Healthcare Programme Evaluation At RED NOSES Clowndoctors International

RED NOSES International

Healthcare Programme Evaluation

1. Evaluation Topic

RED NOSES International started out with sending clowns to visit children in hospitals. It has since expanded to bring humour and art to elderly homes, crisis situations, and the classrooms of children with disabilities, but the majority of its work is still within the healthcare system. The healthcare programme includes several artistic formats: clowns visit children and adults in and out of hospitals, accompany children through medical procedures (“Intensive Smile”), put on circuses with patients (“Circus Patientus”), and provide training to healthcare staff and students on how to integrate humour into their work.

This evaluation looks at the context and opportunities of the healthcare programme across 11 countries in Europe and the Middle East, with a focus on partnerships and systemic change.

2. Evaluation Objectives

The objectives of the evaluation are to:

  • Develop a description of the programme’s target groups and primary objectives
  • Introduce a basis for deepening institutional partnerships with healthcare institutions, with the aim of improving the quality of our work and becoming an indispensable member of the healthcare team
  • Support RNI in contributing to sustainable improvements to healthcare systems

3. Users of the Evaluation

The results of the evaluation will be used by the International Programmes department, Managing and Artistic Directors, as well as the executive management, in planning how to reach the Strategy 2025 goals.

The evaluation will also be used by the advocacy team in the International Office.

Finally, the evaluation will support the Research and Learning department in developing tool templates for RED NOSES Offices to use to monitor and evaluate institutional partnerships.

4. Evaluation Questions

The following questions should be answered taking all 11 RED NOSES countries into consideration. The primary focus should be on points that are held in common, but notable divergent trends in specific countries and regions should also be highlighted.

Establishing a baseline

  1. What are the most relevant challenges facing the programme’s target groups (children in hospitals, their families, medical staff?
  2. What is the current role of clowns in the healthcare system? To what extent are they seen as an integrated part of the healthcare team, as opposed to an optional luxury?
  3. To what extent do healthcare staff currently integrate humour into their work? To what extent is humour included in the curriculum for healthcare students?

Understanding the different kinds of partnerships

  1. What are the most important differences between healthcare institutions that are relevant to our work?
  2. Which of those differences support strong, collaborative partnerships between RED NOSES and healthcare institutions? Which differences weaken these partnerships?
  3. Which differences are inevitable and which do we have the power to influence?

Looking towards the future

  1. Which evolving trends in healthcare systems and hospital processes will affect our work? How can we prepare to adapt to these changes?
  2. What opportunities are there for RED NOSES to make a positive, lasting change on healthcare systems?

5. Approach and Methods

The Evaluation should include the experience and perspectives of actors in RED NOSES Offices, as well as at various levels in healthcare institutions and relevant systemic players such as health ministry officials or medical university department heads. Medical directors on RED NOSES advisory boards can be a helpful resource. It will also be important to include the perspectives of nurses, educators, psychologists, social workeers and other medical staff who see the benefits of the clowns’ work on a daily basis.

A balance must be struck between getting results that are broad enough to be relevant to all 11 RED NOSES countries, but also deep enough to be useful towards achieving the evaluation objectives. Research projects that are running parallel to this evaluation may be helpful for this goal: in Austria and Slovenia there are more in-depth studies underway pursuing similar questions. In addition, other healthcare clown organisations outside of RED NOSES are also investigating this topic. The evaluators are encouraged to find ways to make use of these processes and results.

It is expected that the evaluation will apply a mixed-method approach to collect quantitative and qualitative data. In addition, it should utilize existing information and data sources.

● Desk Review: The evaluation should consider published material on the impact of humour and on the role of clowning in healthcare, as well as internal documents relevant to the current status and goals of the healthcare programme, such as the RED NOSES Framework of Change and the international and national strategy documents.

● Interviews and focus group discussions: To gather qualitative information, interviews and/or focus group discussions should be held with a variety of stakeholders. To increase the sampled population and provide additional benefits to the evaluation participants, the evaluators may want to provide guidance for RED NOSES staff in country offices to lead some of these activities in their own languages.

● Survey: To achieve the scope of the evaluation across 11 countries, it is expected that a survey will be conducted, translated into the target languages.

● Creative/innovative methods: Evaluators are also welcome to introduce additional creative and/or innovative methods

6. Timeline

The timeline is foreseen as follows:

May 2021: Inception phase (Sign contract; agree on questions and methods)

June – September/October 2021: Data collection, analysis, drafting of final report

October/November 2021: Presentation of final results

7. Management

The evaluation coordinator and primary contact person is the Head of the Research and Learning Department. The Healthcare Programme working group will provide additional feedback and guidance.

8. Budget

A budget of 12,000 EUR is available. This budget includes fees for all team members, travel costs, translation costs, and any other incidental costs that may arise during any phase of the evaluation.

9. Evaluation Team

The evaluation team need to meet the following criteria:

  • Master’s Degree in a relevant field
  • Experience managing evaluations (minimum 5 references)
  • Experience conducting research or other work within the field of Public Health
  • Experience in quantitative and qualitative data collection and analysis (minimum 7 years)
  • Experience or demonstrable interest in researching artistic interventions
  • Excellent spoken and written English. Other languages spoken in the target countries are an asset

How to apply

To apply, please send the following to maggie.roessler (at) by May 3:

  1. A brief conceptual note of your understanding of this evaluation and your methodological approach
  2. A reference list of relevant assignments
  3. Your CV or the CVs of the experts proposed for this evaluation.
  4. Information on costs charged in EUR (daily rates, travel and totals).