23/09/2025
OGRA FOUNDATION
TERMS OF REFERENCE (TOR) FOR AN IMPLEMENTATION RESEARCH OF THE TULINDE KIFUA PROJECT
1. INTRODUCTION AND BACKGROUND
1.1 Overview of the Client Organization
OGRA Foundation is a national Non-Governmental Organization (NGO) in Kenya with its head office in Kisumu City. The organization was registered in 2004 as an NGO and has operated for 20 years implementing a range of projects to help realize its mission of creating sustainable socio-economic, health & education solutions to communities in Sub-Sahara Africa through innovative integrated interventions that foster community participation. Implementations of the health and development projects are done in close collaboration with local communities and the relevant government ministries and departments. The organization has nationwide coverage including but not limited to Kisumu, Siaya, Busia, Vihiga, Homa Bay, Kakamega counties. In addition, OGRA has project implementation experience in 8 other African countries.
1.2 Overview of the Project
Project duration: October 2024 to March 2026
The TULINDE KIFUA project is part of TB REACH Wave 11, funded by STOP TB Partnership. It implements an integrated TB and lung health care model at primary healthcare that aims to improve detection and care of tuberculosis through increased demand for lung health services, improved service quality and empowerment of women and people affected by TB. The project leverages on the recently introduced primary healthcare networks (PCNs) in Kenya to support integrated service delivery (ISD) for lung health at 20 primary health care (PHC) facilities and 2 hubs. The project sites are in Nyando and Muhoroni sub-counties, Kisumu County- Kenya. ISD is implemented at the PHC level so that patients can access comprehensive lung health services including TB screening including chest x-ray, spirometry, sputum collection for gene x-pert and other laboratory services. Chest x-rays services are made available at the PHC facilities through a rotational portable x-ray, with reports availed in real time through CAD-AI. Complicated cases that require in-patient management are referred to secondary level facilities (hubs) which receive technical support from the chest physicians. The project has a community component that involves community health promoters (CHPs) to further increase demand creation for the services by screening people in the community for lung health conditions are referring them appropriately to the health facilities. Patients diagnosed with TB receive treatment at the nearest health facility. The women empowerment component of the project involves organization and community level interventions including involving young women and survivors of TB to support patient flow and peer education in the facilities.
The project aims to improve detection and treatment of TB by having the integrated and inclusive approach that attracts a wide range of people with respiratory symptoms and ensures all are properly evaluated.
The overall goal of the project is to increase TB case finding and improve lung health diagnosis and treatment by 60% to identify and treat 300 additional TB cases and 10000 other lung health conditions. The objectives include:
i. To improve demand creation for TB, Pneumonia, Asthma and COPD services at community level
ii. To strengthen health systems at primary healthcare to deliver quality integrated TB Pneumonia, Asthma and COPD services.
iii. To support gender mainstreaming and women empowerment in the project
iv. To support sustainability initiatives and strengthen coordination and partnership for lung health
1.3 Context of the project operation
The project is implemented in 20 primary health care facilities and 2 level four hospitals (hubs) in Nyando and Muhoroni sub-counties in Kisumu County with equal distribution between the two sub-counties. Kisumu County has a population of 1,155,574 out of whom 50.3% are females. Nyando and Muhoroni sub-counties (formerly Nyando District) have a population of 315,624 mainly in rural areas and small towns. The area’s main economic activity is farming, with commercial agriculture involving rice and sugarcane. Farm workers tend to stay in crowded informal settlements and work in groups. The area is prone to flooding during rainy seasons which leads to people being moved to evacuation centers that often get crowded. Nyando sub-county boarders Lake Victoria hence contains fishing communities living along its shores.
2. OBJECTIVES OF THE ASSIGNMENT
OGRA Foundation (herein after referred to as “the Client”) is seeking a qualified research consultant (herein after referred to as “the researcher”) with skills and experience in qualitative and quantitative research to conduct implementation research with the support of project team.
The implementation research is expected to examine the implementation outcomes of integrated service delivery of TB, pneumonia, asthma and COPD in public primary healthcare facilities as implemented in the TULINDE KIFUA project.
The specific objectives are:
i. To describe and compare various ISD models used for TB, pneumonia, asthma, and COPD in primary healthcare settings;
ii. To assess the acceptability of ISD interventions among health care workers, CHPs and patients in primary healthcare;
iii. To assess the feasibility, cost-effectiveness, and long-term sustainability of implementing ISD for TB, pneumonia, asthma, and COPD within primary healthcare settings;
iv. To identify and analyze the challenges and opportunities associated with implementing ISD for lung health in public primary healthcare facilities in Kisumu County Kenya.
The researcher is expected to propose the methodology and the logistics of the research in the application. However, it is expected that the project will use mixed methods with both qualitative and quantitative data collection methods.
3. SCOPE OF WORK AND TASKS
3.1 Activities:
The researcher is expected to perform the following activities as part of the assignment:
Propose the research methodology
Review the proposed methodology with the Client and agree on final methodology and work plan of the assignment.
Conduct desk review related to the project and the assignment.
Develop and validate data collection tools
Conduct data collection relevant to the assignment.
Conduct modeling and analysis of data.
