Terms of Reference (ToR) – Operation Sight Evaluation -Trachoma Expert 74 views

About IIfPHC-E 

The International Institute for Primary Health Care — Ethiopia (IIPHCe), which was inaugurated on February 1, 2016, is envisioned to be a world class hub that will disseminate Ethiopia’s experience using Primary Health Care (PHC) approaches to achieve dramatic improvements in health. The Institute also strives to provide a global perspective—historical and current—of PHC experience around the world. The mission of the Institute is to proactively engage and drive the advancement of local and global PHC policy and programing. The Institute provides need-based capacity building training in PHC for trainees from Ethiopia, Africa and the rest of the world. Through PHC implementation research, the Institute provides up-to-date information on the strengths and weaknesses of Ethiopia’s own PHC program and contributes to continually building an even stronger PHC program that ensures fidelity to standards of care and high levels of service coverage for the population. To realize these aspiration, the Institute focuses on four programmatic areas: global support, local support, PHC advocacy, knowledge management, and capacity building.

Project Background

Trachoma is an infectious, bacterial eye disease that thrives where sanitation is poor and access to water for personal hygiene is limited. Prolonged trachoma infection can cause trichiasis – an advanced stage where the eyelashes turn inwards and painfully scratch the cornea, causing irreversible damage that can eventually lead to blindness. Besides being extremely painful, trichiasis may lead to long-term disability, reduced productivity in household and agricultural activities, and added economic pressure on often already deprived households.

WHO has targeted the elimination of blinding trachoma by 2020. Many countries have adopted the SAFE strategy that includes Surgery, Antibiotics, Facial hygiene and Environmental Sanitation. Creating access to trachomatous trichiasis (TT) surgery and providing quality service with low rates post-operative complications are critical to reaching the elimination target. However, with only one year left to achieve the 2020 target, Ethiopia has a backlog 310, 962 cases that need surgical intervention.

WHO recommends use of mid-level health professionals as part of its trachoma elimination strategy (WHO, 1999). Despite this recommendation, such professionals have always been in short supply in many countries including Ethiopia. According to the Ethiopian Ministry of Health (MoH) 2019 report, there are only 547 active integrated Eye Care Workers (IECWs) for the whole country. In places where there is access to these surgeons, however, some patients decline surgery for various reasons (Derje H. 2008, Saun N, 2012).

Operation Sight plans to train primary and secondary healthcare workers in trachoma management to build capacity at the MoH. These newly trained healthcare workers will be incentivised to locate and manage all remaining trichiasis cases, performing an estimated 310,962 surgeries, and provide follow-up care. Surgery kits will be procured and delivered, and a monitoring and evaluation strategy will be in place to monitor quality and progress in the targets. The investment emphasises capacity building within all levels of the MoH to ensure long-term sustainability of eye healthcare practices, delivered by the government and available to all Ethiopians without reliance on external implementation partners. Under this investment, approximately 1,094 new Eye Health Care Workers will be trained to conduct routine trachoma surgeries at a health post.

Specifically, the overall project objectives are to:

• Eliminate the TT backlog in endemic areas in Ethiopia
• Reduce the TT prevalence below 0.2%
• Reduce recurrence and reinfection of TT treated cases
• Improve the behavioural barriers to TT surgery uptake and,
• Build sustainable government capacity to retain and retrain IECWs

 The program objectives will be met through the following interventions:

• Recruitment, training, deployment, and continual evaluation of the IECWs
• Community sensitization and demand creation for TT surgery
• Monitoring the quality of TT surgery through individual follow up of cases using biometric methods and,
•  Building government capacity to sustain the project beyond the intervention period

Job Overview 

The trachoma expert will participate in the evaluation of the Operation Sight project, by providing technical support to the evaluation, and by actively engaging and support the evaluation team throughout the process. She or he will also use lessons learned from ongoing evaluation studies to increase the effectiveness the evaluation. In addition, he/she will provide support to the Institute and will share what the Institute learns at local and global levels.

Key responsibilities

• Provide overall technical support on the implementation of the Operation Sight evaluation project
• Provide technical support to develop assessment tools, methodologies, training guidelines and other works related to the evaluation
• Provide technical support during evaluation planning, trainings, data collection, analysis, and report writing
• Provide technical support to assure the quality of the Operation Sight evaluation during training, data collection and implementation of the evaluation
• Support evaluation operations working in close collaboration with trachoma implementation partners
• Conduct a regular review with the evaluation team
• Develop the evaluation work plan and ensure it is responsive to changing needs of the program.
• Write periodic progress reports.
• Support the Institute’s monitoring and evaluation activities locally and internationally

Location: International Institute for Primary Health Care – Ethiopia /IPHC-E

Funding Source: Children Investment Fund Foundation (CIFF)

Reports to:  PHC-E director

Contract term: Three months (August 2 -September 30) With possibility of extension upon on performance

Number of positions: 1

Education Background and work experience

• BSc in cataract surgery or Ophthalmic nurse, Msc/MPH in health and health related fields, and a minimum of 4 years’ experience
• BSc in Public health or nursing with experience in trachoma programs, Msc/MPH in health and health related fields, and minimum of 5 years of experience can also apply.
• Experience in research and evaluation works related to trachoma is a plus.
• Excellent oral and written communication skills in English.
• Proactively applies relevant local/ international best practices to own work
• Adapts own approach and style when interacting with clients, as opposed to requiring them to adapt
• Overcomes unexpected difficulties and challenges to produce desired outcomes