Job Description
BACKGROUND:
The objective of the U.S. Agency for International Development (USAID) Revenue for Growth Activity (R4G) is to support the Government of the Republic of Zambia (GRZ) in its efforts to improve domestic resource mobilization (DRM), which can help to expand Zambia’s fiscal space for public spending and investments in service delivery and poverty reduction. R4G is engaging both government and non-government stakeholders in building capacity in tax policy analysis, improving tax compliance and administration, and strengthening tax culture in a manner that facilitates private sector growth and promotes effective relationships between taxpayers and the GRZ. The R4G is organized around four Objectives: 1) Improve Tax and Non-Tax Administration and Compliance; 2) Strengthen Tax Policy; 3) Enhance Public-Private Dialogue; and 4) Enhance Capacity to Address Emerging Fiscal Policy and Management Issues.
To help operationalize the Ministry of Health (MOH)’s Health Care Financing Strategy 2019 – 2027, USAID is planning to retain and embed one Advisor in the National Health Insurance Management Authority (NHIMA) and another Advisor in the Health Care Financing (HCF) Unit at the MOH. The responsibilities of the MOH HCF Unit Advisor are outlined below. The Advisor will be employed by R4G for a period of three years (contingent on successful performance). The Advisor will report to the MOH and R4G.
MOH HCF Unit Advisor Position Summary:
USAID, through its Systems for Better Health (SBH) project, supported the MOH HCF Unit by placing a Health Care Financing and Planning Technical Specialist in the Unit from December 2017 to December 2018. However, technical support is still required in order to operationalize the MOH’s Health Care Financing Strategy 2019 – 2027 and other health care financing policies and systems, The HCF Advisor will support the MOH and GRZ in efforts to mobilize domestic resources for the health sector.
The Advisor will report to the Head of the HCF Unit and is expected to establish effective working relationships with officials and staff of the MOH and other GRZ organizations that have a role in health care financing, including the Ministry of Finance (especially the Budget Department and units that compile and use economic and demographic information), the Zambia Statistics Agency, the Parliamentary Budget Office, Parliamentary Budget and Health Committees, university and research communities, and other organizations that may be identified during the course of the Advisor’s work. As other countries may provide valuable lessons in health care financing that can be applied in Zambia, the Advisor is expected to establish effective working relationships with health care financing officials and organizations in other countries, as well as with international donor and/or advocacy organizations involved in health care and its financing. Collectively, these activities are expected to increase and accelerate the development of knowledge and capacity to improve health care financing in Zambia.
Responsibilities of the HCF Advisor
The HCF Advisor’s responsibilities include but are not limited to the following. The responsibilities are listed in order or priority and will be finalized when the position is filled.
1. Explore innovative health care financing strategies such as a medical levy, sin taxes and a motor vehicle accident fund to accelerate progress towards universal health coverage by the government, and produce a report that describes possible health care financing strategies that can be employed in Zambia. This will require, but may not be limited to:
· conducting a review of current health care financing strategies used in Zambia (as well as any strategies used previously);
· conducting a review of strategies attempted and/or used in other countries, and the factors contributing to their success or failure;
· conducting a review of donor-sponsored research and/or technical assistance projects regarding health care financing;
· constructing a generic “standard practice” model, comparing that model to Zambia’s experience, and preparing a gap analysis of the differences; and
· preparing a report, based on international experience and the gap analysis, within the framework of the Health Care Financing Strategic Plan, with recommendations for the way forward.
2. Review and carry out an assessment of efficiency bottlenecks in the health sector to inform decisions to improve efficiencies, produce a report with recommendations on how to reduce bottlenecks and increase efficiencies, and prepare a feasible bottleneck amelioration plan. This will require, but may not be limited to:
· developing a consensus view, at both the central and local levels, of the efficiency bottleneck challenges to primary care, which can be expanded to address health sector wide bottlenecks as well;
· gathering and assessing information regarding the bottleneck causes and previous efforts (if any) to ameliorate them in both Zambia and other countries; and
· developing feasible 1-year and 3-year bottleneck amelioration plans, including specific action steps and designated responsibilities.
3. Update the resource allocation formula/framework to take into account changing needs by districts, and develop a formula that tracks and reports on changing district needs and activities. This will require, but may not be limited to:
· determining sources of district information, including demographic, economic, health care resource (including funding, staffing, and facilities), and health care statistical (morbidity and mortality) data;
· gathering and synthesizing current and recent (5-year) information from the identified sources, conducting 2- and 5-year demographic, health care, and economic extrapolations, and disseminating trends to information sources and GRZ officials;
· assessing current and recent funding trends against current and recent needs, and suggesting optimum resource allocations;
· conducting seminars with the MOF, other relevant GRZ organizations (including local governments and Parliament), and the press in order to provide maximum transparency and public awareness; and
· developing and proposing 2- and 5-year implementation strategies, including monitoring and evaluation methods.
4. Support the development of an investment case for health to help lobby the Ministry of Finance (MOF) to increase funding to the health sector, which will require developing the investment case and conducting discussions. This will require, but may not be limited to:
· Identifying previous efforts in Zambia regarding the successful implementation of investment activities, including long-term capital budgeting/investment programs, to determine effective strategies;
· gathering information from other countries that have implemented (or have sought to implement) health care financing programs, identifying the factors leading to their success or failure, and adapting those lessons learned to Zambia;
· seeking support of international donor organizations regarding potentially successful strategies;
· developing a detailed and costed investment case for health care financing in Zambia, which can be integrated with, and supported by, the Health Care Financing Strategic Plan;
· using the Health Care Financing Technical Working Group as a convening entity, conducting a series of sensitization sessions for MOF leadership and staff, Parliament (including the Parliamentary Budget Office, the Budget Committee, the Health Committee, the committees concerned with local governments, etc.), and other relevant GRZ organizations (i.e., the Ministries of Education, Local Government, etc.), in order to develop a broad base of understanding and support; and
· providing staff support for the development and implementation of 2- and 5-year action plans for the phased and full roll-out of the health care financing strategies.
5. Comply with all R4G project reporting requirements, including but not limited to preparing quarterly and annual reports, work plans, and monitoring, evaluation and learning reports.
Qualifications:
The HCF Advisor will possess the following minimum qualifications. Note that some of the public sector experience may have been earned concurrently.
· An undergraduate degree in health economics, accounting, management, statistics, or a closely related field.
· A graduate degree in economics, public administration, or a medical degree.
· 5 years’ experience in working within, or directly advising, public sector agencies on the delivery, costing, and/or evaluation of human services.
· 5 years’ experience in health care delivery.
· 5 years’ experience in insurance programs.
· 3 years’ experience in cross-cutting public sector activities (i.e. involving two or more units of the same ministry or across two or more ministries).
· 3 years’ experience working with international organizations and/or two or more countries.
· 3 years’ experience developing service delivery costing models.
· Excellent written and verbal communication skills.