Final Evaluation – Terms of Reference At Médecins du Monde

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PROJECT TITLE: “Strengthening community and health system resilience in Ukraine”

Location: Donetsk Oblast (GCA), Dnipropetrovsk Oblast, Vinnytsia Oblast, Kyiv

Oblast, Chernihiv Oblast.

Document Date: October 2025

Donor: German Federal Ministry for Economic Cooperation and

Development (BMZ), (Project number 2020.1879.2)

Funding value: € 5.279.720,00

Project period: Nov 2020 – Nov 2025 – 48,5 months

  1. CONTEXT
  2. Crisis description

The current crisis in Ukraine began with the events of the year 2014, with Russian Federation annexing Crimean Autonomous Republic on the south of the country and investing in creation of an armed “liberation movement” in Donetsk and Luhansk regions in the east of Ukraine. The first outbreak of hostilities, in 2014, resulted in the approximately 7% of Ukrainian territory on the east of the country being occupied and proclaimed the “Luhansk and Donetsk People Republics”. In 2015, the frontline (back then called “the line of contact”) has been stabilized, hostilities across it minimized to episodic, and regulations for access to the occupied territories for civilians were introduced and agreed between Ukrainian government and the de-facto authorities of the territories.

The status quo was perceived as acceptable by and have had a very minimal impact on the lives of most of Ukrainian regions’ residents. However, the residents of the Donetsk and Luhansk regions, that became divided into Ukraine government-controlled areas (GCA) and the occupied or non-controlled areas (NGCA), experienced significant suffering from the new setup. Access to healthcare was one of the most negatively impacted aspects. The war (then referred to as “conflict”) not only has isolated rural health facilities in GCA from the major health centers in urban areas left in NGCA, but also insecurity, lack of maintenance of aging health facilities and medical equipment, and understaffing have seriously undermined the healthcare system’s ability to cope with both new and pre-existing healthcare needs. As the crisis became increasingly protracted, the situation worsened. In 2019, 54% of the households within 20km of the “contact line” and 64% within the rural areas of the 5km zone (GCA) reported problems with accessing health care and required life-saving and essential health services.

In early 2022, with the outbreak of the open full-scale war of Russia against Ukraine, the crisis had scaled-up multiple times and severely exacerbated. Within a short span of time, approximately 20% of the territories of Ukraine became occupied, with no access to those from Ukrainian side for either civilians or humanitarian organizations. The invasion has resulted in loss of life, injuries, and mass displacement of the civilians. The ongoing violence has also resulted in widespread destruction and damage to residential housing and civilian infrastructure. Access to primary health and social care, especially in areas close to the frontline, has become severely limited, as health facilities have suffered significant damage, with some being destroyed causing disruption in providing essential lifesaving support. The regions hosting high numbers of the internally displaced people (IDPs), started facing overstretching of the capacities of the local healthcare systems, leaving many people underserved.

The full-scale war continues for the fourth year; the healthcare system remains among the most affected, with a range of problems from physical destruction of buildings, roads, transport, and assets; to outflux of the qualified personnel due to conscription to military, migration to safer regions/countries, and war-related losses; to increased workload on the remaining personnel, especially in the areas hosting large numbers of IDPs. The healthcare facilities across the country experience constant lack of equipment and supply, as well as burnout among the remaining personnel. The social care system, dealing, among other, with palliative and bed-ridden patients, is also underfunded and understaffed. People living in the remote rural areas, as well as those close to the frontline are the most underserved, the role of local lay professionals, equipped with basic healthcare skills becomes increasingly important. Regardless of the depth of the crisis, healthcare reform continues in the country, with the changes launched pre-2022 continuing proving effective, and slow but steady progress on the ongoing measures.

  1. About the organisation

Ärzte der Welt e. V. is the German division of the international network Médecins du Monde/Doctors of the World (MdM). The MdM network provides medical assistance worldwide to people affected by crises or marginalized – regardless of their ethnic, social, religious and political background. Ärzte der Welt / MdM Germany pursues the vision of a world in which all people have access to health care: a world in which health is recognized as a fundamental right for all. The mission of the organization is to provide short, medium and long-term free health support and medical assistance all over the world, including Germany, to people who have no or limited access to healthcare due to environmental disasters, accidents, armed conflicts and exclusion of any kind. The purpose of the organization is also to promote public health, welfare and development cooperation. The humanitarian and political work of MdM Germany is in line with the United Nations Universal Declaration of Human Rights. We are independent, committed to social justice and to the rights of our patients.

