Terms of Reference for Vision Impact Project target Health Facilities Accessibility Audit Consultancy

1. Accessibility Audit Summary

Program/Project,

Vision Impact Project Kenya

Project Number

Partner Organisation

Kwale Eye Centre (Kwale County), Operation Eyesight Universal ( Kajiado County), AICHM ( Meru County), The Fred Hollows Foundation ( Embu County), PCEA Kikuyu Hospital ( Kiambu County), Sabatia Eye Hospital ( Vihiga County) and Tenwek Hospital (Bomet County)

Project start and end dates; phase of project if applicable

1st December, 2021 – 31st December, 2025

Accessibility purpose

To assess barriers to accessibility of eye health services for persons with disabilities in VIP target health facilities

Commissioning organisation/contact person

CBM Kenya Country Office, Kenya

David Munyendo, Country Director

Accessibility Team/Organizations

· Audit Team Technical Lead – contracted by Christoffel-Blindenmission Christian Blind Mission e.V.

· KCO focal staff for Vision Impact Project

· Representatives from National Council for Persons with Disability

Primary Methodology

The activity will entail focused group discussions, taking actual measurements, observation, Key Informant Interviews, taking photographs, and literature review. Multiple teams will be set up to work concurrently across the 7 Counties (Refer to the list of health facilities per County).

Proposed Assessment Start and End Dates

1st July – 30th July 2022

Anticipated Accessibility Audit Report Release Date

20th August 2022

Recipient of Final Assessment Report

CBM Kenya Country Office

Background of the Vision Impact Project (VIP Kenya)

CBM is an international Christian development organization, committed to improving the quality of life of people with disabilities. We work in partnership addressing disability as a cause and consequence of poverty to create an inclusive society for all. We recognize that this desire can only be achieved through systemic change, transforming communities and supporting others to make inclusion a reality. www.cbm.org.

About Vision Impact Project:

It is estimated that about 7.5 million Kenyans (15.5%) are in need of eye health services, ranging from age related cataract, diabetic complications in the eyes, refractive errors, trachoma, allergic eye diseases and di­fficulties in reading among many others. Only 21.3% (1.6 million) are able to access eye health services from both public and private facilities. VIP is responding to; Unmet need for health workforce, equipment, infrastructure and eye health medical products.

Vision Impact Project is a 4-year project aimed at improving delivery of quality eye health services to over 8 million people in Kiambu, Embu, Meru, Kajiado, Kwale, Bomet and Vihiga Counties of Kenya by strengthening eye health systems to provide quality eye health services to those in need, including persons with disabilities. Designed on the model of demand, supply and governance, through this project, we envision nation where People understand the importance of caring for their own eye health and demonstrate health seeking behaviour; Eye care and rehabilitation services are accessible and affordable to everyone, everywhere, whenever they are needed; No-one acquires sight loss as a result of avoidable blindness; and Men, women, Boys and girls with disabilities enjoy their human rights as provided for in the constitution of Kenya and achieve their full potential in all spheres of life.

The National Council for Persons with Disabilities (NCPWD)is a state corporation established by an Act of Parliament; the Persons with Disabilities Act No. 14 of 2003 and set up in November 2004 to promote and protect equalization of opportunities and realization of human rights for persons with disabilities. In line with its mandate, the NCPWD therefore plays a key role in supporting the implementation of the Disability Act provisions including disability interventions under Vision Impact Project.

Health Facilities Accessibility Audit

Even with availability of quality services, where there are barriers, then not everyone will have access to equal opportunities. This exclusion can be as a result of physical, communication, lack of signage, lack of sign language services among others. The most marginalized are persons with disabilities who may not benefit from available eye health services being offered at County Referral Hospitals, Sub-County Hospitals, Health Centres and Dispensaries. The accessibility audit therefore aims at documenting baseline data key for informing required adjustments to address barriers and make eye health services accessible to ALL in the target 7 Counties.

Scope of the audit

The scope of the audit shall be on physical barriers, sign language interpretation services, signage, accessibility of information, data capture on disability among others and shall be conducted within the agreed period as indicated in the TOR. Refer to Section 3 below on roles and responsibilities. For each County, the audit report should provide detailed information for each health facility outlining the findings, recommendations, estimate cost implications and M&E plan.

Below summarises number of health facilities per County:

• Bomet – 5
• Vihiga -4
• Kiambu- 5
• Kajiado- 4
• Embu- 5
• Meru- 11
• Kwale-4

1. Role

To ensure successful audit the following roles will be performed by each of the parties as below:

1. CBM

• Provide brief about VIP to the audit team and contractual obligations
• Share any available accessibility audit tools for adaptation as appropriate
• Provide list of target health facilities and introduce the audit team to the contacts at the county level
• Inform the county leadership of the exercise and ensure constant communication between the parties involved
• Approve the final report

​​​​​​​2. CBM Partners

• Link the audit team with various county health management teams to grant access to target health facilities
• Coordinate mobilization of entry and exit meetings; focused group discussions and key informant interviews
• Receive the final audit report and action recommendations

3. Audit team Technical Lead

• Mobilize team of competence to undertake the assignment
• Develop and share detailed and costed work plan to deliver the assignment in period not exceeding 30 days
• Identify and adapt the audit tool
• Assign teams per County and supervise actual audit process
• Take lead in entry and exit meetings including actual audit process
• Keep stakeholders informed on overall progress of the exercise
• Collect data and or supervise actual data collection across all the seven Counties
• Monitor, validate and ensure quality of data collected
• Prepare final reports as per contractual obligations and submit to CBM

4. Expected Deliverables

• Audit team details
• Detailed work plan that is costed (with budget)
• Raw data as collected from the field
• Draft Accessibility Audit Report for each County (in Word for input)
• Final Accessibility Audit Report (in Word)