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Tenders are invited for Consultancy to Conduct Baseline Evaluation Eye Health Workforce Project. Location: Kigali Deadline: Friday, 20/11/2026 23:59 INTRODUCTION 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. It operates in more than 20 countries across Australia, the Pacific, South and South-East Asia, and Africa. Since 2006, The Fred Hollows Foundation has worked in partnership with the Ministry of Health to advance Eye Health outcomes in Rwanda through systems strengthening, capacity building, and workforce development initiatives. These efforts have included sustained support for the training and professional development of ophthalmologists and allied eye health professionals. Building on the work FHF and MoH are doing on the integration side (Performance Based Financing) and Strengthening Systems for Eye Health (HSS), The Foundation, MoH and key stakeholders have jointly designed the Rwanda Eye Health Workforce Project (20262030) to strengthen the sustainability of Rwandas Eye Health System by addressing one of the most binding constraints to equitable, high-quality eye care in Rwanda: the shortage and maldistribution of well-trained ophthalmologists and the limited capacity of national training institutions to produce and retain them. 1. BACKGROUND AND CONTEXT The Rwanda Eye Health Workforce Project (RW26-01) is a five-year initiative (January 2026 December 2030) funded by The Fred Hollows Foundation, implemented throughpartners including the Ministry of Health (MoH), the University of Rwanda (UR) and the Rwanda International Institute of Ophthalmology (RIIO) and other partners in eye health in Rwanda. The project responds directly to the severe shortage and inequitable distribution of ophthalmologists in Rwanda. The country has approximately one ophthalmologist per million population far below the WHO benchmark of one per 250,000 with most specialists concentrated in Kigali, leaving rural and underserved populations with limited access to essential eye care. Rwanda continues to face a significant burden of avoidable blindness and visual impairment, with cataract the leading cause of blindness and uncorrected refractive error the main cause of visual impairment. The National Strategy for Health Professions Development (NSHPD 20202030) sets an ambitious target of 44 public-sector ophthalmologists by 2030, and the Governments 4- by-4 Health Workforce development Initiative aims to rapidly scale the health workforce. In alignment with these reforms, both RIIO (through its accredited residency) and UR (through its new Master of Medicine in Ophthalmology) are expanding national training capacity. The Workforce Project is designed to strengthen this pipeline, so that expanded training translates into competent, motivated, and equitably deployed specialists embedded within the public health system. The project purpose is to reduce avoidable blindness and visual impairment in Rwanda by strengthening the ophthalmology workforce pipeline (training, deployment, retention and leadership) to deliver equitable, high-quality eye care nationwide. The end-of-project outcome is a competent, equitably distributed, and sustainable ophthalmology workforce, fully embedded within the public health system and delivering high-quality, accessible eye care services across all provinces. The project is organized around three interlinked outcomes: Outcome 1: Increased supply of highly competent ophthalmologists graduating from nationally accredited training programs. Outcome 2: Improved deployment, retention, and motivation of ophthalmologists in public health facilities. Outcome 3: Strengthened leadership, partnerships, and research capacity addressing Rwandas eye health priorities. This baseline evaluation establishes the reference values, institutional capacity status, and system readiness against which the projects progress will be measured at mid-term (2028) and end-term (2030). It is designed as an independent, primarily desk-based assessment that consolidates existing evidence, complemented by targeted key informant consultation, and is expected to be conducted between November to January 2027. 2. OBJECTIVES OF THE ASSIGNMENT The overall purpose of the baseline evaluation is to measure the status of the project prior to implementation, establishing a robust reference point against which performance will be monitored at mid-term and end-term. The evaluation will document the current capacity of institutions to train, deploy and retain ophthalmologists, and provide an evidence base to guide institutional strengthening and adaptive management. The specific objectives are to: Establish baseline values for the projects outcome, output and activity indicators as set out in the Project Design Document (PDD), Monitoring, Evaluation, Research and Learning (MERL) framework, including those currently marked TBD. Validate and, where necessary, correct the baseline values already recorded in the PDD (see Section 4.3), so that a single baseline set is established. Propose SMART, evidence-based targets for all PDD indicators whose targets are currently marked TBD, benchmarked against national commitments. Assess the current institutional and training capacity of UR, RIIO and affiliated teaching hospitals against national, regional (COECSA) and international accreditation standards, including faculty numbers and skill mix, equipment and infrastructure, simulation/wet-lab capacity, educational resources, and quality assurance and student support systems. Assess the current status of workforce specifically ophthalmology deployment, distribution, retention and motivation across the public health system, including gaps affecting equitable placement beyond Kigali. Assess the baseline status of professional leadership, partnerships and locally led research capacity in the eye health sector. Review and align findings with existing national and sectoral evidence sources, and triangulate baseline values against these sources with clear references (see Section 3). 8. Identify key implementation gaps, risks, opportunities and priority actions the project should focus on to achieve its intended outcomes, ensuring alignment with national priorities and integration into Rwandas broader health workforce development system strengthening agenda. Provide practical recommendations to strengthen project design, targeting, sequencing, implementation, and the MERL framework. 3. SCOPE OF WORK / TASKS The evaluation covers the full scope of the Rwanda Eye Health Workforce Project (20262030) at national level, encompassing the two national training institutions (UR and RIIO), affiliated teaching and clinical training sites, and the public-sector deployment and retention environment for ophthalmologists across Rwandas 30 districts. The consultant will assess the baseline situation against each of the three project outcomes and will have autonomy to expand the indicative questions below to suit the evaluation. Alignment with existing evidence sources The consultant must review and align baseline findings with existing evidence sources, ensuring consistency, avoiding duplication of data collection, and clearly referencing the source of each baseline value. These sources include, but are not limited to: The Eye Care Service Assessment Tool (ECSAT) for facility- and system-level service capacity, human resources and infrastructure data. Rwandas Eye Health Strategic Plan the National Strategic Plan for Eye Health (NSPEH 20182024 and the successor plan 20252030 for national targets, priorities and coordination structures. Other available national and sectoral evidence, including the National Strategy for Health Professions Development (NSHPD 20202030) and the 4x4 Health Workforce Initiative; HSSP V (20242029) and the National Health Policy; RAAB (2015); the Gender Equity and Inclusion Analysis of Eye Care (2022); the Cataract Surgery Business Case (2023); UR and RIIO partner capacity assessments; COECSA minimum equipment and accreditation standards; the WHO IPEC framework and WHA 74.13; HMIS/DHIS2, PBF and CBHI/RSSB records; and ROS workforce records. Findings must be interpreted in a way that emphasizes alignment with national priorities and integration into Rwandas broader health system strengthening agenda, including the health workforce, service delivery, leadership and governance, and medical products and technologies pillars. Indicative evaluation of core and exploratory questions by outcome Outcome 1: Increased supply of highly competent ophthalmologists graduating from nationally accredited training programs. What is the current institutional and training capacity of UR, RIIO and affiliated teaching hospitals relative to COECSA and national accreditation standards (faculty numbers and skill mix, equipment and infrastructure, simulation/wet-lab capacity, educational resources, quality assurance and student support)? What is the current faculty-to-resident ratio, number of residents enrolled and graduating (disaggregated by gender and institution), and pass rate in regional/international certification examinations? What are the main gaps in training quality, standardization, surgical exposure (including MSICS) and subspecialty capacity that the project should prioritize? How effectively do the current training arrangements support the equitable recruitment, retention, and completion of residency training for women and residents with disabilities? What funding and financing mechanisms are availa Tender Link : https://www.jobinrwanda.com/job/terms-reference-consultancy-conduct-baseline-evaluation-eye-health-workforce-project
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