1.Purpose of Position
The goal of the Health Sector Resiliency Project is to support the Government of the Islamic Republic of Afghanistan (GIRoA) to foster a strengthened, reformed, and increasingly self-reliant Afghan health system prepared for the decreased donor support anticipated over the coming decade.
The HSR Project acts as a resource and a catalyst to the MoPH and other GIRoA entities as it considers and implements critical sector-wide reforms that are required to make the system more resilient and sustainable. The HSR Project is a five-year, $37+M project that primarily focuses on governance, health finance and human resources for health and engages both the public and private components of the health sector. Futures Group is partnering with IntraHealth, Panagora, Thinkwell, Tadbeer, The Liaison Office (TLO) and SADEC to implement the HSR project but the team also collaborates closely with the MoPH, EC WB, SEHAT and other stakeholders to ensure synergies and avoid duplication.
HSR builds on the accomplishments of other USAID projects including the COMPRI-A project and Health Policy Project - specifically improving the private sector policy environment, building the capacity of key MoPH departments such as Private Sector Coordination, Health Economics and Finance, Licensing and streamlining and improving health sector systems such as the National Health Accounts, Expenditure Management Information System (EMIS), hospital Public-Private Partnership (PPP), hospital autonomy, procurement processes, implementing private hospital Minimum Required Standards (MRS) to ensure safety and quality, private sector HMIS, and the private health center licensing process.
HSR stimulates and provides assistance to the MoPH to conceptualize and operationalize the more difficult, longer-term decisions/policies that must be made in order to strengthen the system and make continued advances in the health of Afghans, relying increasingly on domestic resources. These could include decisions surrounding how to improve efficiencies and increase the potential for sustainability such as staff rationalization, financial compensation and hiring modalities; organizational restructuring; the contents and cost of the Basic Package of Health Services and Essential Package of Hospital Services; strengthening engagement with the private sector; health facility rationalization; and streamlining the MoPH’s stewardship role.
Increased domestic financing for priority health services is one of the three components under the HSR. Under this component, the project aims to:
- Increase GIRoA funding made available for the health sector.
- Improve efficient use of health sector resources
- Improve transparency and accountability of MoPH financial management systems
HSR has initiated the implementation of the PY2 workplan which was developed in extensive consultation with the MoPH and other partners. An important component of the workplan is to identify, implement, and evaluate innovative approaches to promote efficiency and identify areas for enhancing efficiencies in the health system based on findings of the fiscal space analysis and other studies._Part of this will be to support the MoPH in designing a provider payment mechanism (PPM) in close coordination with GDCM and national hospitals and to assist the MoPH to pilot this approach in three national hospitals. To help implement this work, HSR is looking for an experienced expert to help the project in designing provider payment reform for public hospitals, particularly the national hospitals. Recently national hospitals have been granted certain degree of autonomy in their financial, procurement and human resource management in Afghanistan. However, there are also ongoing discussions about recentralization of some functions, particularly procurement to the central MoPH. Currently, national hospitals receive line item based budget without flexibility to shift from one item to another. The MoPH is considering to revise the provider payment mechanism to increase flexibility to the hospital in their fund management and hence ultimately improve delivery of health services. MoPH has identified the global budget for National Hospitals as a suitable option for such reform.
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2. Primary Responsibilities:
The consultant will work closely with the MoPH Health Economic and Financing Directorate and General Directorate of Curative Medicine (GDCM), MoPH leadership and other departments and donors, as needed to complete the following tasks.
- Conduct situational analysis and assess readiness for introducing PPM including assessment of enabling environment and review of current funding mechanism and level of flexibility that national hospitals have in utilizing their allocated budget
- Review existing literature including recent assessment on hospital autonomy and costing studies regarding the performance of the national hospitals
- Identify existing challenges and barriers regarding budgetary planning for national hospitals and their financial management system
- Review recording and reporting system of the hospital and identify indicators for the monitoring of hospital performance
- Produce an implementation modality (and mapping/flow chart) for the operationalization of global budget in national hospitals with consideration on performance enhancement and administrative feasibility
- Recommend mechanisms to strengthen governance, accountability and financial management under the global budget system at national hospital level.
- Facilitate stakeholder consultation on the implementation modality (and mapping/flow chart) of the global budget and produce a final design report including step-by-step implementation plan
- Define business processes including ideal flow of fund and reporting mechanism for the successful implementation of global budget system and one that promotes accountability, checks and balances, and transparency (and possibly public involvement or awareness)
- Develop a monitoring and evaluation framework with specific indicators and timeline
- Identify capacity gaps of the national hospitals for the implementation of global budget and develop training materials
- Provide orientation to national hospitals and other stakeholders on implementation modality, monitoring approach and facilitate in-service training for its implementation
- At least 7 years of professional experience in budget management, hospital financing and and/or provider payment reform
- At least 7 years at a senior level (leading, assessing, designing and implementing corrective measures);
- Excellent understanding of hospital management and financing, particularly in relation to provider payment reforms;
- More than 2 years’ experience in designing and implementation of global budget for the hospital sector;
- At least 5 years of experience working with ministries and relevant entities;
- Strong capacity building and training/mentoring experience.
- Strong inter-personal communication skills;
- Strong English language and writing skills.
- Multiple country work experience is required.
4. Submission guidelines:
Note: Only short listed candidates will be contacted by the client for the interview. Date and location will be determined and communicated with the short listed candidates only
Deadline for Application: Open until filled