In 2019, Ärzte der Welt became part of the response to a protracted crisis in eastern Ukraine, joining Medicos del Mundo (MdM Spain) in addressing the needs of the healthcare system and the most vulnerable population in Luhansk and Donetsk regions, being the most affected by the crisis at the time. In 2022, due to the rapid advance of the Russian army in those eastern regions, both MdM Germany and MdM Spain had to relocate the operations to other regions of Ukraine, and supported first, internally displaced people (IDPs) and host communities across Ukraine, and later, when the frontline fluctuation had slowed down, also the residents of the communities in the frontline proximity. Currently MdM Germany has operational presence in Dnipropetrovsk, Donetsk GCA, and Vinnytsia regions, with coordination office in the city of Dnipro; MdM Spain works in Kyiv, Chernihiv, Kharkiv, Zaporizhzhia, and Chernivtsi regions, with coordination office in Kyiv city.

  1. Brief Introduction to the current project

The project to be evaluated started in November 2020, as a 3-year 2,700,000 EUR budget initiative, implemented by MdM Germany and MdM Spain, aimed to increase reslience of communities and the local health system in the local communities of Donetsk and Luhansk Oblast, by improving availability and access to quality multi-disciplinary PHC (Primary Health Care) services (including SRH (sexual and reproductive health) and MHPSS (mental health and psychocosial support)) to meet health needs of the conflict affected population. In 2022, as the context had dramatically changed, MdM Germany approached BMZ, and a joint decision was made to re-orient the project towards the new realities and extend it beyond the initial timeframe. After the needs assessment, an amendment was signed in the mid-2023, extending the project until the end of June 2025, for it to be implemented in the new project areas: Dnipropetrovsk, Kyiv, Chernihiv, Vinnytsia, and remaining Donetsk GCA regions. While the objective and outcomes of the intervention remained the same, the adjustments contained interventions, aimed at improving availability and quality of the primary healthcare, sexual and reproductive health, and mental health services, as well as improving knowledge on the health-related topics and patient rights among the population of the newly targeted communities. In 2025, the project was extended once more, by end-November 2025, with the final total budget becoming 5.279.720,00 EUR.

The project continues being implemented by MdM Germany and MdM Spain, and the local partner organizations Svitanok (until 05/2022) and 100%LIFE (since 2023).

  1. Evaluation purpose, objectives and scope of work
  2. Evaluation Purpose and Objectives

The final evaluation bears two main purposes:

  1. To assess the project intervention, focusing on the topics and answering the questions mentioned in this ToR, and taking into consideration the contextual situation.
  2. To inform MdM about best practices and lessons learnt and support the development of future programming. The evaluation will help to review and adjust the MdM strategy in Ukraine for the coming years.

Along with the questions listed in the Scope of Work section, the following thematic aspects need to be covered by this evaluation:

Current intervention:

Support to local healthcare systems:

  • Strengthening access to primary healthcare, including sexual and reproductive health.
  • Role of the material support, provided by the project (premises rehabilitation, donation of equipment and consumables).
  • Role of needs-based training provided to healthcare professionals.
  • Capacity building of the social care system, complementing healthcare system.
  • Development and challenges of home-based and palliative care in the targeted areas.
  • Importance of MHPSS support, provided to healthcare professionals in the targeted areas.
  • Role of the community healthcare focal points.
  • Role of the local NGO partnership.
  • Role of the support provided to people living with / being at risk of HIV/TB.
  • Community-based MHPSS interventions.

Strengthening the healthcare capacities of the local communities:

Future Intervention:

  • Which of the current project activities should be continued to further build capacity of the local healthcare systems and communities?
  • Any new directions of interventions / target groups MdM could potentially explore in future?
  1. Scope of Work

The following questions are based on the evaluation criteria of the OECD/DAC standards and will be specified in discussion with the consultant.

Relevance, is the intervention doing the right thing?

