Terms of Reference (ToR) for a consultant to conduct a research
study to explore perceptions of persons with disability towards
the inclusiveness of health services in two areas of Nigeria
Seeing is Believing (SiB) is a three-year (2017-2020) Comprehensive Child Eye Health in Nigeria
(CCEHiN) programme, that seeks to make comprehensive child eye health services available and
accessible through promotion, prevention, medical care and rehabilitation/inclusive education
targeted at vulnerable children. The SiB programme is being implemented in eleven (11) States of the
Federation divided into four clusters as follows: Cluster 1: Oyo, Ogun and Osun States; Cluster 2: the
Federal Capital Territory, Nasarawa and Plateau States; Cluster 3: Kano, Katsina and Jigawa States;
and Cluster 4: Cross River and Akwa Ibom States. The goal of the programme is to contribute to the
reduction of avoidable blindness and visual impairment through the provision of comprehensive child
eye health services to over 1.5 million children aged 0-14 in selected states of Nigeria. Quality of care is
critical for client’s satisfaction and sustained use of health care services.
Disability inclusive eye health programming provides holistic services that takes cognizance of all
members of a community whether they have a disability or do not have a disability. It caters for all
ranges and different types of disability. Working in two pilot secondary health facilities, the SiB
Project will ensure barriers are identified and removed if possible, and that disability-specific
processes are in adequately put in place.
Purpose of Assignment:
This study will provide a endlineline survey for work on disability inclusion at the two pilot facilities
under the Seeing is Believing programme. The purpose of the study is to examine the perception of
persons with disability regarding the inclusiveness of health services in their local area and compare
with a baseline study, commenting on significance of any changes.
The findings of the research will guide planning, programming and policy formulation as well as work
to address barriers militating against access to services and inclusiveness of persons with disability.
This study will also evaluate how well the SiB programme addressed the identified barriers that affects
access to services and inclusiveness of persons with disability in the pilot sites.
Objectives of the research study:
The objective of this research study will be to assess the perception persons with disabilities and other
relevant stakeholders about the inclusiveness of basic services (focusing particularly on health, also
covering education and other services) for people with disabilities including children with disabilities
and their peers without disabilities in comparison to baseline findings.
The specific objectives of the study are to:
- To understand the perceptions and experiences of persons with disability and other community
- members regarding the inclusiveness of health and other services, including the barriers to accessing
- To determine the level of satisfaction of persons with disability regarding inclusiveness of health and
- other services;
- To understand the perceptions and attitudes of health workers in pilot facilities regarding the
- inclusion of persons with disability in the pilot health facilities;
- To recommend interventions and strategies that should be put in place to make pilot facilities more
- inclusive of persons with disability, and to improve access of people with disabilities to health
- Understand the broader context for inclusion of persons with disabilities in society in the pilot areas
- (attitudes towards persons with disabilities, root causes of any discrimination encountered).
- To discern how much point 1-5 has changed (if any changes are observed) after programme
- implementation and noting any possible attribution to programme implementation.
- Scope of Work
- The study will focus on two project sites - Gwagwalda (FCT) and Doma (Nasarawa state) - where
- inclusive eye health services were piloted in secondary health facilities.
The target groups for the study will include the following stakeholders:
- community members;
- health facility staff (CHEWs, doctors and Nurses) and non-facility care providers (e.g. TBAs);
- community gatekeepers and opinion leaders;
- parents and care givers of children (0-14 years) with disabilities;
- people with disabilities;
- their peers without disabilities in the same age group.
The sample size will endeavour to be representative of the diversity of the population in the catchment
areas; the methodology to achieve a representative sample should be clearly outlined in the research
protocol. The study is expected to respond to but not limited to the following research questions:
- What are the perceptions of persons with disabilities regarding the inclusiveness of and access to
- public health services in the area?
- What are the perceptions of persons with disabilities regarding the inclusiveness of and access to
- the two pilot secondary health facilities?
- To what extent are persons with disabilities, including children with disability, accessing health
- services at the two pilot secondary health facilities?
- What level of knowledge, awareness and understanding do stakeholders in the pilot areas have
- about accessible and inclusive health services?
- What barriers are faced by persons with disability, including children with disability, in accessing
- health services, in the two pilot secondary health facilities?
- What factors support the access and inclusion of persons with disability, including children with
- disability, in accessing health services, in particular in the two pilot secondary health facilities?
- What interventions and strategies should be put in place to improve inclusiveness and access of
- persons with disabilities to health services, in particular in the two pilot secondary health
The consultant(s) is/are expected to present, in detail, their approach, methodology and tools, with an
action plan and timeframe that addresses the expected outputs, with reference to the overall and
specific objectives as well as a budget. A mixed methods study is envisioned, comprising of: a review of
hospital records, quantitative survey and qualitative research.
