Terms of Reference for Accessibility Audit of health facilities implementing the Cataract Surgery project in West, South and South West Uganda. At Christian Blind Mission

1. Introduction

CBM is an international christian development organization, committed to improving the quality of life of persons with disabilities in the poorest countries of the world. CBM visualizes, “An inclusive world in which all persons with disabilities enjoy their humanrights and achieve their full potential”. It is estimated a billion people around the world have a disability. Over 80% of persons with disabilities live in developing countries. However, these people have been excluded in areas of health, education and livelihoods, a fact that increases poverty, additional burden and costs to their households and societies. CBM is committed to build inclusive and sustainable local and national systems and services making health care and other vital services accessible.

Through funding from Australian NGO Cooperation Program and Fred Hollows Foundation, CBM together with Ruharo Mission Hospital Eye Centre (REC) and Mbarara University Regional Hospital Eye Centre (MURHEC) are implementing an eye health project titled, “Increasing Equitable Access to Effective Cataract Services in West, South and South West Uganda”. REC and MURHEC will work in collaboration with Regional Referral and District Hospitals to implement the project. The health facilities selected are located in : Mbarara, Bushenyi, Rubirizi, Masaka, Lyantonde, Kyotera, Kabarole, Bundibugyo, Kagadi, Kyenjojo, Kamwenge.

The above project falls under CBM Inclusive Eye Health (IEH) initiative. CBM IEH initiative plan promotes principles of inclusion, comprehensiveness and integration, underpinned by sound technical leadership and strong evidence base. CBM also respects the UNCRPD principle of “Accessibility” and it is emphasized in all collaborations established with partners. To ensure the Cataract project services are inclusive and accessible to all, CBM together with the project lead partner Ruharo Mission Hospital, wish to conduct accessibility audits for health facilities that are implementing the Cataract project. The findings will be used to lobby and advocate for interventions to address accessibility gaps identified at project health facilities.

1. Purpose of the Accessibility Audits

The purpose of accessibility audit is to; assess the ease of use of services offered at the project health institutions by a wide range of actual and potential users, including persons with disabilities and recommend access improvements.

The specific objectives of accessibility audit

1. Assess the level of access to the health facility building by persons with disability.
2. Assess the level of access to services offered at the health facility by persons with disability.
3. Create awareness about the accessibility audit targeting hospital administrators and relevant authorities.
4. Scope work

A total of 12 health institutions will be assessed, which will include: 2 tertiary, 2 Secondary and 8 primary level institutions. The institutions are located in 11 districts selected in South, South West and West Uganda (Mbarara, Bushenyi, Rubirizi, Masaka, Lyantonde, Kyotera, Kabarole, Bundibugyo, Kagadi, Kyenjojo, Kamwenge). The assessment should assess: Physical access to buildings, access to information and communication, and inclusiveness of services provided. The Consultant is also expected to disseminate the findings, recommendations and support concerned health facilities develop appropriate action plans.

1. Specific deliverables

The consultant is expected to submit to CBM:

• A high profile accessibility audit report, not more than 10 pages with an Introduction, methodology, ethical considerations, major findings and recommendations.
• Annexes with individual health facility accessibility audit reports highlighting findings, access gaps, recommendations and actionplans.

1. Consultant’s roles and responsibilities.

The consultant will offer technical and strategic direction for the entire accessibility audit exercise and dissemination of the findings. The specific tasks will include

• Develop assessment methodology.
• Develop data collection templates and present to CBM before data collection.
• Conduct data collection: perform the required interviews, assessments, desk reviews, and dissemination meetings.
• Analyze data collected to identify gaps and recommendations for each health facility.
• Compile individual health facility accessibility audit reports.
• Present Accessibility Audit findings to CBM and the lead partner.
• Present Accessibility audit findings to individual health facilities and relevant district leaders.
• Support individual health facilities to develop actionplans.
• Produce the final high profile accessibility audit report.

CBM and Ruharo Mission Hospital, will work together with the Consultant during data collection and dissemination of the findings to right stakeholders.

Ethical considerations regarding data collection should be highlighted in the methodology. Ensure the confidentiality, do no harm approaches, and respect information sharing protocols at participating institutions. In addition, ensure involvement of leaders/organisations of persons with disabilities in the exercise.

1. Technical and Financial proposal

The consultant is expected to submit a technical and financial proposal demonstrating the assignment: methodology, detailed workplan, and budget. Also submit a Curriculum Vitae and experiences of the technical team in relation to the assignment.

1. Time schedule

The assessments are expected to commence by 1st September 2022. Prior meetings between CBM/Ruharo Mission Hospital and selected consultant will discuss and agree on the duration of the exercise. The starting point will be the workplan submitted by the Consultant at time of application and project resources.

• Deadline submission of Consultancy applications- 26th Aug 2022- Submission of applications through agreed upon channels
• Review technical and financial bids- 30th & 31st Aug 2022- Qualifying Consultants shortlisted for interviews.
• Conduct interviews for the shortlisted consultants- 6th Sept 2022- The best Consultant selected and informed.
• Meeting with the consultant to finalize methodology, workplan and budgets- 8th & 9th Sept 2022- Finalized assignment methodology, workplan and budget
• Meeting between consultant, CBM and Ruharo Mission Hospital-13th Sept 2022-Project staff oriented about accessibility audit exercise and plans
• Conduct accessibility audit assessments-14th Sept 2022-Assessments for 12 health facilities
• Data analysis and report writing-TBD-Individual health facility reports
• Share preliminary findings with CBM and lead partner-TBD
• Dissemination of findings to individual health facilities and relevant leaders- TBD- Obtain feedback and develop action plans
• Consultant presents high profile accessibility audit report to CBM- TBD-Final Accessibility Audit report submitted to CBM

8. Required profile of Consultant/team

The consultant must demonstrate the following qualifications to be eligible for the assignment:

• The consultant should have expertise in carrying out accessibility audits. S/he should have competency in managing, organizing and writing accessibility reports.
• The Team leader should have a minimum Bachelor’s Degree in one or more of the following fields: Disability Studies, Social Sciences, Development Studies and Public Health.
• Team members should have relevant knowledge about the subject matter and with at least 2 years experiences performing similar tasks.
• The team should demonstrate ability to work independently and deliver timely outputs.