: May 20, 2022, 1:25:44 PM
: Jun 10, 2022, 11:59:00 PM
: Tanzania, United Republic of-Zanzibar
Purpose of the consultancy
Background
Fair and sustainable financing is essential for achieving Universal Health Coverage. The overall health policy objective is to ensure that all Zanzibaris have access to quality and equitable health services rendered in a cost effective and affordable manner.
The World Health Report in 2010, expressed the need to ensure that people can obtain the health care services they need without the fear of being impoverished in paying for them. In Zanzibar, health financing reform was explored from early 2000 by considering other options of financing health care such as cost sharing in government health facilities. They were more consolidated during the year 2013/14 when a feasibility of introducing National Health Insurance Scheme was undertaken. The report shows that it is possible, and the design of the scheme was completed. The proposed National Health Insurance Scheme was suspended in 2019 since the government was not in agreement with the proposed scheme which is contributory. The new administration in 2021 decided to revive the scheme. The new scheme i.e Zanzibar Health Insurance Scheme is now in advanced stage.
The government wishes to come up with a strategy that will outlines appropriate sources of health financing that ensure the health needs of people are met to all with without financial barrier and health provision is made much more efficient and effective by adopting strategic purchasing over the next the next 5-10 years. Presently, the health system is affected by multiple inefficiencies, including but not limited to structural inefficiencies such governance, unavailability of one national insurance, and health system fragmentation. These inefficiencies affect the revenue raising and pooling efforts needed for optimized and resilient health financing. Strategies to address this are required.
To meet these needs the Ministry of Health in Zanzibar embarked on a number of initiatives and reforms. It was further resolved that these reforms should be done in a comprehensive and systematic way. This necessitates the development of a medium to long term health financing strategy. So far, some analytical work has been done through various studies which will be used as inputs to the strategy; the studies include NHAs, PERs, Household Budget Surveys, HF Policy Note, HF System Analysis, and a costed Essential Health Package, among others. Furthermore, four Preparatory Workshops have taken place; the first with members of the Health Financing Technical Working Group, the second and third with health financing stakeholders and the fourth with Senior Management in the Ministry of Health. These workshops focused on health financing concepts, principles and values guiding reform and what could be learned from country’s Health Financing Strategies and their implementation.
Scope and Methodology
The work will include reviewing of “minimum” benefit packages based on source of funding considering the roles of tax, social and private health insurance and out-of-pocket payments. Deciding on the structure of the insurance market, i.e. define the roles of Health Insurance and individual insurers; extent of management/decision rights at public providers taking into account the need for efficient management and necessary human capacities; Define the role of performance oriented financing and identify reform potentials recognizing the role of management autonomy;
Evaluate and define the role of equity-oriented financing and identify reform potentials with a special focus on the role of the budget and formula funding. Develop a plan for including the poor and vulnerable in social health protection
The consultancy is expected to:
- Work with Technical Working Group (TWG) of Health Care Financing and Public Financial Management of the MOHSWEGC
- Conduct consultation with the relevant stakeholders.
- Desk reviews for all relevant documents including policy document, health sector strategic plan, evaluation reports and best practice from other countries
- Present the final draft of the Zanzibar Health Financing Strategy to the MOHSWEGC Management Committee and stakeholders:
Summary of Assigned Duties:
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- Review key policy documents
- Conduct literature review of sustainable financing strategies in developing countries
- Present and share different alternative options and strategies in their generic form to the technical working group Healthcare Financing
- Diagnose health systems performance in terms of UHC, identifying problems and the underlying causes
- Contribute to organise and structure the discussion of country specific objectives.
- Identify strategic reforms, policies and actions required to meet country specific objectives
- Propose the necessary governance and capacity building arrangement to ensure implementation of strategic reforms
- Develop monitoring and evaluation systems to monitor progress and adjust implementation accordingly.
- Assessment of current situation of healthcare financing in Zanzibar.
- Produce a summary of key finding of the Zanzibar healthcare financing.
- Develop set of healthcare financing options suitable for Zanzibar context.
- Present those options with benefits and drawbacks to MOHSWEGC senior management.
- Develop agreeable health financing goals and vision for the health sector based on UHC
- Develop draft healthcare financing strategy with implementation and monitoring and evaluation framework for Zanzibar and way forward for the options decided upon.
Technical Supervision
Objective
The Main objective of the consultancy will be to assist the Ministry of Health to develop a medium- to long-term Health Financing Strategy to facilitate achievement of universal coverage.
More specifically;
- Engage policy makers and other senior entities to discuss and agree on the overall goals and vision for the health sector, based on UHC aspirations;
- Review the health financing landscape with a view to diagnosing the present health system’s performance in terms of UHC; identify problems and their underlying causes
- Develop/propose specific objectives needed to steer the country towards universal health coverage;
- Identify strategic reforms and actions needed to realize the stated objectives, including, but not limited to
- strategies in eliminating health financing fragmentations;
- appropriate actions to improve efficiency and effectiveness of health financing to providers;
- A review of the existing and proposed health benefits.
- Outline the governance and capacity building actions needed to ensure implementation of the proposed strategic reforms
- Outline the evaluation modalities/framework needed to monitor implementation aspects and corrective actions as may be needed.
Specific Requirements
LANGUAGE:
Essential: Fluency in both English and Swahili language.
Desirable: Working knowledge of other UN language is an added advantage.
EDUCATION:
Essential: Masters’ Degree in Public Health or Health Economics or above
Desirable: Ph.D. in Public Health or Health Economics is an added advantage.
EXPERIENCE:
Essential:
The Consultant must have at least 5 – 7 years’ experience on health financing related tasks.
Desirable:
At least 5 years in developing of health financing strategies
The Consultancy firm or individual for this assignment must have the following qualifications;
- Registered as a consulting firm or an individual by appropriate authority.
- Evidence of working experience of at least five years in developing health financing strategies.
- Existence of professional staffs in the area of health financing strategies where upon the team leader should have at least a master’s degree in public health/ health economics, or other relevant fields. Other team members should have at least Bachelor’s degrees in health economics or other relevant fields.
SKILLS AND COMPETENCIES
- Technical understanding in health care financing is strongly desired.
- Experience of working in developing countries (multicultural environment)
- Must have excellent research and analytical skills
- Excellent communication, writing and editing skills and fluent in English language, including ability to present information in different stakeholders. Ability to communicate well in Swahili will be an added advantage.
- Ability to commence work immediately.
COMPETENCIES REQUIRED
- *Producing results;
- *Fostering integration and teamwork;
- *Communicating in a credible and effective way;
- Moving forward in a changing environment
- Respecting and promoting individual and cultural differences
Other Skills (e.g. IT):
Basic IT skills is a requirement: Good command of MS office software: Word, Excel, Access, PowerPoint and use of the Internet.
- Good computer skills in Microsoft Office.
- Submission of weekly activity plans and end of week update reports
- Report on the rapid infrastructural and operational analysis of isolation and treatment units of designated facilities. This should include HCWM infrastructure, supplies needs, capacity/no. of beds, staffing needs for HCWM, coordination, diversion of non-essential staff, supplies, equipment, etc.
- End of contract report documenting all activities including gaps and recommendations
PLACE OF ASSIGNMENT
- Will be working in Tanzania Zanzibar physically and remotely.
Duration
- The contract will be for two months and half.
Salary
Grade: NOC