Short Term Consultant - Analysis to inform policy towards UHC in Cambodia
- BACKGROUND
The Cambodia health system is at a critical juncture in its development. Current health expenditure in 2016 was about 1.2 billion USD, and grew rapidly from 2012 to 2016. About 60% of that figure was from out-of-pocket payments by the population, 22% from public sources, and 17% from donor funding. Cambodia became a lower-middle income country in 2015, and at current levels of GDP growth, is projected to become an upper-middle income country by 2030. This will indubitably result in a rapid reduction in external support for the health sector in both absolute and relative terms. Health service delivery is provided by both the public sector, and a thriving private sector. The private sector is estimated to provide more than two-thirds of care. The regulatory regime for the private sector is a growing area of focus for the Royal Government of Cambodia. Analysis is underway on the costs of service delivery in the public sector, of the workload of health professionals in the public sector, of the private sector in health, and of a new guaranteed benefit package for the health system based on disease burden, fiscal space, cost-effectiveness, and equity.
In terms of financial risk protection in health, the National Social Security Fund (NSSF) of Cambodia was established in 2008 based on the provisions of the social security law adopted by the National Assembly in 2002. The NSSF health insurance branch launched in October 2016. The benefit provisions under the SHI branch for private sector workers include both medical (in-kind) benefits and income replacement (cash) benefits payable in the event of absence from work due to maternity or sickness. Social health insurance benefits for employees in the public sector, covering also retired officials and war invalids was launched nationwide in January 2018.
The Health Equity Fund (HEF) is a non-contributory social health protection scheme reimbursing health care providers for user fees incurred by poor people seeking health services at public facilities. The HEF is supported under the Health Equity and Quality Improvement program jointly funded by the RGC and four external partners. HEF covers about three million citizens and enables free health care for beneficiaries. Beneficiaries are identified through a nationwide means-testing system. While HEF focuses on poor households, it has been extended to certain prescribed groups, and its future extension to other vulnerable groups is under consideration. In 2016 a Payment Certification Agency was established as a third party to certify claims submitted to HEF by providers.
2. PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY
The Ministry of Health and WHO in Cambodia have a comprehensive understanding of the health system, including service delivery infrastructure, human resources, digital health, financial protection schemes, as well as the opportunities and challenges for expanding and improving coverage going forward. Furthermore a significant amount of information is available from published and unpublished analyses.
2020 is a key year in Cambodia for strategic planning for the health system. In particular, the MoH with support from WHO and other partners will develop the new Health Strategic Plan (the paramount health sector policy document) for the period commencing 2021. To aid WHO’s support to the MoH in strategic planning towards universal health coverage in Cambodia., WHO is producing a range of analyses on different areas of health systems and services.
The purpose of these short-term-consultancies (STCs) is to work in December 2019 to produce policy briefs on key areas of work to support this process, by reviewing existing publications and data, and interviewing WHO staff. This output will be useful to inform future health system development in Cambodia.
This consultancy is open only to individuals. Applications from firms will not be reviewed.
3. DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT
Under the supervision of the Health Systems Coordinator, WHO Cambodia, the consultant will undertake the following tasks:
- Review documents on the health system as supplied by Health Systems Coordinator, and identified during desk review;
- Interview WHO staff (and other stakeholders), at the direction of the Health Systems Coordinator, on the current status of the health system, as well as thoughts on potential future pathways towards universal health coverage;
- Draft a policy brief on one of the following topics:
- Strengthening primary care in Cambodia – rationale and options for the way forward
- A comparison of Cambodia’s trajectory towards UHC with the experience of other countries in the region (e.g. Thailand, Viet Nam and China).
- Community outreach and engagement in the Cambodian health system – rationale and options.
- Health system strengthening priorities to accelerate progress on communicable disease programme targets.
- A review of the current structure of the Cambodia Socio-Economic Survey for health utilization and expenditure questions and propose revisions which will inform WHO’s proposals to the National Institute of Statistics.
- A review of potential utilization and expenditure questions for the next round of the Demographic and Health Survey.
- Submit draft to Health Systems Coordinator, WHO Cambodia for feedback;
- Submit a final policy brief to the Health Systems Coordinator, incorporating feedback.
- Submit a PowerPoint presentation summarizing the brief to the Health Systems Coordinator.
4. METHODS TO CARRY OUT THE ACTIVITY
- Desk review of materials.
- Interviews with WHO staff and other stakeholders
- Data collection activities as required.
- Data analysis using Excel and other software as required.
- Documentation of analyses in policy brief and PowerPoint.
5. DELIVERABLES
- Complete policy brief on specified topic.
- PowerPoint presentation
6. QUALIFICATIONS & EXPERIENCE
EDUCATION
Essential:
A Master’s degree in public health, health economics, or related field.
Desirable:
EXPERIENCE
Essential:
Minimum five years of working in health systems, including analysing health systems of low- or middle-income countries. Demonstrated (in the form of written reports or publications) ability to synthesize large amounts of information swiftly and incorporate multiple views into coherent argument.
Desirable:
Experience working in public health in a low- or middle-income country. Experience working in Cambodia, or other country in Southeast Asia.
TECHNICAL SKILLS & KNOWLEDGE
Essential:
Demonstrated knowledge of health systems. Demonstrated ability to write technical documents on health systems (writing samples must be submitted with this application). Demonstrated ability to write strategically on health systems with understanding of political economy.
LANGUAGES
Fluency in English (writing, reading and speaking) is essential.
COMPETENCIES
- Communicating in a credible and effective way
- Producing results.
- Moving forward in a changing environment.
- Fostering integration and teamwork.
- Knowing and managing yourself
ADDITIONAL INFORMATION:
The contract is composed of 20 days from 1 December to 31 December 2019. The consultant will work remotely. Access to WHO resources including journals, relevant internal documents, databases, and software will be made available, as necessary and appropriate.
APPLICATIONS
Qualified and interested specialists should submit their CV to the Supply Officer through WP RO UNGM at < wproungm@who.int > by 25th November 2019. This consultancy is open to individual consultants only.
The CV should include the consultant’s proposed daily rate.
Please use Tender Notice No. WPRO/2019-11/CAM_HSD/TN100282/mom as subject to all submission. Only successful candidates will be contacted.