TERMS OF REFERENCE (TOR) FOR A CONSULTANT TO DEVELOP THE RWANDA NATIONAL STRATEGIC PLAN FOR EYE HEALTH (2025–2029)

1. Background

Eye health is a critical component of Universal Health Coverage (UHC) and a key determinant of social and economic development. Visual impairment and blindness have a profound impact on individuals, families, and communities, contributing to reduced productivity, increased dependency, and diminished quality of life. Recognizing this, the World Health Organization (WHO) has emphasized the Integrated People-Centred Eye Care (IPEC) framework, which advocates for the delivery of eye health services that are equitable, sustainable, and fully integrated into national health systems.

In Rwanda, eye health has been prioritized within the broader health agenda, and significant achievements have been realized in the last decade. Some of the relevant health policies and strategic documents referring to eye health include National Health Sector Strategic plan NHSSP V (2024-2029, and the National Health Policy 2025 currently being finalised. The National Strategic Plan for Eye Health (NSPEH 2018–2024) was the first comprehensive roadmap for the country, articulating priorities linked to the Universal Health Coverage reforms in coordination, workforce training, infrastructure, and service delivery. Under this plan, Rwanda made progress in integrating eye health into primary healthcare, training and deploying ophthalmic professionals, equipping health facilities with essential diagnostic and treatment tools, and increasing awareness and utilization of eye care services. Others entail eye health indicators integrated into the national HMIS from 2019, allowing routine reporting by all public and private health facilities and eye health included in PBF, creating financial incentives for service delivery.

Despite these gains the burden of eye disease continues to be significant, with the 2015 Rapid Assessment of Avoidable Blindness (RAAB) showing that one percent of Rwandans aged 50 years and above are blind, and that 84 percent of blindness cases are due to avoidable causes. Visual impairment is more prevalent among women, indicating gender disparities in access and outcomes. The shortage of qualified eye health professionals, inequitable distribution of services between urban and rural areas, underdeveloped preventive and rehabilitative services, and limited financing for eye care continue to constrain progress. With the NSPEH 2018–2024 term completed, there is now an urgent need to design a new strategic plan that consolidates achievements, addresses persisting gaps, and aligns eye health priorities with national and global eye health agendas. Evidence generated from various national studies and evaluations including the Rwanda Cataract Surgical Business Case (2023), the end term evaluation of the NSPEH 2018–2024 and ongoing Eye Care Situation Analysis (ECSAT 2025) will be invaluable. Key global and regional eye health documents will include but not limited to: the WHO Universal Eye Health: Global Action Plan 2014–2019; WHO World Report on Vision (2019); WHO Catalogue of Eye Health Indicators (Africa);VISION 2020: The Right to Sight; SPECS 2030 (WHA78); Value of Vision Report (IAPB, 2025) and IAPB School Eye Health Guidelines and Best Practices.

The upcoming National Strategic Plan for Eye Health (NSPEH 2025–2029) will serve as the roadmap for the next five years, ensuring that Rwanda builds a sustainable, equitable, and integrated system for delivering quality eye health services across the population more so catering for gender, disability and geographic iniquities.

Purpose of the assignment

The overall purpose of this consultancy is to develop the 2025-2029 National Strategic Plan for Eye Health for Eye Health that will:

• Build on the lessons learned from the National Strategic Plan for Eye Health(NSPEH2018–2024) referencing to both Mid-term and End-term review reports.
• Provide clear strategic directions for eye health service delivery, workforce development, information systems, supply chain, health financing, leadership and governance and community engagement.
• Strengthen the integration of eye health into Rwanda’s national health system.
• Align with national and global health prioritiesincluding but not limited to Rwanda National Health Policy 2025, IAPB 2030 In Sight Strategy, UN Resolution on Vision for Everyone 2021 – 2030, WHA Resolution 74.13 – Integrated People-Centered Eye Care (IPEC), WHO’s Eye Care in Health Systems: Guide for Action among others, ensuring sustainability and equity.
• Focus on addressing equity and inclusion for eye health services especially for marginalised groups. 
• Leveraging private sector and public-private partnerships (PPPs) for service delivery and financing.
• Serve as a tool for resource mobilization, advocacy, and accountability in eye health.

3. Objectives

General objective

To design the National Strategic Plan for Eye Health2025-2029 that will serve as a roadmap for the country’s eye health development over the next five years.

