Review of the Sensory Screening and Early Intervention Model as implemented in Garissa and Kwale Counties – Sense International Kenya

1. BACKGROUND

1.1 Sense International Kenya

Sense International Kenya is part of Sense International, a global organization supporting children and adults with deaf-blindness and those with complex disabilities in Kenya, India, Bangladesh, Peru, Romania, Nepal, Uganda, and Tanzania. Sense International Kenya is the only organization in the country which works exclusively to help persons with deaf-blindness to connect with their families, and to the world around them. We work to ensure that persons with deaf-blindness have the emotional, health and educational support to become active and valued members of their communities.

1.2 The Project

Since October 2021, Sense International Kenya has been working on a three-year project in Kwale and Garissa Counties to implement the sensory screening and Early Intervention model. This is implemented in two county referral hospitals and two sub-county hospitals in Garissa and Kwale counties. Through this project, children under four years will know if they have a disability, and those found to have complex disabilities, including deaf-blindness, will be enrolled and supported through a comprehensive early intervention programme which will help improve their function, implemented activities of daily living and ready them for schooling.

The project adopts a multi-level approach to identifying infants with multi-sensory impairments, including deaf-blindness. This ranges from engaging Community Health Volunteers (CHVs) to raise awareness at community level, to screening new-born babies in maternity wards and infants aged 0-4 years in immunization clinics at health facilities. Currently Sense International implements a two-step screening process: the risk factor screening questionnaire (1st-step) followed by equipment screening for those identified with risk factors (2nd-step).

After the child is identified with a sensory impairment, sensory assessment reports are aligned with an appropriate and individualized Early Intervention programme that is implemented by the Occupational Therapists (OTs) at the hospitals. The Early Intervention programme consists of weekly scheduled therapy visits at the early intervention units and home-based therapy services. The OTs make regular home visits for each infant enrolled in the Early Intervention service to conduct periodic assessments of the infants’ intervention activities at home.

2. PURPOSE OF THE MODEL WORKABILITY REVIEW

Sense International Kenya is seeking to engage a consultant to;

1. Assess the quality, cost efficiency, impact, relevance and replicability of the Sense International Kenya Sensory Screening and Early Intervention model for children with complex sensory impairments in order to make the case to the County Governments of Garissa and Kwale to adopt and roll out the model throughout their Counties.
2. Identify the opportunities and barriers to continuation of current activities, scale-up and replication of the model to influence policy in Kenya, and more specifically to the Counties of Garissa and Kwale.
3. Analyze and provide evidence demonstrating that this innovative Sensory Screening and Early Intervention Model is effective; has impact; is cost effective; and is scalable.
4. Examines the impact on individual children and their families/carers, quality assurance from a technical perspective, and the broader policy environment in both Counties.

2.1 End of project evaluation – the difference

The Model workability review differs from the project evaluation in terms of its purpose and involvement of beneficiaries and stakeholders. It aims to analyze the project model on its effectiveness, strengths and weaknesses unlike an evaluation which aims to assess impact attained by a particular project. This Model workability review aims to gather evidence to demonstrate the opportunities and barriers to implementation, adoption and scale up of the model by the Governments in Garissa and Kwale Counties. Sense International Kenya will utilise the review findings for its advocacy work with both County Governments to take up the current project activities and ideally scale-up the sensory screening and early intervention activities to other areas in both Counties. It will also provide crucial lessons for other Sense International country teams and stakeholders who wish to establish sensory screening and early intervention activities in partnership with their Ministry of Health.

3. PROPOSED METHODOLOGY

The model workability review will consist of the following suggested components:

• Analysis of documentation/literature review: for evidence of success, change, learning, barriers to implementation and access to services. This will include periodic project reports, donor reports, minutes from Steering Committee meetings, and training reports and a sample of individual child development plans. It will also include detailed monitoring data sets of both quantitative and qualitative information for analysis.
• Key Informant Interviews for project staff: Initial meetings with the project team to explore issues and lessons relating to successes, challenges, and impact from a range of perspectives. It is expected that the project team will be involved throughout the review.
• Fieldwork – KII and FGD for project stakeholders: Meeting with a number of key stakeholders in both Garissa and Kwale for Key Informant Interviews and Focus Group Discussions in order to gather evidence of effectiveness, workability and scalability of the Model.
• Data analysis and reporting: Analysis of the results will identify and provide evidence of the workability and effectiveness of the Model, discuss opportunities and barriers to scale up and replication and discuss pertinent issues relating to Sense International Kenya’s influencing agenda.

4. KEY DELIVERABLES

1. A comprehensive set of data collection tools to be reviewed and approved by Sense International Kenya. Each tool should clearly outline the type, its purpose, target audience, and how it will be used.
2. A report which provides evidence of the workability and effectiveness of the Sensory Screening and Early Intervention Model, highlighting opportunities and barriers to continuation of current activities, and scale-up and replication of the Model by the County Governments of Garissa and Kwale. The report should range between 20 – 25 pages before adding annexes.
3. A summary report, in an easy to read, format that can be used by the Steering Committees, Sense International and implementing partners to advocate with County Government and funders. This should be a maximum of six pages.

Sense International Kenya will utilise the summary report for official publication on its website and other channels, and therefore the quality of the report should be of such standard that it can be submitted for a peer review and publication.

5. TIMESCALES

The whole exercise will take 21 working days.

The schedule below indicates the total number of days available for this model workability review.

• Analysis of documentation – 2 days
• Briefing and field work – 8 days (4 in Garissa / 4 in Kwale)
• Analysis and report writing – 6 days
• Travel – 3 days
• Presentation of first draft to SIK teams – 1 day
• Consultant Working on first round of review – 2 days
• Consultant working on final version – 2 days

Total – 21 days

The Consultant, in liaison with SIK, will develop a detailed work plan on the exercise, including start dates.