STC to draft policy options for the evolution of the Cambodian health system towards UHC over the next decade
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.
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.
The goal of this work is to work with the Ministry of Health and WHO to review the aforementioned publications, and then to synthesize these information sources into an options policy brief for the evolution of the Cambodia health system. The brief will contain a short history of the health system, a detailed summary of the current context, a short section stating the policy goals which the options seek to achieve, and a limited set of coherent policy options including sequencing of reforms under each option with explanation of how they each achieve the policy goals. This output will be useful to inform future health system development in Cambodia.
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 MoH and 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 brief on policy options for expanding and improving coverage for the population, covering all aspects of the health system;
- Draft a brief analysing the functions of the National Maternal and Child Health Centre, and options for way forward.
- Submit draft to Health Systems Coordinator, WHO Cambodia for feedback;
- Submit a final report to the Health Systems Coordinator, incorporating feedback.
- Submit presentation slides on policy options for expanding and improving coverage, and for the functions of the National Maternal and Child Health Centre, to the Health Systems Coordinator.
METHODS TO CARRY OUT THE ACTIVITY
- Desk review of publications and documents.
- Interviews of MoH, WHO and other stakeholders staff.
QUALIFICATIONS & EXPERIENCE
EDUCATION
Essential:
At minimum a Master’s in public health, health economics, or related.
Desirable:
EXPERIENCE
Essential:
Minimum ten years of working in health systems, including in low-income or lower-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. Experience working in Cambodia, or other country in Southeast Asia.
Desirable:
None
TECHNICAL SKILLS & KNOWLEDGE
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. Fluency in Khmer would be an asset.
COMPETENCIES
Communicating in a credible and effective way. Synthesizing large amounts of new information quickly. Project management, including ability to liaise effectively with colleagues. Producing results.
ADDITIONAL INFORMATION:
This opportunity is open to individuals only, no firms. The contract is composed of 70 days of work during the period 1 October 2019 to 31 January 2020. The consultant will be required to visit Phnom Penh for at least 20 days of this period, where the place of work will be the WHO Cambodia country office. A WHO email account will be provided, valid for the period of the contract. The consultant is required to supply their own laptop.
APPLICATIONS
Qualified and interested specialists should submit their CV and writing samples authored by the candidate on any health systems-related topic, to the Supply Officer through WP RO UNGM at < wproungm@who.int > by 20th 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. WPRO/2019-09/KHM_HSD/TN96570/vrs as subject to all submission. Only successful candidates will be contacted.