To Conduct A Comprehensive Situational Analysis Of The Eye Health System Within The Assigned State/assessment Area And Provide Evidence-based
full-time
Terms of Reference for Situation Analysis SITUATION ANALYSIS (SITAN) SUMMARY Project ID and Program/Project Name P11150 – SightQuest Nigeria Programme Project start and end dates; phase of project if applicable 2026 - 2031 Evaluation Purpose To conduct a comprehensive situational analysis of the eye health system within the assigned state/assessment area and provide evidence-based recommendations for strengthening eye health services and improving access to quality eye care. Evaluation Type Situation Analysis (SITAN) Location Jigawa, Imo, Abia/Rivers, Plateau, Borno, Adamawa, Ogun & Kogi States. Contracting organisation/contact person CBM CO Nigeria Evaluation Team members (if known) External Consultants – not yet identified Primary Methodology (Mixed Methods; quantitative and qualitative methods) Proposed Evaluation Start and End Dates September – October 31st, 2026 Recipient of Final Evaluation Report CBM Country Office (CO)Nigeria 2. PROJECT DESCRIPTION Blindness and severe visual impairment (SVI) remain major public health challenges globally, particularly in low and middle-income countries where access to quality eye care services is limited. In Nigeria, cataract and uncorrected refractive errors continue to be the leading causes of blindness and visual impairment, while emerging conditions such as diabetic retinopathy and age-related macular degeneration (ARMD) are contributing to an increasing burden of eye diseases. Access to eye health services is often constrained by inadequate financing, shortages of trained personnel, weak health information systems, insufficient infrastructure, and gaps in the implementation of existing policies and strategies. To address these challenges, CBM is implementing SightQuest Nigeria Programme, a ten-year programme aimed at strengthening eye health systems and scaling up inclusive eye health services across 14 states in Nigeria. The programme seeks to eliminate avoidable blindness and severe visual impairment by improving access to quality, affordable, and inclusive eye care services. The main objective of the programme is to increase effective cataract surgical coverage (ECSC) by 30 percentage points and (EREC) effective refractive The SightQuest Programme seeks to employ a health systems strengthening approach that addresses gaps in service delivery, human resources, infrastructure and equipment, financing, governance, and health information systems. The main areas of intervention include strengthening district eye health programmes, improving access to primary eye care services, establishing vision centres and eye centres, improving referral pathways, enhancing the quality of cataract surgical services, and strengthening sustainable financing for eye health services. Programme implementation will be phased, beginning in Bauchi and Oyo States in 2026, and subsequently expanding into Imo, Jigawa, and Plateau States before scaling to all 14 target states by 2029. Given the diverse contexts and varying levels of eye health system development across states, there is a need for a comprehensive situational analysis to generate evidence for effective planning and implementation. The situational analysis will assess the eye health system using the World Health Organization (WHO) Health System Building Blocks Framework and provide a clear understanding of the status of eye health services, resources, policies, and systems within each selected state. To facilitate a context-specific and comprehensive assessment, one consultant will be engaged per state to lead the Situation Analysis (SITAN) process. Each consultant will work closely with relevant state-level stakeholders and the SightQuest Programme team to collect, analyse, and validate data on the eye health system, identify key gaps and opportunities, and develop a state-specific SITAN report. The findings will provide an 3 evidence base for prioritising interventions, informing programme design, and guiding implementation within each state. The SITAN will be implemented as separate state-specific consultancy assignments. One consultant/consulting firm will be engaged for each assigned state/assessment area. Each engagement will cover one state/assessment area only and will result in one standard, state-specific SITAN report. The consultancy is therefore not intended to produce one comparative or consolidated report covering all selected states. For the purpose of this assignment, Abia/Rivers will be treated as one combined assessment area and will result in one consolidated Abia/Rivers SITAN report, subject to the final procurement structure. Each consultant/consulting firm will be responsible for the full SITAN process within the assigned state/assessment area, including stakeholder engagement, data collection, analysis, validation of findings, and preparation of the final report. A standardized assessment framework, methodology, and agreed tools will be applied across all assignments to promote consistency and comparability of findings, while allowing sufficient flexibility to capture state-specific priorities, gaps, opportunities, and contextual factors. 