The overall goal of the project is to improve equitable access to sustainable, quality eye health services for women and men, with and without disabilities and/or belonging to other marginalised groups in target districts. The project is specifically focusing on strengthening existing eye health systems in project district while making the services equitable and accessible for marginalised communities especially people with disabilities. The project has adopted a community-rooted approach through engaging with marginalised communities, people with disabilities and the general public for generating more demand for eye care services. To address increased demand for eye care services, the project is mobilising resources to strengthen service delivery through infrastructural modifications of health facilities, provision of trained human resources, bridging equipment gaps and training of ophthalmic and non-ophthalmic staff.

Objectives of Mid-Term Learning Review 

The project uses outreach camps to increase access to services and inclusion of people with disabilities and is using this model with public and private charity sector partners. The project also has a strong influencing/advocacy aim, including advocating for the integration of People-centred Eye Care data into DHIS2.

The project is at mid-point and is also expanding (as part of a planned phased approach) into a new district within the same province. This is therefore an opportune time to look at some of the learning so far and make adjustments for the remainder of the project. The learning review will involve desk review, internal reflection and a stakeholder workshop.

Purpose of the learning review:

• To facilitate a learning process, using the project's Theory of Change (ToC) as a framework

• To understand what is working well, what could be improved, and if there are any adjustments that should be made for the remainder of the project

• To identify emerging insights for the project’s contribution towards the organization’s thematic learning question LQ.EH6: “What have we learned from engaging with community-level organisations and networks in eye health that is useful to increase availability, affordability, and sustainability of quality eye health services?”

• To document learning, particularly about challenges and how these were managed, so that project expansion can be planned accordingly.

Areas of focus for the learning review are:

1.  Reflection on progress to date – looking back and looking forward:

1. What progress has been made in relation to

• quality of services

• inclusion of people with disabilities 

• reaching women (including women with disabilities) 

• Contribution to Integrated People-centred Eye care (IPEC) plans?

2. What has worked well and why?

3. What has not worked well and why?

4. What have we learned from collaboration with other stakeholders and community-based actors and networks for inclusion?

5. What are the prospects at this stage for realising the project’s intended outcomes and impact?

2. Testing our Theory of Change

1. Are our assumptions holding true?

2. Have we increased our understanding of any elements? Has anything changed?

3. Do we need to adjust anything in the ToC – its content elements or the balance of effort?

3. Building our evidence

3.1. Are we on track to contribute evidence for the project’s learning question? What methods are we using to build evidence that will help us understand better how to make engagement with Organisations of Persons with Disabilities and other community organisations as effective as possible when it comes to improving access to eye health services for marginalised groups?

3.2. Can we identify further learning opportunities to strengthen our evidence base during the remainder of the project?

4. Sustainability:

1. What is the likelihood at this stage that any progress made by the project will be sustained after the end of the project?

2. What could be done to increase the likelihood of project sustainability, if necessary?

5. Behaviour change regarding disability inclusion:

4. 1. What were the strategies used for behaviour change in terms of inclusion, what worked well and what has not worked? 

   2. What challenges do we face in making any change towards disability and inclusion perception and practices?

6. Advocacy:

1. What level of influence have we reached at this stage?

2. Where are we gaining traction in our advocacy plan? Has the experience been similar or different for the three objectives? Why is that? Do we anticipate any changes in the advocacy context during the rest of the project period? 

Methodology

The process will involve a light preparatory desk review of relevant project documents, internal reflection sessions and a 1-day workshop in Khanewal or Multan with up to 35 project stakeholders in two sets: Set 1 - government and other public service providers; Set 2 - service users, community-based stakeholders, OPDs, CBOs and networks, private optical vendors. The desk review will summarise relevant learning points from the first half of the project for validation and further development during the workshop. Internal reflection sessions will assess i) advocacy level of influence achieved, to feed into the desk review, and ii) implications of the review outcomes for the project.

The workshop will be based on the project’s Theory of Change. Workshop participants will seek to achieve consensus on the implications of the project’s experiences during the first half, including any revisions needed to the ToC and any adaptations needed for the remainder of the project. Participants will also explore opportunities to build the project’s evidence portfolio during the remainder of the project.

Review Deliverables 

• Initial desk review of project documents 

• Full day participatory workshop engaging up to 35 stakeholders in Khanewal or Multan

• Detailed note taking and translating the key findings, discussion, and recommendations of the workshop into the report.  

• Workshop report outlining clear learning outcomes and how they were derived 

Skills & Experience

• Proven experience in conducting/facilitating learning review/monitoring & evaluation of developmental projects. 

• Preferably thematic expertise in eye health reviews, preferably with experience in refractive error, inclusive health, and primary eye care.

• Strong understanding of equitable access to inclusive healthcare for women, people with disabilities, and other marginalised groups.

• Ability to travel in targeted districts (Khanewal or Multan) to facilitate the workshop. 

• Proven ability to produce concise, readable, and analytical reports.

• Excellent communication skills in written and spoken English. Fluency in local language is preferred. 

• Proven ability to work independently, manage resources, and deliver work within agreed timeframes.

Timeline

We anticipate that a total of approximately 7 working days will be required to complete the assignment, including preparatory work, a learning workshop, and report writing. 

Logistics

Any expenses related to travel, accommodation, and food will be facilitated/managed by the client.