STC for Training on Analysis of Household Surveys for Health Utilization and Expenditure
BACKGROUND
The Cambodia Socioeconomic Survey is essential in a number of ways. First it is the only source for the Royal Government of Cambodia to assess the magnitude of out-of-pocket payments by the population in accessing health services. This information is used to inform the National Health Accounts. The data from 2012 to 2016 National Health Accounts indicates that out-of-pocket expenditures represent on average 60% of funding to current health expenditure, therefore making the accurate analysis of CSES for out-of-pocket expenditure essential.
Second, the CSES allows for understanding where the population seeks services. There are two sources for this type of information. The Demographic and Health Survey asks such questions once every five years. The advantage of the CSES is that it asks these questions every year. This allows the Royal Government of Cambodia to understand where the population is seeking care, which has specific policy-relevance to discussions around primary care, and the private sector.
Third, the CSES allows the Royal Government of Cambodia to assess the level to which the population is burdened by health payments when seeking care, through an equity perspective. This is particularly important to assess the success of Government policies and mechanisms to help the poor and vulnerable groups.
PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY
The World Health Organization proposes to support the Royal Government of Cambodia in making greater use of the Cambodia Socio-Economic Survey (CSES) for the purpose of monitoring progress in the health sector and crafting evidence-based policy.
The National Institute of Statistics organizes an annual data collection for the CSES which includes data on out of pocket health expenditures, and utilization of health practitioners. The CSES is implemented using a large sample every five years (roughly 12,000 households) and a small sample in the intervening years (roughly 3,600 households). The next large-sample survey is scheduled to begin later in 2019, and to last the standard 12 months (with equally-sized primary sampling units surveyed each month).
The CSES surveys households on a wide variety of topics, and is a large undertaking for the National Institute of Statistics. It is costly to implement, and therefore it is important to justify that cost by making full use of the data. This will ensure future funding for the health questions in the survey, and will increase the likelihood of use of data to inform policymaking. The CSES as currently structured also provides detailed data on health expenditures. However there are also several ways in which the structure could be improved. The National Institute of Statistics seeks to conduct a consultation in that regard, for which a better understanding of the health questions in CSES, their advantages and limitations, is required.
The primary client within the Royal Government of Cambodia for the health information produced by the CSES is the Ministry of Health. Within the Ministry of Health the Department of Planning and Health Information produces information on utilization and expenditure in the health sector, manages the process of production of the National Health Accounts, manages the Health Management Information System which tracks utilization in the public sector, and increasingly also in the private sector. The Department of Planning and Health Information has requested support to analyze CSES data to produce overall expenditure information, and financial protection indicators such as household catastrophic expenditure, and household impoverishment. The National Institute of Public Health conducts analysis on financial protection, and may also benefit from this support.
The Department of Social Statistics at the National Institute of Statistics is responsible for, among other domains, the health aspects in the CSES. This team‘s activities include collecting data in the health sector, and analyzing, compiling, publishing, and disseminating related health statistics. In addition, the Department of Social Statistics also takes responsibility for providing data for monitoring and evaluation of Goal 3 of the SDGs, “Ensure healthy lives and promote well-being for all at all ages”. The Department has requested capacity-building support to its staff such that they are better able to clean and analyze the health questions from the CSES, as well as from the Cambodia Demographic and Health Survey (CDHS).
Relatedly in the near future, the Department intends to build consensus around future revisions to CSES health questions. Important to that goal is that the Department have a solid understanding as to how CSES data is used to inform policy-making in the health sector.
The overall goal of this support is to catalyze increased use of household survey data to inform health policy, and to encourage the Government entities involved in production and use of the data to benefit from a closer collaboration.
DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT
Under the supervision of the Health Economist, WHO Cambodia, the consultant will undertake the following tasks:
- Meet with staff of National Institute of Statistics Department of Social Statistics, and Ministry of Health Department of Planning and Health Information, to assess their competencies in household survey design, data cleaning, data interpretation, and data analysis;
- Discuss with focal points within each ministry which members of their teams they assign for training, and a schedule of on-the-job training;
- In coordination with the focal points and the Health Economist, WHO Cambodia, develop job-related training topics relevant to the output and deliverables of the two departments;
- Set outcome-based goals for the training for each individual, in coordination with the focal points and the Health Economist, WHO Cambodia;
- Carry out training;
- Explore with focal points opportunity for a joint training session between Department of Planning and Health Information staff, and Department of Social Statistics staff, and organize if proposal is approved;
- Document in prose form the methods used in already-existent Stata do files to calculate out-of-pocket expenditure, catastrophic expenditure, and impoverishment based on the CSES;
- Submit a final report to Health Economist, WHO Cambodia, on content of training, names of individuals trained, overall assessment of capacity of each department, suggestions for future training content, and any other information deemed relevant.
METHODS TO CARRY OUT THE ACTIVITY
- Training at Department of Planning and Health Information, Ministry of Health.
- Training at Department of Social Statistics, National Institute of Statistics.
- Review of Stata do files and documentation of them in prose form.
QUALIFICATIONS & EXPERIENCE
EDUCATION
Essential:
Master’s or PhD in public health, health economics, or related.
Desirable:
EXPERIENCE
Essential:
Minimum seven years of working in health systems and / or health financing, including in low-income or lower-middle-income countries. Demonstrated work on household survey analysis for health utilization and expenditure. Demonstrated work on financial protection analysis in health. Demonstrated expertise in Stata.
Desirable:
Experience with training practitioners in low-income or lower-middle-income countries on household survey analysis, and on Stata.
TECHNICAL SKILLS & KNOWLEDGE
Manipulating household survey data. Manipulating household survey data in Stata. Calculating out-of-pocket expenditure from household survey data. Calculating catastrophic expenditure and impoverishment from household survey data.
LANGUAGES
Fluency in English (writing, reading and speaking) is essential. Fluency in Khmer is highly desirable.
COMPETENCIES
Communicating in a credible and effective way. Explanation of complex quantitative methods and data to non-technical audiences. Project management, including ability to liaise effectively with colleagues and country counterparts and development partners. Producing results.
ADDITIONAL INFORMATION:
The contract is composed of 40 days of work in country from 8 October to 30 November 2019. The consultant will be based in Phnom Penh. The place of work will be either at the Ministry of Health, the National Institute of Statistics, or the WHO Cambodia country office, based on the training schedule to be developed. A WHO email account will be provided, valid for the period of the contract.
APPLICATIONS
Qualified and interested specialists should submit their CV to the Supply Officer through WP RO UNGM at < wproungm@who.int > by 6th September 2019. This consultancy is open to individual consultants only.
The CV should include the consultant’s proposed daily rate.
Please use Tender Notice No. 95591 as subject to all submission. Only successful candidates will be contacted.