3. SITAN OBJECTIVES AND INTENDED USE Specifically, the situational analysis aims to: 1. Assess the status of eye health services in the assigned state/assessment area using the WHO Health System Building Blocks Framework. 2. Determine the strengths, weaknesses, opportunities, and threats (SWOT) within the State eye health system, particularly in relation to: Leadership and Governance; Health Financing; Human Resources for Eye Health; Service Delivery; Medical Products, Equipment and Technologies; and Health Information Systems. 3. Assess the management structure and implementation challenges of existing CBM-supported eye health programmes in the assigned state/assessment area, where applicable. 4. Evaluate the availability, accessibility, quality, and inclusiveness of eye health services across primary, secondary, and tertiary levels of care. 5. Identify barriers and facilitators to accessing eye health services, especially among vulnerable and marginalized populations, including persons with disabilities. 6. Map key stakeholders, programmes, facilities, workforce, and resources supporting eye health service delivery in the States. 7. Generate baseline information and actionable recommendations to guide strategic planning, programme implementation, policy development, advocacy, resource mobilization, and future investments under the SightQuest Nigeria Programme. The findings from the situational analysis will provide the evidence base for strengthening sustainable, equitable, and inclusive eye health systems and will inform the design, implementation, and scale-up of the SightQuest Nigeria programme in the selected states. 4. SCOPE OF THE EVALUATION The situational analysis will be conducted between September and 31 October 2026 and will cover the eye health systems of the selected assessment areas: Imo, Abia/Rivers, Plateau, Borno, Adamawa, Ogun, and Kogi States. The assessment is being undertaken within the framework of the SightQuest Nigeria Programme, a ten-year CBM initiative aimed at strengthening eye health systems and scaling up inclusive eye care services to eliminate avoidable blindness and severe visual impairment. The scope of the assessment will cover the eye health system across the six WHO Health System Building Blocks, namely: leadership and governance, health financing, human resources for eye health, service delivery, medical products, equipment and technologies, and health information systems. It will also assess the management structure and implementation arrangements of existing CBM-supported eye health programmes where applicable. The assessment will examine a range of interventions and service delivery approaches, including district eye health programmes, primary eye care services, referral pathways, vision centres, eye centres, cataract surgical services, workforce, and financial systems that support access to eye care services. Geographically, the assessment will be conducted across the selected states and will include a representative sample of eye health facilities and stakeholders at the primary, secondary, and tertiary levels of care. Data will be collected in selected Local Government Areas (LGAs), health facilities, communities, and relevant institutions within each state to ensure adequate representation of the eye health system while remaining feasible within the evaluation timeline and resources available. 5 Each state consultant will be expected to apply a standardized assessment approach and agreed tools to facilitate consistency and comparability across states, while allowing sufficient flexibility to capture state-specific priorities, gaps, opportunities, and contextual factors. The findings from the individual state assessments will serve as an evidence base for prioritising interventions, informing programme design, and guiding the phased implementation of the SightQuest Nigeria Programme. The consultant shall undertake the following activities: A. Inception Phase Review relevant national and state policies, strategic plans, reports, publications, and available eye health data. Review the material collected by the Consultant for the State National Eye Health Policy domestication process. Conduct stakeholder consultations with key actors. Develop and submit an inception report outlining methodology, workplan, sampling approach, and data collection tools. B. Data Collection The consultant shall adopt a mixed-method approach involving both quantitative and qualitative methods. Activities shall include: Desk review of relevant literature and programme documents. Collection of secondary data from health facilities and government institutions using: Relevant sections of the CBM DECSAT Tool (District Eye Care Situation Analysis Tool) any data collection tools deemed fit by the consultant Assessment of all eye care facilities across the State using a desk review tool in consultation with the facility leads. Key Informant Interviews (KIIs) with relevant stakeholders. Focus Group Discussions (FGDs), where applicable. Stakeholder consultations. Key Informants may Include: State Ministry of Health representatives. State Eye Health Committee members. Representatives of the National Eye Health Programme. Ophthalmologists and other eye health professionals. Professional associations. Development partners and NGOs working in eye health. Representatives of Organizations of Persons with Disabilities (OPDs). Community and traditional leaders. Beneficiaries of eye health services. 