The main objective of this consultancy is supporting the implementation of Model of Care in selected states to advance progress towards attaining Universal Health Coverage and health security in Sudan.

Background:

Federal Ministry of Health in collaboration with health partners and stakeholders developed the National Health Policy 2020 – 2024 in line with the national priorities for the transitional period. National health priorities and strategic directions are being finalized in consultation with different stakeholders. A recent mission from WHO Regional Office for Eastern Mediterranean Region has provided recommendations to re-imaging the health system and advance progress towards attaining Universal Health Coverage in Sudan.

Over the past few years, Sudan developed several health policies and strategies to address the key health system and programme-specific challenges and bottlenecks using evidence generated from different assessments and surveys. Partners and donors contributed significantly to support evidence generation and development of these policies and strategies. However, translating these policies and plans into action remains a challenge as the implementation rates are quite low due to various structural and contextual reasons that include:

Inadequate capacities at national and sub-national level to support implementation of policies and strategies (human, financial, etc.).
Lack of clarity on roles and responsibilities between the three tires of health system (federal, state and locality), overlapping, week coordination among these levels in addition to lack of accountability mechanisms.
Fragmentation and lack of systematic approaches to address cross-programmatic inefficiencies and advance integration at all levels. Fragmentation is the salient feature of the health policy system, with multiple actors developing separate health policies with minimal coordination among these entities.
Although Sudan is among the first countries to adopt Health in All Policies (HiAPs) to move towards “Whole of Government” approach through development of a roadmap to address the Social Determinants of Health, however, implementation of this roadmap is very limited. Improving policy coherence between different government sectors remains a key challenge.

FMOH supported by WHO is planning to design and implement a “Model of Care” based family health approach and in line with the UHC Benefit Package through strengthening the local/decentralized health system in selected states. The MoC is focusing on improving access to quality, integrated PHC and Emergency Healthcare services. Implementation of the comprehensive integrated model for strengthening health system will be through phase-based approach. Two or three states will be selected for the first phase (demonstration states) for a period of two years (one to two years) then a second group of states will be added before rolling out the implementation into the remaining states. Phase-based approach is recommended modality of implementation in contexts where capacities and resources are scarce. Focusing resources and efforts in limited number of states will allow producing results, building capacities and drawing lessons for smooth and successful implementation in other states during the rolling out phase. During implementation of the first phase, other states will continue their routine activities and will not be affected negatively. Resources needed in the demonstration states will not be skewed from currently allocated resources, but these should be additional.

Planned timeline

Start date: 20 February 2022

End date: 19 September 2022

Work to be performed

To achieve the below mentioned tasks and responsibilities, the consultants will be supported by the federal and states Technical Working Groups:

Output 1: A roadmap and workplans to guide development and implementation of the Model of Care developed

Deliverable 1.1: Conduct desk review of literature and key documents (national policies, strategies, assessments, reports, etc.)

Deliverable 1.2: Facilitate consultation workshops at federal and state level on findings of Health Facility Mapping involving key stakeholders (National Medical Supply Fund (MNSF), National Health Insurance Fund (NHIF), donors, NGOs, communities, academia and other stakeholders)

Deliverable 1.3: Develop a roadmap and workplans (national and states) to guide implementation of the Model of Care in selected states.

Deliverable 1.4: Facilitate advocacy and dissemination workshops at federal and state level involving all stakeholders and partners.

Output 2: Model of Care is designed and implemented in the selected states

Deliverable 2.1: Support establishment of the Steering Committee and Technical Working Groups at national and state level involving key stakeholders.

Deliverable 2.2: Support implementation of the action plan at national and state level focusing on:

1. 1. Support implementation of PHC Services Improvement Plan guided by the health facility mapping
2. Training of family physicians and family health team (medical assistances, nurses, Community Midwifes, Community Health Workers)
3. Support NHIF and MOH to implement the newly developed Provider Payment Mechanisms
4. Support strengthening the capacities of Local Health System in the selected states
5. Organize regular M&E activities including joint supportive supervision, review meetings, assessments, etc.

Deliverable 2.3: Facilitate documentation and draw lessons from different implementation phases focusing on progress made, what works and what doesn't.

Deliverable 2.3: Submit monthly progress reports highlighting progress made in the implementation, key challenges and recommendations to improve the performance.