Consultant (To provide assistance to MNHSR&C for health financing reforms in Pakistan and development of Health Financing Strategy)

Contract

This is a No grade contract. More about No grade contracts.

Purpose of the Consultancy

The purpose of the consultancy is to assist Government of Pakistan by providing the Technical Assistance to the Ministry of National Health Services, Regulations & Coordination (MNHSR&C), for health financing reforms in Pakistan and development of Health Financing Strategy.

Background

Health outcomes in Pakistan are subpar and inequitable, which reflects poor coverage of quality health services. Health financing is one of the main factors responsible for this. Total health spending in 2017 comprised only 2.9% of GDP ($45 per capita), which is low compared to a global average of 9.9%. It also the lowest in South Asia. However, the root cause of Pakistan’s relatively low levels of health coverage remains its chronically low levels of public financing for health. Public health expenditure in 2017 accounted for 1% of GDP, or around $14 per capita. This level of public spending on health is among the lowest worldwide.

In the absence of adequate public financing (efficiency and effectiveness of spending included), Pakistanis often resort to financing health care via out-of-pocket payments, which account for 57% of total health expenditures. In addition, most health allocations are consumed by secondary and tertiary care, leaving a scant allocation for preventive and primary care. There are inefficiencies in the public health spending due to weak management systems, resulting in low utilization and eventual lapse of funds. Donor funding has been minimal.

Health financing strategy of a country define how resources are collected, pooled, and used to purchase health services for the population and typically result from a structured policy- making process. Health financing strategy diagnoses health system performance and identifies a prioritized set of actions – reformative and evaluative - within a 5-10 years period; and develops a service delivery plan for ALL, ideally integrated within national/provincial plan or health policy document. A health financing strategy is only useful, and successful, if it is based on and responds to a detailed analysis of both the current performance problems in the health sector and their underlying causes.

The Ministry of National Health services, Regulations and Coordination (MNHSRC), is working for development of Health Financing Strategy in consultation with provinces/ federating areas, partner organizations and key stakeholders. In this regard a Technical Working Group (TWG) has been notified.

The WHO being a major technical agency is an important stakeholder, it seeks services of an international finance expert as to help the Ministry in development of Health Financing Strategy. In this regard P4H which is the global network for health financing and social health protection and aims at promoting equitable and sustainable health financing systems to progress towards Universal Health Coverage, has agreed to provide financial assistance for Short Term Consultancy.

Work to be performed

1. To effectively engage with all relevant national and international stakeholders involved with the ongoing health financing reforms for UHC

2. To connect and establish contacts to support Government’s UHC policy implementation plans in collaboration with Government ministries (MoNHSR&C) and other relevant federal and provincial stakeholders involved in health financing and social health protection (SHP) for UHC.

3. To create networking among Pakistan GAP partners (UNICEF, UNFPA, World Bank, GAVI, UNAIDS, GFATM, GFF), but not limited to, other bi and multilateral organizations such as Expertise France, GIZ, USAID and ILO that committed to support UHC and SHP in Pakistan;
4. To facilitate a dialogue on joint activities aimed at strengthening the health system in Pakistan with a focus on GAP accelerators, Primarily Sustainable Financing for Health
5. To support Federal and Provincial governments’ dialogues on health reformative plans and their implementation along with WHO’s health financing policy and strategy.

6. To raise awareness of P4H in relation to the UHC objectives, value proposition, theory of change, principles and operating processes of the P4H Network at national, regional and global levels.

7. To stir better knowledge management among relevant stakeholders:

8. To Identify and gather information and gaps related to the action plans and activities of federal and provincial governments, GAP and other partners active in health financing and SHP reforms

9. To provide, initiate and engage in production of insights, analytics, information and evidence-based knowledge, reports and other useful information and feedback among relevant stakeholders.
10. To populate the P4H Web platform with all relevant information and documents in the scope of work in Pakistan to ensure continuity and a growing volume of insights brokered amongst Web platform users.

11. To gather and circulate information about other relevant dimensions of health financing and social health protection for UHC including issues and challenges around COVID-19.

12. To promote innovation for better coordination and collaboration among health financing actors at federal and provincial levels:

13. To facilitate dialogues and consensus on the most feasible mechanism for effective partnership collaboration to stimulate and maintain regular exchanges on operational implementation of joint activities among GAP and other partners.

14. To support “Leadership for UHC Program (L4UHC)”, collective action initiatives developed under the L4UHC Pakistan teamwork and ensure their links with the GAP activities, as well as other health system wide interventions including the COVID-19 crisis response.

15. To participate actively in the P4H network as a Coordination Team member

16. To contribute and provide feedback to the P4H CT and CD to support the P4H network knowledge generation and M&E as well as its internal and external communication. This includes material for such productions as:

• Annual report
• Regular newsletters
• Social media communication (tweets and other P4H digital ecosystem tools)

2. To engage within the P4H CT and with the CD to generate ideas and identify opportunities for P4H supported activities in Pakistan directed to capacity development and knowledge generation as well as other P4H objectives and expected results.
3. To engage pro-actively in the discussions and actions of the network response to the COVID-19 crisis in line with P4H technical specificity and value proposition.
4. To liaise with the P4H CD on potential opportunities for Asia regional expansion of the Network based on established relationships at country level with international partners that are not yet part of the P4H Network.

Deliverable:

2. Report on Analysis of stakeholders in relation to health financing in Pakistan
3. Concept paper on health financing reforms in Pakistan based on synthesis of existing evidence
4. Report on Health system problems and and their underlying causes with a focus on health financing issues/ challenges
5. Working paper on health financing strategic reforms and actions required to meet country-specific and province-specific objectives

Requirements:

• Qualifications required:

Advanced university degree in economics, finance, political or social sciences (law, public health, or other relevant disciplines).

• Experience required:

More than 10 years’ experience in the areas of health financing, social protection and/or health systems strengthening. Geographical exposure according to the geographical area of work is essential while previous experience of working in the country where the focal point will be based is desirable.

Prior Experience in development of health financing strategy will be an added asset.

• Skills / Technical skills and knowledge:
  • Demonstrated expertise in the field of health financing, economics, health policy and/or social health protection programs implementation.
  • Ability to identify, process and broker strategic insight in the above fields.
  • Proven capacity to engage a variety of diverse audiences effectively and operate in a multicultural environment working on sensitive policy issues.
  • Capacity to promote and build sustainable collaborative working relationships across a wide range of organizations with specific mandates and organizational cultures
  • Demonstrated effective negotiation and communities of practice facilitation skills.
  • Proven innovation-driven collaboration empowerment skills.
  • Strong IT/Web platforms proficiency required.
  • Familiarity with WHO country support work will be advantage.
• Language requirements:

Proficiency in reading, writing, and speaking English is required

Intermediate knowledge of local language is an asset.

Place of assignment

WHO Country Office, Islamabad, Pakistan.

Medical clearance

The selected Consultant will be expected to provide a medical certificate of fitness for work.