5. LIMITATIONS Several factors may affect the scope and implementation of the assessment: Availability and quality of secondary data may vary across states, facilities, and institutions, particularly for eye health indicators and programme records. Security and accessibility challenges may limit travel to certain locations, especially in parts of Abia, Borno, Imo and Adamawa States. Availability of key stakeholders for interviews and consultations may affect the scheduling of field activities. Logistical constraints, including distances between facilities and communities, may limit the number of locations that can be visited within the available resources. Where access constraints arise, the consultant may complement face-to-face data collection with virtual interviews, telephone consultations, and online meetings while ensuring adequate participation of key stakeholders. Attention shall be given to ensuring inclusion of persons with disabilities and other vulnerable groups regardless of the engagement approach. 6. TARGET AUDIENCE AND LEARNING The findings will be used to establish baseline information for the SightQuest Nigeria programme implementation, Inform state-specific programme design and prioritization, strengthen eye health system planning and coordination, identify priorities for programme implementation, resource mobilization, and eye health system strengthening, support advocacy and policy development for inclusive eye health services, inform future monitoring, learning in the SightQuest Programme. The consultant will facilitate learning through engagement with relevant eye health stakeholders, findings and recommendations will be presented in accessible language and formats to ensure they can be easily understood. State Ministry of Health representatives. State Eye Health Committee members. Representatives of the National Eye Health Programme. Ophthalmologists and other eye health professionals. Professional associations. Development partners and NGOs working in eye health. Representatives of Organizations of Persons with Disabilities (OPDs). Community and traditional leaders. Beneficiaries of eye health services. 7. EVALUATION QUESTIONS Recommended Approach The assessment questions will focus on the six WHO Health System Building Blocks within each of the selected states of the Situation Analysis. Governance and Leadership What policies, strategies, governance structures, and coordination mechanisms currently support eye health service delivery in the State? How effective are existing leadership and accountability mechanisms for the eye health programme? What opportunities exist to strengthen governance and coordination within the eye health system? Health Financing What financing mechanisms currently support eye health services in the state? How adequate and sustainable are existing financing systems/mechanisms on eye health in the state? What are the major financing gaps affecting service delivery and access? Human Resources for Eye Health What is the current availability, distribution, and capacity of eye health personnel? What workforce gaps exist across different levels of care? What capacity-building and workforce development needs should be prioritized? Service Delivery What eye health services are currently available at primary, secondary, and tertiary levels? To what extent are eye health services accessible, equitable, inclusive, and people-centred? What referral systems exist and how effectively do they function? Medical Products, Equipment and Technologies What eye care equipment, medicines, technologies, and consumables are currently available? What challenges affect availability, maintenance, functionality, and supply? Health Information Systems How effectively is eye health information collated, reported, analyzed, and utilized? What data quality, reporting, and utilization gaps exist? Access, Equity and Inclusion What barriers influence access to eye health services? To what extent do eye care services meet the needs of persons with disabilities within the state? How accessible are facilities, information, communication, and referral systems for persons with disabilities? Stakeholders and Partnerships Who are the key stakeholders supporting eye health service delivery? What opportunities exist to strengthen collaboration, coordination, and resource mobilization? Sustainability and Future Programming What systemic strengths can be leveraged during SightQuest implementation? What priority interventions and actions are required to establish sustainable, inclusive, and people-centred eye health programmes? CBM Programme Quality Principles The assessment should also examine: Equality and inclusion within service delivery. Gender responsiveness of eye health services. Accessibility and universal design considerations. Participation of persons with disabilities and OPDs. Safeguarding mechanisms within health facilities and programmes. Advocacy opportunities for strengthening eye health systems and inclusion. 