Terms of Reference
THE REPUBLIC OF TAJIKISTAN
MINISTRY OF HEALTH AND SOCIAL PROTECTION OF THE POPULATION
Maternal and Child Health Integrated Care Project (G0627-TAJ)
LEAD HEALTH CARE FINANCING SPECIALIST
Consulting Services:
LEAD HEALTH CARE FINANCING SPECIALIST
Consultant Type:
Individual
Package Name and Number:
CS-07-01 Lead Health Care Financing Specialist
Source:
International
Engagement Period:
59 intermittent person-months
Location of Assignment:
Dushanbe, Tajikistan
BACKGROUND
The Republic of Tajikistan received a grant from the Asian Development Bank (ADB) for the implementation of the Maternal and Child Health Integrated Care Project in Tajikistan. The Maternal and Child Health Integrated Care Project will help address key issues affecting Tajikistan’s health sector, such as inadequate funding, outdated infrastructure and health facilities, as well as lack of qualified medical professionals and healthcare providers, especially in rural areas.
Ministry of Health and Social Protection of the Population of the Republic of Tajikistan (MOHSPP) is the Executing Agency (EA) of the Project. Project Administration Group (PAG) is established for implementation of the project. The role of the PAG is to manage day to day implementation of project activities including operational and budget planning, recruitment and deployment of national and international Consultants, procurement of works (construction and rehabilitation of health care facilities) and goods (medical and non-medical equipment), monitoring and evaluation of project progress, analysis of issues to identify need for action, and reporting to the Project Director and MOHSPP.
- OBJECTIVES OF THE ASSIGNMENT
The objective of this consultancy is to support the MOHSPP and MOF in the development / improvement of the case-based financing methodology to ensure budget calculation and financing effectiveness of the integrated MCH health system and pilot the case-based financing mechanism at project district hospital(s). The consultant is expected to work closely with the Health Financing Intersectoral Expert Group (IEG) and the World Health Organization (WHO) who are leading the support on the national health financing strategy.
The consultant will perform the following tasks in close coordination with key stakeholders:
1. Design of the Case-based Financing System
- Work with IEG, MOHSPP and MOF in the design of a case-based financing scheme for inpatient services particularly MCH services.
- Identify global best practices and develop case studies from other countries in developing case-based payment systems including costing practices, health information system adoption, and contract content and procedures.
- Provide feedback to IEG in the revision/adjustment of the regulatory framework for government approval of the case-based financing pilot.
- Provide technical support to IEG, MOHSPP, and MOF to develop and prepare arrangement for more centralized pooling and purchasing. Explore ways to centralize resources for strategic purchasing, in light of existing pilot in Sughd and ADB project districts.
- Develop phased implementation plan for the introduction of the case-based financing in project target districts based on design that is aligned with Sughd pilot led by IEG.
- Develop a DRG system based on statistical reporting form on discharged patients (F-020)
2. Contribute to integration of payment system
- Further development of the PHC payment mechanism within the framework of the Single purchaser, for integration of services and enhanced incentives across levels of care, working closely with the Ministry of Health and Social Protection consultant on primary care financing
- PHC service content development, linked to further work and communication of the Basic Benefit package.
3. Facilitate the Introduction of a Virtual Budget Formation and Execution at the hospital level within case-based financing
- Work with IEG to develop / revise / adjust instructions for budget formation at the hospital level based on case based normative including salary calculation in pilot regions
- Analyze and present / discuss results of the virtual Budget Formation system for case-based financing pilot regions to key stakeholders.
- Develop and revise, when necessary, reporting form, M&E framework for the execution of hospital budget within case-based financing
4. Ensure Development and Implementation of the Information System to track case-based financing and financing of referral services
- In coordination with IT/Software expert(s) and Medstat, design unified information system / database for registration and tracking of services financed through case-based financing including referral cases in project regions
- Provide support in development of system for data verification of the inpatient services
- Develop indicators for monitoring of compliance with referral and counter referral pathways
- Design data input forms, analytical framework, and reporting forms
5. Provide Guidance and Technical Support during all phases of the case-based financing pilot system implementation
- Regularly monitor implementation of the case-based financing system in pilot districts and ensure revision/adjustment as needed
- Present results to the MOHSPP, MOF, Local Governments, Partners, etc.
6. Train Hospital Staff and Policymakers in Case-based Financing System
- Work with IEG and WHO to train hospital management teams and MOHSPP staff in application of case-based financing principle
- Develop curriculum and learning modules on health systems and financing, and training materials
- Build capacity of health personnel, data input operators, statisticians, accountants, and economists, in applying the case-based system.
- DELIVERABLES
All reports are to be submitted as follows: 2 copies to EA/PAG and 1 copy to ADB. All reports are also to be submitted electronically, as email attachments in pdf format to all concerned persons. All reports shall be issued in English and Russian or Tajik.
- Inception Report to be submitted no later than 4 weeks after contract commencement; the report shall include review of the history and barriers to case-based financing in Tajikistan and recommendations for development of a new system, and detailed workplan for the assignment.