  • Have the strategy and methodology of intervention been timely and adequately adapted to remain relevant regarding changes in the context within the period of implementation?
  • Were the project objectives appropriate to meet the needs of the targeted population in terms of improvement of access to quality health care?
  • Has the project contributed to strengthening the community’s resilience towards the health-related challenges?
  • Did the project successfully reach out to address the needs of vulnerable groups, i.e. people with disabilities, IDPs, key populations, etc?
  • What was the beneficiaries and stakeholders’ feedback on MdM’s contribution to improve the access and quality of health services as well as the capacities of service delivery institutions and staff.

Coherence, how well does the intervention fit?

  • Was the intervention well-aligned with the other interventions implemented by MdM Ukraine?
  • Was the project design coherent with policies/objectives of the national/regional health department(s)? How did the project contribute into the ongoing healthcare system reform in Ukraine?
  • How compatible was the intervention with other interventions done by NGOs in the targeted areas? How good was the coordination of MdM with other humanitarian actors in the project targeted areas? Mechanism(s) adopted by MdM for seeking synergies and avoiding duplication of efforts with other stakeholders.
  • How did the intervention contribute to the Humanitarian-Development Nexus in Ukraine?

Effectiveness, is the intervention achieving its outcomes and objectives?

  • To what extent have the project contribution helped to improve healthcare-related capacities of communities and their members?
  • To what extent have the project contribution helped making community-based health and social service systems more available?
  • To what extent has the project helped with improving access to health care and social services for particularly vulnerable population groups through strengthening networks, links and partnerships between civil society actors, local authorities and other stakeholders?
  • Factors that caused obstacles in achieving objectives? How has the project handled these factors?

Efficiency, how well are resources being used?

  • To what extent the project implementation and approach have been efficient?
  • Did internal and external coordination mechanism exist and apply adequately? And did it help to achieve the desired project objectives?

Sustainability, will the benefits of the intervention last?

  • To what extent key sustainability issues have been effectively addressed and what mechanisms are in place to ensure sustainability?
  • How effectively has MdM collaborated with civil society and local authorities?
  • Did the program ensure anchoring of community ownership through community participation?

Considering the significant changes of the project design in the middle the project, timewise it is not yet fully feasible to make any final conclusions on the intervention impact. However, the evaluation can provide preliminary observations on the effects the intervention made or plausible contribution pathways.

Cross-Cutting Considerations

  • The evaluation should apply a gender-sensitive and age-inclusive lens across all criteria. Particular attention should be paid to how the intervention addressed the needs, access barriers, and participation of women, girls, and elderly individuals, especially among vulnerable groups such as IDPs, people with disabilities, and key populations.
  • The evaluation should assess how the project integrated the “Do No Harm” principle across all stages of implementation. This includes examining whether the intervention avoided unintended negative consequences, respected conflict sensitivities, and contributed to social cohesion and protection of vulnerable groups.
  1. Preferred methodologies

The evaluation should follow OECD/DAC criteria and DeGEval standards. The desired method is a mix of quantitative and qualitative methods including desk phase with document review, focus group discussions, staff /beneficiaries’ interviews.

The consultant’s field presence is a must to oversee & supervise the field work to ensure quality of information collection as well as for timely completion of the tasks.

The Consultant will be responsible for developing and presenting a sound methodology. The draft methodology will be submitted before the departure of the Consultant and discussed between MdM and the Consultant.

  1. Process
  2. ManagEment of the evaluation

Key Persons involvement:

MdM Ukraine Field Team: General Coordinators of MdM Germany and MdM Spain, Programme/Grants/Medical/MH Coordinators of both MdM missions, Logistics and Administration personnel ensuring the evaluator’s movement within the country

MdM Germany HQ – Desk Manager for Ukraine (Munich)

MdM Spain HQ – Desk Manager for Ukraine (Madrid)

Equipment: No specific equipment available for the consultants.

Means of communication: No specific means of communication available for the consultant. MdM Germany will ensure translation, if necessary.

Travel/Accommodation: MdM will organize transport and accommodation to and within Ukraine and will provide administrative support. Interviews and group discussions will be organized by MdM in cooperation with the relevant authorities and target group. The consultant will access the different locations in the project regions only with people from the project’s team on the field.

Administrative formalities: The consultant is responsible for obtaining her/his visa and must undertake to do so.

Security: The consultant will be briefed by the MdM security focal point(s) on the specific security issues in the areas to be visited and MdM security rules. To ensure maximum possible extent of safety, the consultant is expected to comply with MdM security rules during all their stay in Ukraine.