Specific objectives

1. To facilitate stakeholder engagement and consultations to ensure the plan is participatory and evidence based.
2. To define the vision, mission, strategic objectives, and priority interventions for eye health.
3. Ensure the plan is aligned to national and global priorities and strategies including cross-sector integration.
4. To develop a costed implementation plan with clear milestones, responsibilities, and financing strategies.
5. To develop a strategic plan that advances equitable, digitally enabled, and sustainable eye health services by leveraging both public and private sector capacities.
6. Ensure that gender, equity, and inclusion considerations are meaningfully integrated throughout the strategic plan.To establish a monitoring and evaluation framework with measurable indicators.
7. To produce a final, validated strategic plan as per the agreed template ready for adoption and sign off by the Ministry of Health.

4. Scope of work

The consultant will undertake the following tasks:

1. Review and consolidate existing evidence and data of the Eye Health Situation in Rwanda 

1. 1. • Conduct a Desk Review of existing documents such as the NSPEH 2018–2024 End Term Report, Cataracts Business Case (2023), the recently concluded ECSAT (2025) to determine the status of Eye Health in Rwanda that includes progress, successes, challenges etc. 
      • Map stakeholders, service coverage, financing mechanisms, workforce capacity, and infrastructure.
        • Mapping will include public and private sector providers, insurance schemes, and training institutions
      • Analysis of domestic financing trends, insurance coverage (e.g., CBHI), donor dependency, and co-investment strategies from existing information sources.
      • Review the various HSS pillars from an IPEC lens and draw recommendations for each of the pillars including integration of community engagement and GAPSED+.

2. Engage stakeholders

1. 1. • Hold consultations with the Ministry of Health, Eye Health Technical Working Group (TWG), NGOs, CSOs, professional bodies, academic institutions, private sector, and development partners.
      • Include community-level voices, particularly patients, vulnerable people including women, and persons with disabilities.
      • Facilitate workshops and validation meetings for input and consensus building.

3. Draft the Strategic Plan

1. 1. • Define vision, mission, and guiding principles for eye health.
      • Propose strategic objectives, priority interventions, and measurable targets.
      • Develop an implementation framework with clear roles and responsibilities.
      • Outline a monitoring, evaluation, and accountability framework (with sustainability indicators and milestones).
      • Propose a resource mobilization and sustainability plan.

4. Validation and finalization

1. • Present the draft to the Eye Health TWG and the Ministry of Health.
   • Revise the draft strategic plan based on feedback.
   • Produce the final NSPEH 2025–2029 ready for endorsement and dissemination.

5. Expected deliverables

1. The consultant will deliver an inception report that outlines the methodology, proposed tools, and work plan for the assignment. 
2. A draft NSPEH 2025–2029 will be developed, covering strategic objectives, interventions, a costed implementation plan, and monitoring and evaluation mechanisms. 
3. Present the Draft Strategic Plan draft in a validation workshop 
4. Dissemination of the final National Strategic Plan for Eye Health 2025–2029, incorporating all comments and feedback from stakeholders.
5. Summary Brief of the Strategic Plan and Presentation Slides of the key highlights.

A. Activity timeline

The exercise is expected to be conducted by the consultant in collaboration with the Ministry of Health (MOH) and Eye Health Technical Working Group (EHTWG), who will also provide financial support for the assignment within a timeframe of 30 days. The consultant shall report to the Ministry of Health/Department of Planning, M&E and Health Financing and the Eye Health Technical Working Group members.

1. PROFILE OF THE CONSULTANT

The consultant should be a seasoned professional with proven expertise in public health policy and health systems strengthening.

Minimum qualifications

• Advanced university degree (Master’s or PhD) in Public Health, Health Policy/Planning, Health Economics, or related field.

Professional experience

• At least 10 years’ progressive professional experiencein health systems planning, strategic plan development, or health financing.

• Proven experience in developingnational health strategies, investment cases, or policy frameworks.

• Demonstrated knowledge ofeye health and non-communicable diseases (NCDs).
• Familiarity with theRwanda health systemand its governance, financing, and service delivery structures.

• Solid track record in conducting national level health sector reviews, situational analyses and strategic plan development.

• Strong background inresource mobilization and sustainability planning.

• Experience working withgovernments, international agencies, and NGOs in Africa.

2. Institutional arrangement

The consultant will be contracted by the Ministry of Health and will report to the Department of Planning, Monitoring and Evaluation, and Health Financing. Technical oversight and guidance will be provided by the Eye Health Technical Working Group (EHTWG). The Ministry of Health will facilitate access to relevant data, stakeholders, and documents, and will provide logistical and administrative support in collaboration with development partners.

Interested individuals or institutions are invited to submit a cover letter, resume, and both technical and financial proposals by 7th November 2025 to rwanda@hollows.org.

Please reference “Consultancy to Develop Rwanda NSPEH 2025–2029” in your email subject line. Only submissions that include all required documents as outlined in the TOR and meet the minimum eligibility criteria will be considered. Qualified consultants may also undergo a background check on child protection as a condition of engagement.