Background

Sightsavers is an international development agency working on the promotion of eye health and establishing an inclusive and sustainable eye care system. The cataract support programme is one of the major programmes aimed at strengthening the cataract service delivery at public and charity hospitals. 

Gilgit-Baltistan, a region with unique geographical and socio-economic challenges, has been facing significant healthcare delivery issues, particularly in the field of eye care. Sightsavers is supporting seven public sector hospitals in six districts of Gilgit Baltistan for strengthening the cataract service delivery through equipment support, consumables and lenses, and surgical instruments.  These hospitals are now producing a large number of cataract surgical outputs, and the outreach of these hospitals has expanded to far-flung areas. 

The evaluation of operating theaters dedicated to eye surgeries in selected public sector hospitals is essential to assess their operational efficiency, quality of care, and overall capacity to meet the eye health needs of the population. Moreover, quality assurance and maintaining the required quality standards are highly important for generating positive surgical outcomes. Hence, it is important to ensure that operating theaters of these public hospitals meet the required clinical standards.  

Objectives of the Assignment

• Assess the current status and functionality of operating theaters for eye surgeries in selected public sector hospitals.

• Identify strengths and weaknesses in the existing infrastructure, surgical processes, equipment availability, and staff competencies.

• Provide actionable recommendations to improve the quality of eye surgical services.

• Enhance patient safety and outcomes in eye surgeries.

Scope of Work

The consultant will evaluate the following key areas:

• Infrastructure Assessment: Evaluate the physical condition and design of the operating theatres, including sterilization facilities, recovery rooms, and waiting areas.

• Equipment and Supplies: Review the availability, functionality, and maintenance of surgical equipment and instruments required for eye surgeries.

• Human Resources: Assess the qualifications, training, and workload of surgical teams, including ophthalmologists, nurses, and support staff.

• Surgical Protocols: Examine existing surgical protocols and adherence to best practices in eye care.

• Patient Outcomes: Analyze data on surgical outcomes, complication rates, and patient satisfaction.

• Regulatory Compliance: Ensure that the theatres comply with national regulatory standards (for example, developed by Punjab Healthcare Commission) for surgical safety and infection control.

• Patient satisfaction and access to services: This can be evaluated through FGDs or IDIs with a selected pool of patients in various districts on anonymity basis.

Methodology

The evaluation will employ a mixed-methods approach, including:

• Site Visits: Conduct on-site assessments of selected hospitals to observe operating theatres and interact with healthcare providers, in the light of Sightsavers Cataract Quality Standards

• Interviews and Focus Groups: Engage with hospital management, surgical teams, and patients to gather qualitative insights.

• Document Review: Analyze relevant documents, including surgical records, OT equipment maintenance logs, and patient feedback.

• Data Analysis: Utilize quantitative data to assess surgical outcomes and operational efficiency.

• Observational assessments of procedures and facilities

Deliverables

• A comprehensive assessment Report detailing findings, analysis and recommendations.

• Assessment Report addressing feedback and comments (substantiated by MOVs)

• Presentation to Sightsavers and CEC Cell, GB

Targeted Health Facilities and Duration

The duration of the assignment is one month

Qualifications and Requirements

• A minimum of a consultant/specialist in Ophthalmology or a relevant degree 

• At least 7-10 years of experience in cataract surgical services and experience in the management of eye OPD and eye OT

• Experience and a degree in public health/community eye health will be an added preference 

• Strong knowledge of global practices and procedures of eye care surgical services and eye OT management from QA perspective.

Indicative Budget

PKR 1,000,000/- inclusive of all expenses and consultancy fee