diseases-ncd-programme