Prepare final report with relevant implementation recommendations.
Participate in dissemination of research findings to relevant stakeholders.
4. METHODOLOGY AND DELIVERABLES
4.1 Proposed Approach:
The researcher is expected to propose the approach to the assignment. The client, however, expects the researcher to employ standard methods for implementation research. We encourage the researchers to review the frameworks below as they conceptualize their approach.
i. Proctor E at al. Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011 Mar;38(2):65-76. doi: 10.1007/s10488-010-0319-7. PMID: 20957426; PMC3068522.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068522/
ii. Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999 Sep;89(9):1322-7. doi: 10.2105/ajph.89.9.1322. PMID: 10474547; PMCID: PMC1508772.Detail the OR modeling and solution approaches the consultant should use, including any software tools or techniques.
Data collection methods may include:
Desk-base review: The researcher may review relevant project documents and content produced before and during project implementation including the project proposal, annual and quarterly work plans, project progress reports, annual project reports, public policy documents and other documents produced by or associated with the project.
Interviews with Project stakeholders/partners: In addition to the desk review, the researcher may conduct interviews with key project stakeholders using a structured methodology developed by the researcher in collaboration with OGRA Foundation.
Key Informant Interviews (KIIs): A set of KIIs may be conducted with selected relevant key informants and institutions (a list of key informants and institutions will be agreed between the researcher and the project team at inception).
Focus Group Discussions: Data may be collected using focus groups discussion with project beneficiaries and other project stakeholders using a pre-designed focus group discussion guide.
5. WORK PLAN: DELIVERABLES AND TIMELINES
The implementation research is expected to begin by 21st October to 28th November 2025.
No Deliverables Description Timeline
1 Inception Report This must define the scope of the work with a proposed work plan and data collection tools to be submitted 7 days following the official commencement of the assignment. The inception report should detail the researchers’ understanding of what is being evaluated and why, showing how each research question will be answered by way of: proposed methods; proposed sources of data; and data collection procedures. The inception report should include a proposed schedule of tasks, activities and deliverables, designating a team member with the lead responsibility for each task or product.
By 28th October 2025
2 Fieldwork Training of enumerators, testing of tools and final validation, Data Collection & Analysis By 11th November 2025
3 Draft Report The researcher must submit draft report for review and comments by all parties involved after analysis of the field data. By 18th November 2025
4. Final Report This will be submitted 7- 10 days after receiving comments from the project team. The content and structure of the final analytical report with findings, recommendations and lessons learnt covering the scope of the research and must include the following:
• Executive summary (1-2 pages),
• Introduction (1 page),
• Description of the research methodology (6 pages),
• Situational analysis about the research questions, and partnership strategy (6-7 pages),
• Analysis of opportunities to provide guidance for future programming (3-4 pages),
• Key findings, including best practices and lessons learned (4-5 pages),
• Conclusions and recommendations (4-5 pages).
• Power point presentation of the report.
Appendices: Charts, terms of reference, field visits, people interviewed, documents reviewed By 28th November 2025
6. MANAGEMENT AND LOGISTICS
The researcher shall report to the Project Director/ Principal Investigator (PI) at the Client who will not have control over the professional work of the researchers. The Client will provide logistical support to the research team not included in their budget.
7. CONSULTANT QUALIFICATIONS AND EXPERIENCE
The researcher shall have the following expertise and qualifications:
o At least master’s degree in public health, public policy, social sciences, medicine, Project Management or any other relevant master’s degree.
o Extensive expertise, knowledge, and experience in the field of public health and project management in developing countries
o Experience of project formulation and evaluation and practical experience of end of project evaluation in a similar context.
o At least 5 years of experience in working with non-governmental organizations and donors, evaluating projects with multiple partners with complex implementation modalities
o Excellent written and verbal Communication skills is English.
o Experience with evaluation of TB and/or lung health projects will be an added advantage
Applications will be evaluated on these criteria as well as the quality of the technical offer (proposed methodology, capacity to mobilize qualified personnel in the field, etc.) and the soundness of the financial offer.
8. APPLICATION PROCEDURE
Interested, qualified and experienced person, group of persons or firms must submit an Expression of Interest that includes:
The expression of interest should contain: (a) a technical offer and (b) a financial offer, comprising:
A. A cover letter (max 1 page) addressed to:
The Project Director, TULINDE KIFUA Project,
OGRA Foundation
P.O BOX 3050 - 40100 KISUMU
B. Technical offer:
Up to date CV of the lead researcher (showing education and expertise) – Maximum 3 pages
A brief profile of the firm where applicable (Maximum 2 pages)
Technical proposition detailing proposed methodology and resources needed (max 5 pages).
C. Financial offer:
A list of all expenses expected to be incurred by the researcher including a consultancy charge on daily rate or per deliverable.
Submissions can be made by either:
a) Email to [email protected] and Cc. to [email protected]
b) Post (registered mail) to the address above.
c) Physical delivery of hard and soft copies to:
OGRA Foundation Head Office
Milimani Estate- Off Aga Khan Road, Opposite Jalaram Academy
KISUMU- KENYA.
Applications should reach OGRA Foundation not later than 3rd October 2025 at 1200 Noon.