Health Financing Consultant

Pathfinder International, NGO Health Service Delivery Project

SOW for Independent Contractor Agreement (ICA):

Assignment Title:

Health Financing Consultant

Department/Unit:

This assignment will be administered through Pathfinder’s headquarters in Watertown, MA.

Pathfinder Involvement:

The following individuals will be involved in this assignment according to the roles below:

Administrative Manager: Sarah Lance, Senior Program Officer, Program Operations Unit

Technical Manager: Minal Rahimtoola, Technical Advisor for Health Systems Strengthening

Local Counterpart: Bruce Rasmussen, Deputy Chief of Party/Health Service Delivery

Background:

Pathfinder’s five-year, $86 million USAID/DFIDF-funded NGO Health Service Delivery Project (NHSDP) provides technical assistance and capacity building to the “Smiling Sun” (“Surjer Hashi” in Bangla) network of 25 local nongovernmental organizations (NGOs) that operate 388 static clinics and nearly 10,000 satellite clinics. The Surjer Hashi facilities provide an essential service package (ESP) for poor and underserved populations throughout Bangladesh, including services for family planning and reproductive health; maternal, newborn and child health; communicable disease control and limit curative care; and behavior change communications and community mobilization. The project serves a catchment population of between 22 to 25 million people, approximately 15% of the country’s population, with nearly 40 million service contacts each year.

The project has three Intermediate Results:

1. Client base expanded, especially for the poor, to access a quality essential service package
2. Optimal healthy behaviors promoted
3. Local ownership of service delivery enhanced

Focusing on strategies to increase acceptance of antenatal care, skilled delivery, postnatal care, and contraception, in the three years from January 2013 through December 2015 the Smiling Sun network provided 4.4 million ANC checkups, 90,000 deliveries attended by a skilled provider and nearly 5 million couple years of protection (CYP). The project has consistently met annual service delivery targets and is on track to continue doing so through the life of project, which is scheduled to end in December 2017. The project is tasked with ensuring that by the end of project at least 40% of service contacts are with poor clients, and at the same time that the NGOs recover at least 40% of total operating costs. Thus, commitment to the poor as well as commitment to long-term sustainability must be held in balance. As of December 2015, the project was already very close to achieving both targets of 40% service to the poor and 40% cost recovery.

As Bangladesh approaches middle-income status, the Government of Bangladesh (GOB) continues to prioritize the health of the poor in their latest Health Care Financing Strategy. USAID, is working closely to support the Government as it takes greater responsibility for achieving universal health coverage. Progress towards this goal requires sustainable health financing mechanisms that minimize barriers and risks especially for the poor. In this context, USAID/Bangladesh is also seeking ways to build the long-term sustainability of the Smiling Sun network as a provider of quality services which are accessible to the poor through effective health financing mechanisms. The aim is to minimize dependency on direct donor funding to subsidize operations, as is the current model, and to increase the capacity of the network to compete for and win resources through other mechanisms.

Purpose and Objectives:

The purpose of this consultancy is to assist NHSDP to develop a health financing strategy for the Smiling Sun network, including piloting a model over the next 18 months before the project end. The strategy will include both macro-level and micro-level elements, based on analysis of the health financing landscape in Bangladesh and an analysis of the performance of Smiling Sun clinics. Analysis will include answers to the following questions:

• At macro level, what is the current landscape of the health financing policy environment and government contracting mechanisms to ensure universal access to health services?
• At micro level, how can Smiling Sun clinics operate more efficiently and cost-effectively?

The strategy and plan will be developed in consultation not only with NHSDP staff and USAID counterparts, but with the Smiling Sun NGOs. Understanding the capacity and willingness of the NGOs to respond to a changing funding environment is an essential element of the strategy. This will help establish the groundwork for the Smiling Sun network to benefit from the anticipated next phase of USAID funding for the health sector in Bangladesh.

Location of Assignment:

Remote and Bangladesh

Deliverables:

1. Health Financing Strategy for the Smiling Sun Network—including health financing landscape analysis for Bangladesh; and health financing readiness analysis of Smiling Sun NGOs which will include phased action plan with illustrative milestones for strengthening NGO preparedness
2. Health Financing Overview Workshop designed and conducted with NGOs
3. Action Plan for piloting a health financing model in the final 12-16 months of NHSDP

Timeframeof Assignment:

• Periodofassignment:** To be completed by September 2016
• In-countrydates:** (exact dates TBD, ~ 3 weeks)
• Level of Effort (maximum number of billable days): 40 days
• (10 for remote landscape analysis + 17 days in country (10 stakeholder meetings + 4 workshop prep + 3 workshop) + 10 day for developing pilot plan + 3 travel days (1 ½ each way)

Funding: NGO Health Service Delivery Project

Interested candidates should send updated CV, a completed US biodata form, dates of your availability between now and September 2016, and an expression of interest to: Sarah Lance, Senior Program Officer,slance@pathfinder.org

Deadline for application: May 27, 2016