The research protocol will use representative sampling as appropriate, considering both quantitative
(survey) and appropriate qualitative approaches. Two sets of tools will be developed; a questionnaire
to administer the quantitative component of the survey and qualitative tools. These tools may be as
used in the baseline for easy comparative evaluation where appropriate.
Qualitative research is expected to include:
- People with disabilities within the community, including parents (of both genders), children and
- young people:
- Key opinion leaders in the communities, community gate-keepers, group leaders, religious leaders ;
- Health facility manager/lead.
- The findings of the survey will, where possible, be disaggregated by type of disability, age, sex,
- rural/urban, and other standard socioeconomic characteristics.
- Ways of working:
- Research tools will be developed in collaboration with the research committee from the Seeing is
- Believing team (Programme Manager, Programme Director, Knowledge Management and M&E
- Manager) The baseline tool was developed by studying existing tools and questionnaires developed for
- International Agencies for the Prevention of Blindness (IAPB), other national household surveys,
- Washington group questionnaires and WHO developed tools.
- The consultant will conduct the research in an ethical manner, that is sensitive with regards to
- different cultures, local customs, religious beliefs and practices, personal interaction and gender roles,
- disability, age and ethnicity. Requirements for participant informed consent and confidentiality will
- be maintained, including children participating in the research. Ethical clearance will be sought as
The consultancy will primarily be responsible to plan, design, manage, conduct and report on the
The consultant will be responsible for the following tasks:
- Review existing literature.
- Develop research protocol, including methodology, tools and analysis plan.
- Adjust and finalize the research protocol.
- Recruit and conduct training of enumerators.
- Pre-test research tools (quantitative and review of hospital records)
- Data collection and entry
- Data cleaning, processing and analysis of data
- Drafting of the Preliminary Research Report
- Present the draft research report to research committee
- Integrate the feedback and comments received from research committee and finalise research
- Power Point Presentation including speaker notes
- Research Report with annexes
- Data Sets
Structure of the research report:
The Research Report should incorporate the following main components:
I. Title Page and Opening Pages (including executive summary)
II. Introduction and Background
Introduction/Background - context of inclusion pilot and purpose of research
III. Research Methodology: Description of the methodology of the research
The rationale for choice and design of methodology, including sampling approach
Data sources used, data collection
Analysis methods used for both quantitative and qualitative data, including how the data was mixed
- Description of who was involved and in what capacity
- V. Data Analysis, Quality, and Results
- Sample size and response rates
VI. Key findings of the research, under each research question
Integrated analysis of the findings of different elements of the research (quantitative and qualitative)
Includes key graphs and diagrams to illustrate data
VIII. Conclusions, Lessons Learned and Recommendations for future implementation and the
- Research protocol, including tools
- Additional relevant statistical tables and graphs
- List of persons interviewed (anonymized by role)
- List of abbreviations and sources used
- Supervisor Name and Type of Supervision that will be provided:
- Supervision, regular contact, feedback and comments on deliverables will be provided through the
- research committee, led by the Programme Director and KM & M&E Manager. The consultant will
- work under the general guidance of the research committee.
Consultant’s Work Plan and Official Travel Involved:
- The consultant(s) is required to make his/her own return travel arrangements from Place of
- recruitment-Duty Station-Place of recruitment on the most direct route.
- Travel costs will be reimbursed to the consultant upon submission of invoice and travel documents.
- All related (internal/external) official travel of the consultancy will be organized by the consultant and
- costs reimbursed accordingly.
- The consultant(s) is also required to organize his travel schedule. Research committee, wider SiB team
- and partners will support him/her in arrangements.
- Consultant’s Work Place:
- The consultant will be based either at home, in the field or at the CBM country office in Abuja/Jos
- field office.
Qualifications or Specialized Knowledge/Experience Required:
- Seven years of professional work experience relevant to research and/or disability inclusion. In
- particular, experience of conducting KAP studies is desirable.
- Advanced degree in a relevant social sciences.
- A consultant with multi-disciplinary background such as disability, statistics, research, and analysis,
- social sciences and development is preferable.
- The suitable consultant(s) should have experience in designing, conducting, and managing studies
- related to disability, children’s issues and/or social development.
- Proven experience in conducting qualitative and quantitative research is required, including
- household surveys
- Experience of consulting with people with disabilities, and experience in conducting research with
- children are desirable.
- Experience in producing high-quality reports and analysis.
- Work experience in international organizations is an asset.
The consultant(s) must have good interpersonal communication and negotiation skills. Excellent
English report writing and editing skills and additional knowledge of Hausa language is an asset.
- Good facilitation and qualitative research skills.
- Understanding of human rights-based approaches to programming and results based management
- principles is required, in particular related to child rights and disability rights.
- Ability to bring together diverse stakeholders.
- Effective oral and written communication skills.
- Ability to work in an international and multicultural environment.
- Sensitivity towards different cultures, local customs, religious beliefs and practices, personal
- interaction and gender roles, disability age and ethnicity.
- Strong quantitative analysis skills.
- Good attention to detail.