Introduction

The Fred Hollows Foundation (The Foundation) is a secular non-profit public health organisation 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. The Foundation operates in more than 20 countries across Australia, The Pacific, South and Southeast Asia, and Africa. The Foundation was named The Australian Charity of the Year 2013 in the inaugural Australian Charity Awards.

The Foundation in Pakistan has been working with the Government of Pakistan and other partners towards the goal of eliminating avoidable blindness in the country. The Foundation is a key stakeholder in the National Program for Eye Health in Pakistan and has made major contributions to the strengthening of the public eye health care system in the country following the World Health Organization (WHO) recommended Health Systems Strengthening approach. From the beginning, The Fred Hollows Foundation Pakistan (FHFP) has implemented multiple projects that focus on cataract surgeries, systems development and strengthening, refractive error and subspecialities in different parts of the country. The current project i.e., Comprehensive Eye Care for Female Agriculture and Garment Factory Workers is based on the same approach.

Project background

The project originated from the implementation of “Comprehensive Eye Care for Female Agriculture & Cottage Industry Workers Phase I Project (CEC Phase I)”. During the project implementation it was observed that women who were working in sectors other than bangle manufacture and agriculture also face hurdles in accessing eye care services. (i.e., textile/garments, sports goods, and other small/medium industries). Similarly, women working in the agriculture sector were being referred from districts other than our targeted districts; for example, women were travelling from Vehari, Lodhran, Bahawalpur and Okara. These are also agriculture-based districts and have a high load of cataract cases, where women have less awareness of seeking eye care services and limited resources. This indicated that demand for gender sensitive eye care for female agriculture workers is high in Punjab and Sindh as both are predominately agriculture-based provinces.

The project aims to increase access to inclusive, equitable and quality Integrated People-Centred Eye Care (IPEC) services (Cataract and Refractive error) for Female Agriculture and Garment Factory workers in Lahore, Vehari, Bahawalpur, Lodhran, Sanghar and Thatta over the period of four years from October 2023-September 2027. This project is designed to ensure full participation of all beneficiaries regardless of their ethnic background, gender, religion, language, poverty, or disability. The most vulnerable groups, particularly women and persons with disabilities, will be encouraged to maximize their participation in the project. In addition, the project is providing promotive, preventive, and curative eye health services whilst also ensuring that the use of these services does not expose the beneficiaries to financial hardship, therefore contributing to UHC. About 300,000 female agriculture and garment industry workers in Punjab (Lahore, Vehari, Lodhran and Bahawalpur districts) and Sindh (Sanghar and Thatta districts) will directly benefit from this project. The project will upgrade eye care services through provision of high quality, efficient and cost-effective technology at the primary and secondary levels of the health system, closer to the community to allow better access for women. Appropriate eye health personnel will be trained to provide quality preventive, promotional & curative eye care services. The project will strengthen referral systems from community to secondary level health facilities and raise awareness on prevention & promotion of eye health. The project will integrate eye health into the existing social security structures through multi-sectoral engagement & effective partnerships. The project will work closely with relevant health departments under the provincially devolved public health system as well as work with private/charity organizations, in addition to any existing health and welfare programmes already in place.

Expected Outcomes of the Project:

• Quality gender sensitive & inclusive IPEC services are established in agricultural districts by 2027.
• Increased awareness of eye health care and available services amongst female agriculture and garment factory workers and other stakeholders.
• Increased number of women seeking eye health care amongst garment factory workers in the targeted factories
• Increased availability of affordable quality RE and cataract treatment for poor communities, elderly women, and all workers
• Increased partner capacity and ownership of inclusive IPEC services

Purpose of the Consultancy

The purpose of the consulting services will be to develop a need-based Behaviour Change Communication (BCC) Strategy and develop effective and innovative core messages, tools, and Information, Education and Communication (IEC) materials on eye health care for Female Agriculture and Garment Factory Workers and update training curriculum for Lady Health Workers (LHWs) and General Duty Medical Officers (Posted on RHCs and BHUs) on the data gathered in the survey report.

