FHI 360 is a non-profit human development organization dedicated to advancing equity, health and wellbeing through data-driven, locally led solutions — so that humanity thrives. Our staff includes experts in Health, Education, Nutrition, Environment, Economic Development, Civil Society, Gender, Youth, Research and Technology; creating a unique mix of capabilities to address today’s interrelated development challenges. FHI 360 serves more than 60 countries, all 50 U.S. states and all U.S. territories.
Project description:
The Millennium Challenge Corporation (MCC) has entered into a new Compact with the Government of Lesotho (GOL). Recognizing that strong human capital is key to driving poverty reduction (Lesotho scores only 0.4 on the Human Capital Index, indicating that a child born today would only be as 40% as productive as if they were to attain good health), $75m of the Compact has been allocated to the Health Systems Strengthening (HSS) Project which will improve outcomes through strengthening Lesotho’s Primary Health Care (PHC) system.
It is an opportune time to invest in strengthening PHC. In 1990, Lesotho had a relatively solid PHC system, with a Healthcare Access and Quality (HAQ) Index 9pp higher than the sub-Saharan Africa average1, but was hard hit by the HIV epidemic soon after. This directly affected health outcomes and pivoted the health system away from other critical areas. Lesotho now has the highest neonatal mortality rate in the world (43/1000 live births), lowest life expectancy (53), and third highest rate of adult deaths from non-communicable diseases (43%) (WHO Global Health Observatory). Lesotho is currently ranked 197th out of 204 countries on the HAQ, and 203rd for progress since 1990. After sustained e orts by the GOL and partners, including MCC’s first Compact whose investments in rural health infrastructure enabled decentralization of HIV services, Lesotho is now moving towards epidemic control and positioned to rapidly improve the coverage and quality of PHC, the bedrock of Universal Health Coverage (UHC). Regional experience from other countries with epidemic control shows that rapid improvement is possible: whilst Lesotho scores 48 on the UHC Index, Namibia scores 62 (despite a lower real expenditure on PHC per capita) and Eswatini 58 (despite significantly fewer doctors and nurses per capita).
The current health system does not prioritize PHC (only 7.5% of the health budget in 2018/19) resulting in low service quality, weak utilization, and extensive bypassing to tertiary care providers. Quality PHC requires strong district level management and governance, but Lesotho’s District Health Management Teams (DHMTs) underperform, held back by limited capacity and resources, weak data use, constrained decision space, and sub-optimal processes. Reforms must build the health system’s integral contribution to preventing and responding to Gender Based Violence (GBV) which is a key developmental and economic threat. The total cost of loss of income and expenses of GBV equates to 5.5% of Lesotho’s GDP, greater than the health budget.
MCC’s HSS Project targets these challenges through seven interdependent contracts, including this HSS/PHC/cGBV Support Contract.
Working hand in glove with the other HSS Contractors, this contract will provide technical expertise and support to the Ministry of Health (MOH) to improve the quality
1 Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990–2019. Lancet Glob Health 2022; 10: e1715–43 and availability of essential primary health services (including GBV), enhance the capacity of DHMTs to plan and deliver PHC services and improve budget execution, and amplify data use for decision making. The Contract will be operationalized through 54 tasks linked to 51 payment-based deliverables. Beginning with formative diagnostic and design assessments, a Pre-Compact Phase will be conducted to refine a 5-year Compact Implementation Phase with annually exercised option years.
FHI 360 Lesotho currently seeking qualified candidates for the position of Finance & Operations Manager. The position will be based in Maseru, Lesotho.
Interested candidates may visit our recruitment website (http://www.fhi360.org/careers) to view the full Job Specifications and submit their resume together with a motivational cover letter indicating the position applied for.
Use the Job ID to search for the position you are applying for or access the link below that will lead you directly to individual positions:
Finance & Operations Manager (Job ID 2023201676):
Closing date: November 10, 2023