CONSULTANCY FOR PROVISION OF TECHNICAL ASSISTANCE AND SUPPORTIVE SUPERVISION ON THE MANAGEMENT OF DIABETIC RETINOPATHY, 2024

FHF/NOVARTIS COMPREHENSIVE EYE HEALTH PROJECT

TERMS OF REFRENCE FOR PROVISION OF TECHNICAL ASSISTANCE AND SUPPORTIVE SUPERVISION ON THE MANAGEMENT OF DIABETIC RETINOPATHY, 2024

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.

Project Background

The goal of the project is to contribute to the reduction of the prevalence of blindness and visual impairment caused by Glaucoma and Diabetic Retinopathy in Kenya. The project seeks to increase equitable access to eye health services in Jaramogi Oginga Odinga Teaching and Referral Hospital 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 glaucoma and retinal eye health services across the patient pathway to improve patient eye health outcomes for poor and vulnerable communities.

The Comprehensive Eye Health Project is being implemented in Uasin Gishu and Kisumu between 2021-2024. The project addresses gaps identified in the counties that include low eye health literacy which is as 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, inadequate skilled human resources for management of Diabetic Retiniopathy, inadequate equipment and technology for timely diagnosis and management of Diabetic Retiniopathy, poor patient outcomes that has been impacted by late detection of the conditions, 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, and lastly, weak enabling health systems that hinders adequate planning and resourcing for eye health commodities.

The project aims to realise the following specific outcomes.

• Increased availability of skilled eye health workers for timely diagnosis and management of Diabetic Retinopathy at secondary and tertiary levels of care
• Increased availability of eye health equipment, supplies and commodities at secondary and tertiary levels of care
• Improved access to quality and specialized Diabetic Retinopathy services at all levels of care
• Improved leadership and governance for better planning and resourcing for eye health.

Purpose and Objectives of the Assignment

The purpose of the consultancy is to support institutional capacity building to achieve sustained impact in the delivery of quality and specialized Diabetic Retinopathy services. This will be achieved by providing technical support, mentorship and supportive supervision to the facilities for enhanced diagnosis and management of Diabetic Retinopathy. The exercise will ensure improvement in clinical and surgical skills among ophthalmologists in Diabetic Retinopathy diagnosis and management by

• Enhancing familiarity with and understanding of the major concepts and trends in the management of Diabetic Retinopathy.
• Exploring the latest guidelines for diagnosis, treatment and management of Diabetic Retinopathy.
• Undertaking a technical assessment and supportive supervision of Diabetic Retinopathy services at the Moi Teaching and Referral Hospital and Jaramogi Oginga Odinga Referral Hospital.

Scope of the Consultancy

The assignment shall entail technical assessment, provision of technical assistance, mentorship and supportive supervision on Diabetic Retinopathy to ophthalmologists at Jaramogi Oginga Odinga Teaching and Referral Hospital, and Moi Teaching and Referral Hospital. The consultant undertakes to perform the assignment with the highest standards of professional and ethical competence and integrity. The consultant is strongly encouraged to develop highly interactive and practical outputs for this consultancy.

The consultant is required to perform the following functions at minimum:

• Design the overall structure and content based existing resources and good practice in the management of Diabetic Retinopathy and summarise this in a manual for use and reference.
• Facilitate the transfer of clinical and surgical skills and knowledge on Diabetic Retinopathy through periodic mentorship and supportive supervision to the ophthalmologists.
• Undertake an assessment of existing gaps in Diabetic Retinopathy service delivery and produce a report with appropriate recommendations for improvement of eye health services
• Prepare a final report of the consultancy that includes assessment of the status of service delivery and suggestions to the management of the facilities.

Approach and Methodology

The consultant is required to prepare an experiential based technical assistance module which will allow the ophthalmologists to share and build upon their expertise, skills and knowledge on the management of Diabetic Retinopathy. This will be complemented by practical surgical sessions with the ophthalmologists. The final approach will be discussed and agreed upon with FHF team managing the project.

The consultant shall also undertake facility visits, physical assessment, interviews, administration of a questionnaire and report writing. He/she shall submit a report on the findings of the assessment and supportive supervision, recommendations and a plan of action to The Foundation.

Results and Deliverables

The consultant will provide the following:

• Detailed technical assistance and supportive supervision plan including timelines
• An inception report which details the methodology, approaches and tools for this consultancy and outlines a draft agenda/outline for the consultancy.
• Raw data collected/generated during the consultancy provided in an agreed format. A backup of raw data shall be provided on flash/hard drive.
• Draft and final technical assistance, assessment and supportive supervision reports including a summarized slides for dissemination of findings.

The Foundation will provide the following:

• Focal person to support in the undertaking the assignment.
• Feedback on the consultancy plan, methodology, approaches and tools.
• Support coordination between the consultant and partners during the assignment.

No Activity Man Hours

1. Development of a detailed technical assistance and supportive supervision plan including timelines

1 day

2. Preparation of inception report which details the methodology, approaches and tools for this consultancy -1 day

3. Preparation of agenda and an outline of the technical assistance and supportive supervision consultancy -2 days

4. Undertake facility visits for physical assessment, interviews, meetings, and technical assistance and mentorship sessions -4 days

5. Preparation and submission of draft and final reports for the consultancy -10 days

Duration/Schedule

The assignment involves one quarterly visits to each facility for the next two quarters. A detailed plan including logistics and dates will be discussed and agreed upon with the consultant.

Consultant Qualifications

The consultancy will be contracted to an independent and experienced consultant who will work closely with The Foundation staff in the design and implementation of the technical assistance and supportive supervision. The Foundation seeks to engage the services of an independent individual with the following experiences and expertise:

• A registered and experienced Vitreo-Retinal Specialist.
• Demonstrated experience in experience in developing and facilitating technical assistance and supportive supervision on Diabetic Retinopathy.
• Knowledge and a sound understanding of latest trends and strategies relating to treatment (clinical and surgical) and management of Diabetic Retinopathy.
• Experience in developing and delivering highly interactive and practical outputs for supportive supervision, training, mentorship and technical support.
• 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.
• Ability to work independently, proactively seek information and manage feedback and input.
• Excellent spoken and written communication skills in English.

Management and Logistics

The consultancy on technical assistance and supportive supervision on Diabetic Retinopathy is being commissioned by The Fred Hollows Foundation Kenya. The program team will work closely with the consultant to ensure delivery of timely and quality consultancy outcomes.

Confidentiality

The consultant 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 consultant undertakes 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 any data and information collected from FHF or otherwise.

Intellectual Property

All intellectual property and/or copyright material produced by the consultant 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 consultant is 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. The consultant will be expected to sign and adhere to The Foundation’s Safeguarding Code of Conduct and provide any background checks as required.

Insurance

Any consultant involved in this assignment 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 consultant is expected to maintain high professional and ethical standards and comply with The Foundation’s policies. 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. The consultant will be required to comply with The Foundation’s Safeguarding People Policy and sign the Safeguarding Code of Conduct.