8. METHODOLOGY The consultant shall employ a mixed-methods approach combining quantitative and qualitative techniques and guided by the WHO Health System Building Blocks Framework. This approach includes: Quantitative Methods Facility assessments. Review of routine health information and service delivery data. Workforce and infrastructure mapping. Analysis of eye health service statistics. Qualitative Methods Key Informant Interviews. Focus Group Discussions. Stakeholder consultations. 9. EXPECTED RESULTS The consultant shall submit the following deliverables: Deliverable 1: Inception Report Including: Detailed methodology. Workplan and timeline. Data collection tools. Stakeholder mapping. Deliverable 2: Draft Situational Analysis Report and filled DECSAT The report, limited to no more than more than 25 pages (Inclusive of figures and annexes) shall include: Executive Summary. Brief Introduction and Background information of the State Eye Health programme. Methodology. Findings organized according to the WHO Health System Building Blocks. SWOT Analysis. Conclusions and Recommendations. The filled DECSAT is separate from the consultant's report. Deliverable 3: Review and validation process Presentation of key findings and recommendations to stakeholders for review and feedback. Draft report circulated to the state eye health desk officer to collate review from the State. Deliverable 4: Final Situational Analysis Report Incorporating comments received during the validation process. Deliverable 5: Clean Dataset and Supporting Documentation Including: Interview transcripts. Data collection tools. Facility assessment records. Data analysis outputs The consultancy is expected to be completed within 30 days of contract signing. The timeline is as follows: S/N ACTIVITY DURATION 1 Inception meeting, document review, methodology development 5 days and submission of inception report 2 Stakeholder consultations and key informant interviews 5 days 3 Field data collection and facility assessments across selected states 12 days 4 Data cleaning, analysis, and synthesis of findings 3 days 5 Draft report preparation and submission to CBM for review 3 days 6 Incorporation of CBM feedback and finalization of report, datasets, and 2 days supporting documentation Total 30 days 10. REQUIRED QUALIFICATIONS AND EXPERIENCE The consultant should possess: An advanced degree in Public Health, Ophthalmology, Epidemiology, Health Systems, Social Sciences, Development Studies, or related fields. At least seven (7) years of experience conducting health systems assessments, evaluations, or situational analyses. Demonstrated knowledge of eye health systems and public health programming. Experience working with government institutions and international development partners. Strong skills in qualitative and quantitative research methodologies. Excellent analytical, facilitation, and report-writing skills Safeguarding, PSEAH & Fraud Policy: As a condition of entering into a consultancy agreement the evaluators must sign the CBM’s or the partner organisation’s Safeguarding, PSEAH & Fraud Policy and abide by the terms and conditions thereof. 11. REPORTING STRUCTURE The consultant will report to the SightQuest Nigeria Programme Director and work closely with Inclusive Eye Health Programme Nigerian team of CBM, the State Ministry of Health, and relevant implementing partners. All deliverables shall be reviewed and approved before final acceptance. 12. ETHICAL CONSIDERATIONS The consultant shall: Maintain confidentiality of all information collected. Obtain informed consent from participants. Adhere to safeguarding and ethical research standards. Ensure inclusion of women, men, persons with disabilities, and marginalized groups throughout the assessment process. 13. EXPRESSION OF INTEREST The consultant is expected to submit a technical and financial proposal including - a description of the consultancy firm, - CV of suggested team members, - an outline of the understanding of these TORs and suggested methodology, and - a detailed work plan for the entire assignment. - A detailed budget for the expected assignment shall include all costs expected to conduct a disability inclusive and participatory study, and taxes according to the rules and regulations of the consultants’ local tax authorities. CBM reserves the right to terminate the contract in case the agreed consultant/s are unavailable at the start or during the assignment.