CONSULTANT TERMS OF REFERENCE
Project title: Cluster Randomized Control Trial of Immediate vs Delayed Dispensing for Readymade Glasses
COUNTRY: KENYA
DATE: APRIL 2026
1. 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. 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 began working in Kenya in 2004. The Foundation work in partnership with the Ministry of Health at both national and county levels, Community Based Organizations and private hospitals to deliver high quality eye health services. The Foundation seeks the services of a consultant to conduct a study on Cluster Randomized
Control Trial of Immediate Vs Delayed Dispensing for Ready Made glasses “
2. PROJECT BACKGROUND
Presbyopia is a common age-related condition that significantly impairs near vision, productivity, and quality of life, particularly in low- and middle-income countries such as Kenya. Despite the availability of simple and low-cost corrective solutions, access remains limited due to systemic, socioeconomic, and service delivery barriers. Evidence suggests that immediate provision of reading glasses at the point of screening increases uptake and functional benefits, while voucher-based systems may reduce coverage due to additional access barriers. Reviews of presbyopia correction strategies emphasise the need for more high-quality intervention trials to inform optimal delivery models, particularly in resourcelimited contexts where program cost and ease of uptake drive effectiveness. As a key accelerator of the ‘Value of Vision’ report, there is a clear need for more context-specific research on the costeffectiveness of timely service provision for refractive error. Indeed, it is likely that many of the lessons learned when distributing glasses for presbyopia hold for other types of refractive error service delivery, which can significantly impact The Foundation’s programming approaches to referral and service delivery.
This study aims to evaluate the cost-effectiveness of two delivery models for ready-made reading glasses: (1) immediate on-site dispensing at pop-up screening clinics and (2) voucher-based redemption at partner outlets. A cluster-randomized controlled trial will be conducted in Kisumu and Siaya counties in Kenya.
PURPOSE OF THE RESEARCH STUDY
This study aims to estimate the cost-effectiveness of two models of delivering ready-made reading glasses. Specifically, we will estimate the incremental cost per effectively covered presbyope at six weeks when comparing two delivery models for ready-made reading glasses: (1) immediate, on-thespot dispensing at a pop-up screening site (delivered by trained community health workers (CHWs) and
(2) voucher-based redemption at a partner outlet (to mimic a referral procedure).
AUDIENCE FOR THE FINDINGS
The audience for these research findings includes international eye health peak bodies and NGOs, Ministries of Health and Finance (in Kenya and abroad), health economists working towards Universal Health Coverage (UHC), development sector professionals and researchers worldwide.
RESEARCH / EVALUATION QUESTIONS
Relevant research questions for this specific project include:
- How does eliminating delayed redemption (referral) in the context of readymade near-vision glasses impact the number of people who receive glasses?
- How does eliminating delayed redemption (referral) in the context of readymade near-vision glasses impact the number of people who continue to wear (comply with wearing) glasses?
- What is the comparative cost-effectiveness of on-the-spot vs referral-based models of care for provision of readymade near-vision glasses?
- How do demographic factors impact the impact and cost-effectiveness of each service delivery model?
PROCEDURES
The key activities for this project are as follows:
- DEVELOP A FORMAL TRIAL PROTOCOL (INCLUDING FIELD PROCEDURES, DATA COLLECTION TEMPLATES AND PROCESSES, RECRUITMENT, TRAINING, AND PERSONNEL PLAN, AND OTHER RELEVANT COMPONENTS) FOR ADMINISTRATION AND DELIVERY OF A CLUSTER-RANDOMISED TRIAL DESIGN BASED ON THE DRAFT PROTOCOL (SEE APPENDIX A).
- Consultation with key FHF stakeholders to ensure that the formal trial protocol aligns with aims and outcomes of the project.
- Delivery and management of the cluster-randomised trial in a timely manner, including all data collection associated with trial outcomes and collection of cost data to support the comparative cost-effectiveness analysis.
- Data analysis, including analysis of the impacts on first-order outcomes (e.g. access to and compliance with spectacle wearing) and cost-effectiveness analysis of each model.
It is expected that weekly meetings will be held with FHF project management team to update on progress for the duration of the project. On completion of the above activities, a formal report describing the implementation of the randomised trial in detail, data collection and analysis (including costeffectiveness analysis) and provision of all data associated with the project will be delivered to FHF.
DATA SOURCES
Data will be collected from trial participants. Cost data will be collected as part of training and service delivery activities. The trial is designed to be pragmatic and deliberately lean. Between 12 and 20 clusters will be included, with approximately 25–40 eligible presbyopes per cluster, resulting in a total sample of roughly 300–800 participants. Under plausible assumptions—for example, 65% effective coverage in the pop-up arm versus 40% in the voucher arm—approximately 16 clusters with 30 participants each (about 480 participants total) would provide acceptable power to detect a meaningful difference.
DATA ANALYSIS
The consultant will work with FHF to conduct data analysis on first-order outcomes (e.g. access and compliance to wearing spectacles) and cost-effectiveness analysis of each model of service delivery. Data analysis will include sensitivity analysis and subset analysis (including demographics such as age and sex) to understand determinants of effectiveness in each model.
ETHICS AND OTHER APPROVAL
Ethics approval has been sought externally by FHF and will be provided for the successful consultant responsible for delivery of the project.
CONFIDENTIALITY
The consultancy team agrees to not divulge confidential information to any person for any reason during or after completion of this contract with The Foundation. Upon completion or termination of this contract, the consultancy team undertakes to return to The Foundation any materials, files or property in their possession that relate to the business affairs of The Foundation.
INTELLECTUAL PROPERTY
All intellectual property and/or copyright material produced by the consultancy team whilst under contract to The Foundation remain the property of The Foundation. The consultancy team is required to surrender any copyright material he has created during the term of the contract to The Foundation upon completion of termination of the contract. The consultancy team also consents to The Foundation using any works produced as part of this consultancy without attribution and waives all other moral rights in this work.
INSURANCE
Any consultants involved in this research protocol will be required to have in place insurance arrangements appropriate to provision of the requirements in this ToR including travel insurance
OTHER
The Fred Hollows Foundation strongly condemns all forms of child abuse and categorically states that it is unacceptable in any circumstance. The Foundation is committed to ensuring a safe environment and culture for all children with whom we come in contact during the course of our work. All members of the Evaluation Team will be required to comply with the FHF Child Protection Policy and sign the Child Protection Code of Conduct.
Application procedures
The consultant will be selected based on an Expression of Interest outlining:
- The evaluator’s interest and qualifications
- Relevant skills/experience for the evaluation
- Understanding of the assignment/quality of technical proposal and timelines (ability to meet expected timelines)
- Daily rates and overheads applying to the evaluator/consultant
Letter of application, technical and financial proposals and supporting documents should be sent to the following address: procurementkenya@hollows.org to reach us by 15th April 2026 – at 4:00pm. The applications should be clearly referenced “Cluster Randomized Control Trial of Immediate Vs Delayed Dispensing for Ready Made Classes “
For detailed information, please check the complete version of the advert attached below