- Report 1: Design of the case-based financing system:
- Report on global best practices and case studies from other countries in developing case-based payment systems including costing practices, health information system adoption, and contract content and procedures
- Design of case-based financing system agreed with IEG, MOHSPP, MOF, including development of DRG
- Approved phased implementation plan for the introduction of the case-based financing in project target districts
- Feedback on revised/adjusted regulatory document(s) for government approval on the case-based financing pilot (if needed)
- Data analyses for IEG, MOHSPP and MOF about introduction of the virtual case-based financing pilot in project districts.
- Report 2: Introduction of the virtual salary calculation system for case-based financing report
- Report on the revision/adjustment of the instruction for Budget Formation and Execution at the hospital level in case-based financing pilot districts
- Report on results and analysis of introduction of the virtual Budget Formation and Execution at the hospital level for case-based financing in pilot districts
- M&E framework for the Budget Formation and Execution at the hospital level for case-based financing
- Report 3: Integration of Care
- PHC and MCH service content development
- Further development of the PHC payment mechanism for integration of service
- Report 4: Guidance and technical support during all phases of the case-based financing pilot
- Set of indicators for monitoring of the implementation of the case-based financing pilot
- Data input forms, analytical framework, and reporting forms
- Monitoring reports on implementation progress and challenges
- Final report on implementation of case-based financing in project regions
- Reports on presentations of results to (workshops with) the MOHSPP, MoF, Local Governments, Partners, etc. (including agenda and list of participants)
- Power Point Presentation on results of the case-based financing
- Summary of issues discussed and follow-up actions
- Report 5: Training in health systems and financing and application of the case-based financing system
- Training curriculum and materials
- Training of hospital management teams, accountants, economists
- Training of MOHSPP, MOF, Local legal authority staff
- Coaching on work and support in budget preparation and execution
- Workshop agenda
- List of participants
- Report 6: Training in using the financial/statistical information system (data entry and analysis)
- Training curriculum and materials
- Training of health personnel, statisticians in filling data registration forms,
- Training of data input operators, statisticians in applying the system,
- Training of hospital management teams, statistician, accountants, economists
- Training of MOHSPP, MOF, Local executive bodies staff in applying system, reporting, monitoring of the system.
- Workshop agenda
- List of participants
- REQUIREMENTS
- The Consultant shall work directly with related units of the IEG, MOHSPP, Health providers and development partners in close interaction with relevant staff of the Project Administration Group (hereinafter – the PAG) and consultants working on the MCH referral system development.
- The Consultant shall be accountable directly to the PAG Manager.
- Produced reports shall contain information on progress achieved, findings identified, and recommendations on improving the processes with specification of sources of materials. Reports on results of Consultant’s work shall be agreed with officials in charge appointed by the MOHSPP). The timeframe for reconciliation of reports commented by the Client is 15 working days.
- Design and implementation plan of the case-based financing system should be mutually agreed by the MOHSPP and MOF
QUALIFICATION REQUIREMENTS
Advanced (university) degree in Finance and Economics, Health Economics, Health Policy, Public Financial Management or similar field;
Experience in health budget planning and monitoring of budget execution
Experience in developing materials for and in conducting competency-based training
At least 10 years of experience with the development and implementation of health care financing reforms;
Excellent writing, analytical and interpersonal skills, ability to lead a team of experts;
Excellent knowledge and skills in using spread-sheet software (EXCEL, ACCESS)
Specific experience
Experience in the development of health financing and health care specifically with case based and per capita fee systems activities related to data and information management systems to support claims and payment of provider processes;
Track record in managing operations and coordinating people, agencies and resources through a task network (this Consultant should be able to provide a range of services);
At least 10 years of experience in developing health services budget calculation methods and related guidelines, training modules, monitoring and evaluation tools
International Specialists Experience in the Region / Language Proficiency
- Experience in implementing health financing reforms in transition economies and specifically in former Soviet Union countries;
- Proficiency in English language is essential;
- Proficiency in Russian language would be an advantage.
- CLIENT’S INPUT
Client will provide the following inputs, project data and reports to facilitate preparation of the Proposals:
- Project Administration Manual
- Infrastructure Development Program prepared by TRTA
- Technical Assistance Feasibility Study
- RRP and all linked documents
Detailed information is provided in Terms of Reference which can be accesses through the following link:
Final_CS07-01_TOR_EN_Lead+Health+Care+Financing_Specialist
MOHSPP invites eligible candidates to submit their application to provide the abovementioned services.
Interested individuals shall submit their application in English and/or Russian languages online in a special electronic format accessible through the following link:
https://selfservice.adb.org/OA_HTML/OA.jsp?OAFunc=XXCRS_CSRN_HOME_PAGE
Only successful candidates will be invited to interview. If necessary, PAG reserves the right to re-announce a vacancy or cancel the recruitment
The deadline for submitting documents is March 20, 2020 (until 10:00 local time).
For additional information, interested individuals may contact us:
Project Administration Group
Maternal and Child Health Integrated Care Project in Tajikistan
734025, Dushanbe, Shevchenko str. 61
Email: adbmch@adbmch.tj
