Deadline of this Job:
17 June 2021
Within Uganda , Kampala , East Africa
Date Posted: Thursday, June 03, 2021 , Base Salary: Not Disclosed
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Project Overview and Role:
Uganda has made significant progress in addressing the health needs of its population as part of the move towards achievement of Universal Health Coverage (UHC). To improve access to health care, the Government of Uganda (GOU) has implemented a number of reforms that include establishment of the Uganda National Minimum Health Care Package (UNMHCP) in 1990, abolition of user fees in public health facilities, providing PHC grant to Private Not-For Profit health facilities to enable them lower costs of services, and developing policies and strategies to address some of the pressing healthcare needs in the country.
The World Health Organisation (WHO) recommends that each country should have an essential health care package, which is not only cost-effective and affordable to the country, but also addresses the highest burden of disease in the country. Uganda has had a minimum health care package (UNMHCP) since 1999. The UNMHCP comprises services that have been classified into four clusters: (1) health promotion, environmental health, and community health initiatives; (2) maternal and child health; (3) communicable disease control; and (4) prevention and control of non-communicable diseases (NCDs), disabilities and injuries, and mental health problems. Uganda is however unable to provide universal access to its minimum package as the resources required to deliver all the services exceed resources available.
The current UNMHCP was designed over two decades ago (since 1999) yet the Second National Health Policy (NHP II, 2010-2020) spelt out that the package shall be reviewed from time to time to match changes in disease burden, availability of new interventions, changes in cost effectiveness, resource availability, equity, vulnerable populations and continuum of care. There is urgent need to adapt the package to the current duo burden of disease (NCDs and communicable diseases), as well as epidemics arising from international health security factors and in line with Universal Health Coverage (UHC) aiming at ensuring all citizens access needed services of good quality without suffering financial hardships.
Primary Duties and Responsibilities:
The overall objective of the consultancy is to lead and provide technical support to the process of defining and costing a Uganda National Minimum Health Care Package (UNMHCP) for UHC taking into consideration Uganda’s Road Map Towards Universal Health Coverage 2019-2030. This will consider changes in the various factors comprising of social, economic, and epidemiological pattern of diseases among others to improve the quality, availability, and breadth of essential, and increasingly specialized health care services in Uganda.
Objective of this assignment
The core objectives of this consultancy are the following:
I. To estimate the current cost of UNMHCP and based on that provide recommendations for an affordable package to provide under the National Health Insurance Scheme (NHIS).
II. To provide projections for financing arrangements for UNMHCP that reflects the costs of increased population coverage, necessary health system strengthening activities, etc.
Specific tasks to be undertaken.
The specific tasks for the Consultants include, among others the following:
I. Inception phase: develop an inception report detailing the key analytical questions that are to be answered, the technical approach that will be employed, and a work plan detailing activities and timelines, and present it to a select committee for their concurrence.
II. Literature review: Review reports and studies on how other countries have approached the development and costing of an essential benefit package with a focus on the following countries: Kenya, Thailand, Philippines, Mexico, Ghana, Rwanda, and South Africa.
III. Synthesizing available costing data:
Identify and review costing studies that have been undertaken in Uganda in the past 10 years including but not limited to
(i) the One Health Costing model supported by WHO
ii. the private sector costing exercise conducted by the USAID- funded UPHS program;
iii. the Access, Bottlenecks, Costs and Equity study by the Institute for Health Metrics and Evaluation,
(iv) Activity Based Costing/Management of HIV/AIDS services funded by USAID. Synthesize key elements of the costing studies (purpose of the study, agency that implemented it, time period, data sources used, key outputs/findings, key assumptions, etc.)
IV. Costing the UNMHCP: Liaising with the Lead Consultant on the definition of the UNMHCP:
a. Clearly articulate the services that comprise the UNMHCP by levels of care (community, primary, secondary, and tertiary).
b. Using existing costing data, undertake a costing analysis of UNMHCP services taking into accounts key inputs (human resources, infrastructure, supplies, operations, and maintenance etc.) by levels of care.
c. Identify key gaps in available costing data that need to be addressed in the future.
V. Stakeholder engagement: convene and facilitate a meeting with key health sector stakeholders to present findings from the literature review, the desk review of costing data, and the UNMHCP costing exercise to get their inputs.
VI. Define and cost the basic package for the NHIS: Work with the expert committee to undertake the following:
a. Develop 2-3 options for NHIS basic package using a DELPHI approach. Show how the proposed NHIS basic package options relate to the UNMHCP.
b. Use UNMHCP costing and other available costing data to provide estimates of the per capita cost of UNMHCP options.
VII. Financing model for UNMHCP: Using the cost of the NHIS basic package as well as the UNMHCP, projections regarding population growth and coverage, epidemiological patterns, expressed population needs, cost of health system strengthening activities, and other macro-economic factors; develop projections for the costs of implementing the UNMHCP (provide 3-4 scenarios using different underlying assumptions about population dynamics, macroeconomic factors etc.)
VIII. Validation of the findings: Present preliminary findings to the select committee and key health system stakeholders, and refine it based on their inputs.
Deliverables and preliminary Timelines
The deliverables and their due dates are outlined as follows:
I. A final inception report (5-7 pages) for the assignment detailing the key questions that will be answered, the technical approach, a template for cataloging the costing exercises that have been done to date, and work plan due end of week 1.
II. A PowerPoint presentation (PPT) detailing the proposed UNMHCP emerging from the expert committee and synthesis of available costing information – due end of week 4.
III. A Microsoft Excel file with the cost models for NHIS basic package and UNMHCP, and a PPT of high-level results– due end of week 6
IV. A final report and PPT that present the consultant team’s recommendations as well as feedback received from the select committee– due end of week 8.
Consultancy Costs and Payment Modalities
USAID UHSS will meet all the consultancy costs of this assignment on a fixed price basis. Payment will be done depending on satisfactory delivery of deliverables as highlighted in the contract. There will be no costs to be paid other than the costs that will be highlighted in the contract. All costs will be paid in Uganda Shillings.
Competitive market rates will apply, and the consultant should submit an all-inclusive fee (lump sum) in his/her proposal.
The consultant shall report directly to the Commissioner, Planning, Financing and Policy for the strategic guidance and the Deputy Chief of Party, Uganda Health System Strengthening (UHSS) Activity for the contract management.
Duration of the assignment
This exercise will be carried out during the period between June – August 2021.
Work Hours: 8
Job application procedure
Apply here https://palladium.csod.com/ux/ats/careersite/2/requisition/11415/application?c=palladium&jobboardid=0#1