In Tanzania, several studies indicate that NCDs are a growing problem, with estimates showing that NCDs account for 27% of all deaths in Tanzania. Recent studies show that the distribution of NCDs as a percentage of all deaths stands at 12%, 8%, 3%, 3%, 2% and 7% for CVD, injuries, cancer, respiratory diseases, diabetes and other NCDs for all ages, and at 65% for communicable diseases respectively. For those who are 61 years and above, the overall NCDs Proportional Mortality Ratio (PMR) is close to 60% in some districts of the country.
In Morogoro Region, older people have unique and compounding vulnerabilities caused by the co-morbidities of communicable chronic diseases including HIV, and NCDs which include; eye complications, cardiovascular diseases, diabetes and hypertension cancers dimentia etc. HelpAge’s programmatic experience shows that in rural areas where many older people live, the lower population density and more geographically dispersed populations make it more difficult and expensive to create and maintain a comprehensive service infrastructure as compared to urban areas. Consequently, older people have less access to health and care services and their situation is worse when combined with poorer socio-economic conditions. It is even more tense for older people with mobility problems and who suffer from chronic conditions including NCDs. As a result, older people tend to rely heavily on informal health systems such as home-based care providers (HBCs), and traditional medicine administered by traditional healers (THs) who have insufficient knowledge and skills to manage ailments affecting older people and coordinate referral linkages with formal health facilities. From various studies, these informal health systems are highly relied upon by many older people but it has been difficult to navigate their refferal pathways, linkage with the formal health system and value addition. This is creating a number of bottlenecks when trying to increase access to preventive, diagnostic, treatment management and follow-up services for geriatric conditions, NCDs, chronic communicable diseases and SRH among older people. It was at the backdrop of this reality that HelpAge International Tanzania developed a proposal of two years project entitled Better Health for Older People in Africa – Increasing access to preventive, diagnostic, treatment management and follow-up services for geriatric conditions, NCDs and SRH among older people in Tanzania. The proposal was accepted and the project was funded by BMZ. The project is implemented in Morogoro region in eighty districts (Councils) as follows; Morogoro Municipal Council, Ifakara Town Council, Morogoro, Malinyi, Kilombero, Kilosa, Gairo and Mvomero District Councils. However, the emergency of the COVID-19 Pandemic interfered with the implementation of the project.
The project has two objectives namely;
To contribute to the health system strengthening in 8 districts of Morogoro region, Tanzania through:
i. increasing access to preventative, diagnostic, treatment, management and follow up services for geriatric conditions, NCDS and SRH, among older men and women, including older persons with disabilities; and
ii. promoting healthy aging of and improving healthy habits and health seeking behavior through a life-course approach to the prevention of NCDs and other geriatric conditions.
2.Purpose of the Final Evaluation
The purpose of the final evaluation is to analyze the extent to which project objectives have been met and identify key learned lessons that will help improve upcoming interventions to older people and identify sustainable good practices which can be rolled over to other districts in the country and to assess the impact of the project on the target population.
3. Scope of Area and Evaluation Objectives
The final evaluation will cover 4 selected sample districts which are Mvomero, Gairo, Kilosa and Morogoro Municipal Districts (Councils) respectively focusing on the performance of the project. The final evaluation will address at least the following key evaluation objectives:
i) Has the project increased the access of older people to health and care services?
ii) Has the project strengthened the knowledge and skills of primary health workers in health facilities and are they providing age friendly preventative, diagnostic, treatment, management and follow up services for geriatric conditions, chronic infectious diseases, NCDS and comorbidity?
iii) Has the project strengthened Informal and formal health systems in the coordination and formalized care management, monitoring and referral mechanisms for geriatric conditions, chronic diseases, NCDS and SRH services
for older men and women including older people with disabilities?
iv) Has the project improved the health seeking behavior among older people, are older people practicing healthy habits including doing exercises?
v) Has the project reoriented CHMTs attitude in resource allocation to address older people health services needs?
vi) Has the project strengthened actors in the health sector (CHMTs and RHMTs to develop Action Plans based on the WHO Health System Strengthening Concept (HSS)?
4. Evaluation Criteria
The consultants are expected to be guided by the following evaluation criteria across all activities.
a) Project Relevance
- To what extent have the interventions undertaken by the project been relevant to the needs and priorities of older people?
b) Project Effectiveness
- How well did the project achieve the expected results (objectives and outcomes) in the results framework?
- Are there areas were the project showed significant over- or under-achievement, and what were the major factors influencing this?
- Were there any gaps related to planning, management, monitoring and implementation that influenced the results?
c) Project Efficiency
- To what extent did the project budget factor-in the cost of specific activities, outputs and outcomes to address: (i) Gender equality and non-discrimination? (ii) Inclusion of people with disabilities?
- How well have resources and inputs (funds, expertise, time, etc.) been allocated or used project to achieve the expected results?
- Have programme outputs been delivered in a timely manner? If not, what are the factors that have hindered timely delivery of outputs?
d) Project Sustainability
- To what extent does the results of the intervention likely to have a long term, sustainable positive contribution to the relevant actors/beneficiaries?
