External formative evaluation of the project “Control, elimination and eradication of skin related NTDs" in Ghana

from ANESVAD Foundation
Closing date: 24 Nov 2019


The control activities of Neglected Tropical Diseases (NTDs) requiring intensified disease management - i.e. Case-Management NTDs (CM-NTDs), specifically Yaws, Buruli Ulcer and Leprosy – was managed separately by individual programs with distinct program heads and structures. In the rationale of the project was the assumption that Integration of control activities for these 3 skin-related CM NTDs would afford a more efficient use of scarce resources and help address the issue of co-endemicity of the diseases. Consequently, accelerate the achievement of the various public health targets with regards to the control of Buruli ulcer, sub-national elimination of leprosy and finally the elimination followed by subsequent eradication of yaws. Earlier diagnosis and better management of CM-NTDs would prevent disability and thus reduce the negative socio-economic impact of NTDs. The expected system-wide improvement beyond the scope of NTDs would additionally facilitate the future national scale-up of the novel approach proposed, which is Ghana’s first real attempt at integrating the case management of NTDs.


Title: Control, Elimination and Eradication of Skin Related Neglected Tropical Diseases - Buruli Ulcer, Leprosy and Yaws respectively - in Ghana.

Duration: The project was to be carried out over a period of 24 months starting from January 2018.

Overall objective: Contribute to improve the health of the most vulnerable population of Ghana and achieve the Global elimination of leprosy, eradication of Yaws and control of BU by 2020.

Goal: To improve the control of BU and achieve elimination of Leprosy and Yaws in 15 endemic districts in Ghana through an integrated approach to detection, prevention and management


-BU/Yaws/Leprosy surveillance strengthened at community and Health Facility levels through community sensitization, capacity building and provision of surveillance tools

-Integrated case management strengthened at all levels within an enhanced health system

-Laboratory diagnosis of BU/yaws/ leprosy improved through strengthening of national and selected district labs

-Advocacy and health promotion on skin NTDs undertaken

-Project activities are timely implemented monitored and evaluated

-Research that will provide scientific guidance to skin NTDs’ control, elimination and eradication strategies undertaken

Key participants:

§ Ghana Health Service: The National Yaws Eradication Programme (NYEP), National Buruli Ulcer Control Programme (NBUCP) and National Leprosy Control Programme (NLCP) of the Ghana health service have the primary responsibility to coordinate and monitor the implementation of the project with the regions and districts concerned. They are also responsible for compiling districts reports for onward submission to Anesvad.

§ Districts: responsible for the implementation of the project and making reports to the regional and national levels.

§ Communities: Community leaders, district education authorities, school teachers and village health workers will help to inform and mobilize the populations for screening and treatment. Village volunteers and teachers will also serve as part of the community surveillance network to report any suspected cases.

§ National Research Laboratories (NRL): Noguchi Memorial Institute for Medical Research (NMIMR), have been involved in BU lab diagnosis and serology diagnosis of yaws; Kumasi Center for Collaborative Research (KCCR), School of Medical Sciences, Kwame Nkrumah University of Science and Technology(KNUST) has been giving laboratory support for yaws whilst KCCR has been involved in BU diagnosis; University of Ghana-Chemistry Department - Currently undertaking a project involving the use of fluorescent thin layer chromatography to detect mycolactone in BU lesions. These 3 research laboratories will be responsible for lab confirmation of cases and to provide training for district-level laboratory staff.

Location: A total of 15 out of the 216 districts in the country have been selected for this project based on co-endemicity and specific prevalence of Leprosy, Yaws and Buruli ulcer across the country. Consequently, the chosen districts are not contiguous and are distributed within 7 of the 10 administrative regions.


Type of evaluation: External formative evaluation

Period covered by the evaluation: from January 2018 up to date.

Geographical coverage: 15 districts from 7 regions of Ghana

Purpose: analyze project design and strategies, provide a clear understanding of the progress made so far and draw out lessons and action-oriented recommendations for how the project can be improved.


a) Analyse the project theory of change, design, strategies and determine strengths/weaknesses/gaps, focusing on criteria of relevance.

b) Inform on progress made, focusing on criteria of effectiveness. In the process of assessing effectiveness undertake the following key activities:

  • Consolidate (or generate) base line data (quantitative and qualitative) for the key indicators and measure progress made to date. A before-and-current situation comparison of the data shall give a sense of how the situation among beneficiaries has changed since the intervention.

  • Identify target groups and undertake “qualitative” surveys, in the form of focus group discussions (households and health staff) and key informant interviews (web-based and/or face-to-face), to provide an overview of their understanding of the program progress and their recommendations to improve it

c) With the inputs from the previous objectives, and focusing on criteria of efficiency, coordination/integration, impact, sustainability and gender draw out lessons learnt and action-oriented recommendations, generic and per key actor, for how the project can be improved

For more detail check ToR: https://drive.google.com/open?id=1PgXJSoDxFk6eBSVrwu_JO69R6-zdadwi

How to apply:

The deadline for submitting the tender for the evaluation is November 24, 2019. The tender must be submitted by e-mail with the following Subject header: REF: Proposal for External formative Evaluation of the project Control, Elimination and Eradication of Skin Related NTDs in Ghana, Attn.: Lander Bombien (landerbombien@anesvad.org); Eider Villaverde (eidervillaverde@anesvad.org) and Pedro Landim (pedrolandim@anesvad.org)