The BCC Strategy will:

• Enhance awareness amongst the female agriculture & garment factory workers & employers regarding eye related occupational hazards, prevention and risk reduction, timely treatment if required, and availability of services in Lahore, Vehari, Lodhran, Bahawalpur, Sanghar and Thatta (Urdu and English languages)
• Address and promote attitudinal and value changes among target groups, leading to informed decision- making, modified behaviour, adoption of timely and appropriate practices at individual, family, and community levels (Urdu and English languages)
• Include a training manual on the eye health care curriculum for Lady Health Workers to raise awareness among female agriculture and garment factory workers and General Duty Medical Officers posted at RHCs and BHUs in Lahore, Vehari, Bahawalpur, Lodhran, Sanghar and Thatta.

Consultancy scope and key questions

A Behaviour Change Campaign through LHWs will be launched by FHFP based on the findings of survey report to improve knowledge on eye heath and sensitize on gender and disability inclusion to promote an enabling environment for agriculture & garment factory workers at home, workplaces, and hospitals. The consultant will conduct a small-scale survey to identify eye health related occupational hazards and explore knowledge, attitudes, beliefs, and practices of target communities in Lahore, Vehari, Bahawalpur, Lodhran, Sanghar and Thatta. As part of the Behaviour Change Communication strategy, develop an advocacy strategy to sensitize national, provincial and district level policy and decision makers, key influencers towards reinforcing for hazard free working environment for females in agriculture and garment factories. Similarly, a Communication Strategy for various target groups: husband, family, key influential people, female agriculture & garment factory workers to encourage adoption of appropriate prevention and timely treatment interventions on Eye Health Care. Additionally, to build the capacity of the Lady Health Workers, a training manual will be developed on Eye Health Care at all levels to provide gender sensitive eye care services. The consultant will develop a tool kit and module with user guide for service providers on gender sensitive and disability inclusive eye care services to sustain their interest and participation in the activities. Develop and share IEC materials and key preventative and promotional messages for female agriculture and garment factory workers on eye health care.

Deliverables

• Inception report on the evidence-based BCC strategy development for female agriculture and garment factory workers, male counterparts, families, supervisors and management and curriculum update for the Lady Health Workers and General Duty Medical Officers.
• Survey tool to identify eye health related occupational hazards and explore knowledge, attitudes, beliefs, and practices of female agriculture and garment factory workers in Lahore, Vehari, Bahawalpur, Lodhran, Sanghar and Thatta.
• Short report and PowerPoint presentations on the gaps identified with the help of a survey tool to identify eye health related occupation hazards and knowledge, attitudes, beliefs and practices of female agriculture and garment factory workers in the targeted districts.
• Policy briefs to sensitize national, provincial and district level policy and decision makers, key influencers towards reinforcing for hazard free working environment for all, especially females in agriculture and garment factories in Lahore, Vehari, Bahawalpur, Lodhran, Sanghar and Thatta.
• BCC strategy (Report and PowerPoint presentation) consisting of awareness raising campaign and communication campaign along with key messages (both in Urdu and English) for the target audience in targeted districts
• IEC material/kits and key messages in a book format for the awareness of female agriculture and garment factory workers and their communities on Eye Health Care in Urdu and English Languages (the consultant/s to share the list of IEC material while submitting the proposal)

• Based on the key messages developed a pamphlet and broacher is to be provided for easy dissemination of those messages using modern infographic techniques

• Training manual on Eye Health Care for Lady Health Workers and General Duty Medical Officers posted at RHCs and BHUs.

ü  Course curriculum for LHWs in a book format

ü  PowerPoint presentation of the course curriculum for LHWs

ü  Course curriculum for General Duty Medical Officers in a book format

ü  PowerPoint presentation of the course curriculum for General Duty Medical Officer

Schedule

This assignment is to be completed in 30 days starting from the date of the contract signing. The key consultancy events include briefing, data collection and analysis, draft and final report, recommendations for policy makers and Eye Care Curriculum update for the Lady Health Workers and General duty Medical Officers. The timeline for the deliverables will be negotiated and finalized at a later stage after the signing of the contract.

Consultancy team & qualifications

The consultant/consulting firm must have the following:

• A minimum of five (5) years of experience working in the relevant areas
• At least two (2) years of working in the health sector; preferably eye health care will be an added asset.
• Experience in data collection, data analysis including interviews, surveys, and focus group discussions.
• Minimum bachelor’s degree in social sciences, Public Administration, Development, or any other related field
• A master’s degree or PHD will be an advantage.
• Excellent communication and writing skills.
• Demonstrated ability to write relevant, concise, clear, and presentable reports/materials.

Management and logistics