  1. Location of the evaluation

The fieldwork of the evaluation will be carried out in at least two of the following project Oblasts: Dnipropetrovsk, Donetsk (GCA), Vinnytsia, Kyiv, Chernihiv Oblasts, at least one per each MdM implementing chapter. Due to the possible security and access constraints, the exact locations will be defined at a later stage, closer to the actual field visit.

  1. Timeframe

The evaluation is expected to take place between early December 2025 and mid-January 2026. The following preliminary timeframe is foreseen while a final timetable is expected from the consultant:

Preparation/desk or inception phase: briefings with HQ and document review (approved project proposals, MoUs, project documents, interim reports to donor, database and relevant existing project data/documents), preparing data collection tools, and communication plan

5 working days

Fieldwork phase (data-collection and analysis); in various locations in Ukraine incl. case studies, standard questioning of target groups, qualitative methods, statistics, review with partners and debriefing

10 working days, excluding travelling to and from Ukraine

Preparation for and briefing the steering committee (see below) on the preliminary findings

3 working days

Writing the final report

5 working days

Presenting the final report, discussion, possible exchange

2 working days

Note: It is imperative to complete the evaluation in all aspects and consultant to receive the final payment by the 4th week of January 2026 maximum.

  1. Deliverables

Key documents:

  1. Inception report with statement to questions outlined in the ToR as well as to output and deliverables.
  • Possibility for written feedback by MdM
  • Submission of work plan
  • Developed final methodology for the evaluation, incl. questionnaire, FGDs guide etc. in consultation with project team
  1. Evaluation report:The key points planned to be included in the final report are to be presented by the consultant to

The final report must integrate these comments/observations/debates/ discussions.

The main body of the evaluation report must run to between 25 and 30 pages (excluding annexes), be submitted in Word, 12-point Open Sans/Arial/comparable font and single spacing, and must include the following:

  • Executive summary (maximum of 2 pages)
    • Introduction
    • List of acronyms
    • Context (description of the project)
    • Evaluation objectives and chosen criteria
    • Methodology and limitations
    • Principal results and analysis
    • Conclusions and recommendations (presented according to evaluation criteria)
    • Annexes: ToR, list of persons met and timetable, questionnaires, interview guides, observation grids, etc.

Reporting and Working language will be English. Relevant documents will be made available in English.

  1. Presentation of findings:Preliminary results and recommendations will be presented to the steering committee (MdM GE and MdM SP GenCos and HQ Desk Managers), at the end of the field phase

Use: The evaluation report will be shared with all stakeholders internally at MdM network level, at national and local level in Ukraine and with the German Federal Ministry for Economic Cooperation and Development.

  1. Required Expertise

The consultant requires the following expertise:

  • Minimum of 10 years of proven experience on humanitarian programming and evaluation.
  • Proven professional experience with international NGOs, with focus on medical programs and public health.
  • Professional experience in primary health care, sexual and reproductive health, mental health / psychosocial support.
  • Proven experience in qualitative and quantitative data collection
  • Previous experience in Ukraine is a must.
  • Fluency in spoken and written English as a must.
  • Fluency in Ukrainian and/or Russian languages is an asset.
  • Experience in gender sensitive evaluation could be an asset.
  • Due to restrictive visa issues, consultant needs to have an existing visa or possessing a travel passport allowing at least 30 visa-free days of stay in Ukraine.
  • Ability to work to tight deadlines to produce high-quality outputs.
  • Ability to communicate complex information in understandable and relevant terms adapted for different stakeholders.
  1. Application managEment

Consultants interested to apply must provide a full application pack in English, comprising the following elements accessible:

  • A detailed technical proposal, including the understanding of the ToRs and the proposed methodology Composition of the team (if applicable)
  • Provisional timetable for the evaluation
  • References from three similar previous assignments
  • A sworn statement as to the absence of any conflict of interest
  • Detailed CV
  • Financial proposal: The consultant must cover her/his travel and mission expenses and must provide a detailed financial proposal, including fees, taxes, per diems. MdM Germany will organise transport and accommodation to and within Ukraine and will provide administrative support.

How to apply

The full package of documens should be submitted electronically to MdM Germany by the closing date of 03.11.2025. Please, upload the document packages on:

Evaluation ToR BMZ project | Jobs bei Ärzte der Welt e.V.

Please, specify: “Final Evaluation 2020.1879.2” as the subject of your email.