- To what extent has the project developed scalable and replicable models that can be used for future programming?
- To what extent are the planned results of the project likely to be sustainable, maintained or even scaled up and replicated by other actors after the project has been completed?
- To what extent does the project and its interventions fit with other Interventions in the region and country within the same sector?
- To what extent are observed changes attributed to the intervention? (Both positive and negative changes).
- What changes have occurred as a direct result of the project at different levels, and for different stakeholders?
5. Beneficiaries and Respondents
The Evaluation will involve different stakeholders including older people, HBCs OPMG members, CHMT members, RHMT members, DMOs, RMOs, implementing partner and HAITAN staff.
6. Outputs and Deliverables
a) In light of the above, the consultant(s) will submit: Inception Report (IR) detailing inter alia proposed work plan, methodology that will be agreed upon between the consultant and HelpAge Tanzania and regional office and HelpAge German. The Inception Reports also outlines how the consultant(s) will ensure high quality evaluation standards and ethical standards.
b) Data collection tools: Develop the data collection tools and have them approved by HAIT, regional office and partners before data collection, analysis, interpretation
c) Conduct the evaluation in selected project areas
d) Prepare a Draft Evaluation report: The firm/consultant will prepare a draft evaluation report with details of findings, recommendations and lessons learnt for review by HAIT and regional office.
e) Submit the Draft report to HelpAge Tanzania
f) Revise the draft report based on the feedback
g) The report must be supported by raw data; case studies and/best practices, list of people interviewed, or pictorials taken during evaluation
h) All data in the report should be disaggregated by age, sex and disability
i) Submit Final Evaluation report upon agreement with HAIT and regional office
j) Provide HAIT with all data. This will be both in electronic and hard copy (MS Word document, PowerPoint slides).
6. Expert Profile of the Evaluation Team
In order to carry out this final evaluation exercise, the evaluation team should have the following core competencies, educational and work experiences:
- Ability to research, collate and synthesize a range of information and data (qualitative and quantitative) into useful, strategic and practical analysis and recommendations
- Ability to communicate effectively with a wide range of people within community, Government officials, development agencies at various levels Demonstrates sensitivity, tact and diplomacy, and projects a positive image
- Ability to write high quality and concise technical report with high proficiency in written and spoken English, within agreed terms of reference and deadlines
7. Tentative and Timetable
The consultant will have maximum of 21 days from signing of agreement to complete the assignment.
Payment will be based on submission of deliverables that are satisfactory and have been assessed by the HelpAge team to be of good quality. Taxation laws will apply on the overall consultancy fee.
- 30% of the contract value after the submission and approval of the inception report
- 30% of the contract value after the submission and approval of the Interim Final Evaluation report
- 40% of the contract value after the submission and approval of Final Evaluation Report.
8. Management of the Evaluation
It is envisaged that the evaluation will adopt participatory approaches involving the use of mixed methods. However, the consultants will propose and design a suitable methodology in line with the evaluation objectives.
The consultants will among other things:
- Work closely with HelpAge Tanzania thematic leads.
- Facilitate orientation/meeting with organization's country office key staff and management to clarify expectations and desired outcomes, review and confirm activity and logistics plans.
- Review of project monitoring data and records (baseline report, mid-term report, annual reports and routine monitoring).
- Develop tools to gather information and manage mobile data collection if any using final data collection instruments. The tools will be submitted together with the final report. Develop a data analysis plan
- Train enumerators and pre-test data collection instruments.
- Conduct focus groups and/or in-depth interviews with older people (beneficiaries) from five districts, staff, partner and other stakeholders.
- Conduct Key Informant Interviews and case studies.
- Prepare a draft evaluation report outlining evaluation process, project achievements, constraints, lessons learned, recommendations, next steps/action plan.
- Conduct debriefing meetings with staff/stakeholders/partners to review preliminary evaluation findings.
- Finalize Evaluation Report that includes recommendations and explain how these changes would improve programme outcomes and sustained impact.
10. Education and Experience:
- Consultant should possess a minimum of Master’s degree (PhD is an added advantage) on Social Sciences, Development studies or in a discipline relevant to this assignment with a minimum of 7 years’ experience.
- Proven experience in conducting evaluations of complex development programmes and research
- Proven experience in participatory reviews and research, and capacity assessments
- Proven work experience in Aging issues
11. Expression of Interest
Interested individuals are requested to apply by submitting their expression of interest describing their expertise and background experience. The proposal and CV should explain briefly:
1. Your competency to meet and provide analyzed information as outlined in this TOR
2. A brief outline of how the consultant(s) would approach this evaluation in terms of its methodology
3. An example of a relevant piece of work undertaken by the applicant.
4. Financial proposal: The financial proposal should provide cost estimates for services rendered including daily consultancy fees.
All interest Applicant should submit their application by 16th November 2020 to
the office Manager,
HelpAge international P.O.Box 9846,
Dar es salaam,
by email to
[email removed] and cc: to [email removed] and
To contribute to the health system strengthening in 8 districts of Morogoro region, Tanzania through: