Fred Hollows Foundation 



The Ophthalmic Services Unit in Kenya has been coordinating eye health actors in the implementation of National Eye Health Strategic plan 2020-2025 in the last three years.

The National Eye health strategic plan presents the Ministry of Health’s five-year proposed strategies for eye care in Kenya. It sets the strategic direction for the National Eye Health Care System and presents information on the priorities, objectives, and indicators that the Ministry has adopted especially regarding the main eye diseases and conditions in the country and health system strengthening. The main diseases include Cataract, Trachoma, Glaucoma, Childhood blindness, Refractive errors, Allergic eye diseases and Diabetic complications in the eyes.

The strategic objectives in the plan are oriented to the WHO’s six building blocks of Health Systems and Kenya Health Policy framework investment areas and objectives. In addition, the strategic objectives are guided by the world report on vision launched in 2019.

The Ministry of Health and other eye health implementing partners intends to examine the progress towards achieving the objectives of the National Eye Health Strategic plan 2020-2025 by conducting a mid-term evaluation of the strategy.

Key strategic areas and objectives in kenya national eye health strategic plan

The eye care strategy was formulated in the framework of the National Health Sector Strategy which in turn is in line with the development strategy of Kenya. This strategy is expected to inform the County Eye Care strategy. Each county was, however, to develop their strategy based on the county burden of eye disease.

The Key strategic areas were developed according to the Kenya Health Policy Framework to include the following 8 thematic areas.

1. Eye Health Sector Governance

Key Objectives

  1. Improve Governance arrangements in eye health.
  2. Strengthen eye health partnership.
  3. Strengthen eye health stewardship.
  4. Ensure Continuous Quality Improvement and Assurance

2. Eye Health Care Financing

Key Objectives

  1. To define the different sources of funds for eye health and strategies to mobilize the resources, for implementation of eye health strategy.

3. Eye Health Service Delivery

Key Objectives

  1. Scale up inclusive and integrated strategies for management of eye diseases.
  2. Enhance community awareness and empowerment on eye health.
  3. Reduce the burden of visual impairment through delivery of integrated patient services.
  4. Provide palliative care for the blind (rehabilitate the irreversibly blind).
  5. Promote surgical outcome monitoring and service quality assurance.

4. Eye Health Human Resource

Key Objectives

  1. Avail adequate HReH at all levels of the health system

5. Eye Health Information Systems

Key Objectives

  1. Enhance collection and reporting of eye health data at all levels.
  2. Improve quality of data at all levels
  3. Promote utilization of data at all levels
  4. Promote data privacy and protection.

6. Eye Health Products and Technologies

Key Objectives

  1. Improve availability of eye drugs and products by strengthening the supply chain system
  2. Enhance quality of eye health commodities
  3. Promote use of innovation and technology in eye health sector

7. Eye Health Infrastructure

Key Objectives

  1. To develop/provide requisite infrastructure.
  2. Provide equipment for enhanced eye health service delivery.

8. Eye Health Research

Key Objectives

  1. Promote evidence-based decision making in eye health.
  2. Coordinate National research agenda in eye health.
  3. Promotion of Learning and teaching through conferences

Purpose of the evaluation

The objectives of the review are:

  • To review progress made to date against the objectives and outputs of the strategic plan as defined in the results framework including the quantitative and qualitative targets.
  • To assess the extent to which the NEHSP has gained traction at national and regional levels with partners and key stakeholders and whether it is making the anticipated contribution towards the realization of the intended objectives.
  • To analyse the relevance of the goals and outputs/outcomes identified in the strategic plan.
  • To analyse which, if any contextual changes (including Covid 19) may have influenced the implementation of the strategic plan and what, if any changes are needed during the remainder of the strategic plan period.
  • To draw lessons and make recommendations for the implementation of the strategic plan during the remainder of the period and for a potential review of the strategic plan.

Evaluation scope and key questions

This is a mid-term evaluation of the Kenya National Eye Health Strategic Plan that has been under implementation between 2020 to 2025. The following indicative evaluation questions will be used to assess the status of the strategic objectives in NEHSP. However, the consultant will have latitude to expand the key evaluation questions to adequately cover the evaluation.

Relevance: The extent to which NEHSP meets the needs and priorities of country.

  • Are the strategic plan’s goal, outcomes, and outputs still relevant and attainable?
  • To what extent is the strategic plan aligned to other initiatives or interventions by other eye health players?

Effectiveness: The extent to which the National Eye Health Strategic Plan has achieved its objectives

  • To what extent have the outputs of strategic objectives in the Eye Health Sector Governance pillar been achieved? What are the areas for improvement?
  • To what extent have the outputs of strategic objectives in the Eye Health Care Financing pillar been achieved? What are the areas for improvement?
  • To what extent have the outputs of strategic objectives in the Eye Health Service Delivery pillar been achieved? What are the areas for improvement?
  • To what extent have the outputs of strategic objectives in the Eye Health Human Resource pillar been achieved? What are the areas for improvement?
  • To what extent have the outputs of strategic objectives in the Eye Health Information Systems pillar been achieved? What are the areas for improvement?
  • To what extent have the outputs of strategic objectives in the Eye Health Products and Technologies pillar been achieved? What are the areas for improvement?
  • To what extent have the outputs of strategic objectives in the Eye Health Infrastructure pillar been achieved? What are the areas for improvement?
  • To what extent have the outputs of strategic objectives in the Eye health Research pillar been achieved? What are the areas for improvement?

Sustainability: The continuation of benefits of the NEHSP after the Strategic Plan period has ended.

  • Are the NEHSP activities/interventions likely to continue and be sustained?
  • Do activities of key eye health stakeholders align to the current eye health Strategic Plan?
  • Are the results sustainable beyond the term of the eye health strategic plan?
  • To what extent is eye health integrated into UHC? What policy guidelines exist/are required to anchor the strategy?
  • To what extent has the strategy been integrated into CIDP, HReH and financing at County level?

Recommendations: Provide practical recommendations on how to enhance the effectiveness of the NEHSP. E.g.

  • What are the priority actions and areas of investment to accelerate impact for remainder of NEHSP implementation based on what worked and what has not worked well?
  • What are the priority considerations for developing a successor to the NEHSP, including a) Improving alignment with the National Health Sector Strategy, b) Any gaps/improvements that should be included in successor strategy?
  • etc

SWOT Analysis

  • To what extent have changes occurred in the implementing environment that may be important to consider in the remaining implementation period of the NEHSP?


FHF Kenya, MOH and other development organizations in the eye sector will recruit a research consultant/institution to conduct the mid-term evaluation. The selected evaluation consultant will be required to prepare detailed research methodology in collaboration with MOH and Eye Health Technical Working Group (EHTWG). The consultant will be required to propose the right methodology for the evaluation but at the minimum the chosen methodology should be broad enough to accommodate both quantitative and qualitative methods.

Specifically, information to answer the evaluation questions will be gathered through the following processes:

  1. Review of eye health reports and documents e.g., TWG progress reports, Ophthalmic Services Unit (OSU) reports, and reports from eye health development organizations.
  2. Key informant interviews with eye health service providers and other key government departments. These will Include TWG members, OSU members, MOH planning and budgeting department, NHIF, County health management teams (CHMTs), eye health coordinators and development organizations in eye health etc.
  3. Review of Kenya Health Information System for eye service delivery data.


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

  • Evaluation/Inception Plan and methodology, including timelines.
  • Completed data collection tools in line with evaluation questions.
  • Presentation and validation of preliminary findings
  • Draft and final evaluation reports including summary report, summarized slide decks for dissemination of findings.

The Foundation and MOH will provide the following:

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


The mid-term evaluation is expected to start in September 2023 for an estimated duration of 30 working days. This will include desk reviews, fieldwork, interviews, and report writing and final presentation to internal and external stakeholders. The evaluation is scheduled to take place from September to November 2023 as the indicative schedule.

Activity Person Responsible Completion date

Finalisation of Mid-term Evaluation TOR FHF/MOH /EHTWG 18th August 2023

Contracting FHF/MOH /EHTWG 4th September 2023

Key informant interviews Consultant 24th September 2023

Data analysis and synthesis Consultant 24th September 2023

Draft Mid-term report Consultant 4th October 2023

Internal and external dissemination Consultant 16th October 2023

of Mid-term Evaluation Results

Final Mid-term Report Consultant 23rd October 2023

Evaluation team & qualifications

The consultant will preferably be a Public Health expert with the following competencies.

    1. Advanced training in Public Health, Health Systems, Health Economics, or related Fields
    2. At least 10 years of professional experience in undertaking health systems/programs management and evaluations.
    3. Experience in conducting health systems and program evaluations and designing strategies and action plans.
    4. A proven track record of developing strategic plans, with experience in Sub National, National, or global level engagements.
    5. A proven track record of professional execution of previous consultancies.
    6. Good knowledge of eye health sector and functioning of the Kenyan health system.
    7. Good knowledge of Health information systems, computer systems such as MS Office Suite (Word, Excel, Power Point, etc.).
    8. Excellent analytical and communication skills,
    9. A proven track record in analytical writing skills, with evidence of peer reviewed health systems publications.
    10. Provide previous sample work that is relevant to this study.


The consultant (s) agree to not divulge confidential information to any person for any reason during or after completion of this contract. Upon completion or termination of this contract, the consultant (s) undertake to return any materials, files or property in their possession that relate to the assignment. The consultant will be responsible for safety, security and administration of primary and secondary data collected.

Intellectual Property

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

Safeguarding People

The supporting partners and MOH are 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 partners and MOH have 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 Safeguarding People Policy including Code of Conduct. Contractors/consultants will be expected to sign and adhere to the Safeguarding Code of Conduct and provide any background checks as required.


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 relevant Research and Evaluation Policy and/or other guidelines. The partners are 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 partners’ Safeguarding People Policy and sign the Safeguarding Code of Conduct.

How to apply

This evaluation is being commissioned by The Fred Hollows Foundation in partnership with MOH/EHTWG. Individuals or institutions interested should submit a cover letter, resume, technical and financial proposals to The Foundation office in Kenya by 7th September 2023. Please reference “Consultancy to Conduct Mid-term Evaluation for Kenya National Eye Health Strategic Plan” and send to the following address: procurementkenya@hollows.org. Only submissions with complete documents as stated in the TOR and those meeting minimum requirements will be considered. Qualified consultants may be subjected to a background check on child protection as a condition for engagement.