Kingdom of Lesotho
Ministry of Health
Lesotho Nutrition and Health System Strengthening Project
LNHSSP-P170278
REQUEST FOR EXPRESSION OF INTEREST FOR
Individual Consultant (Health Economist) to Support Strategic Purchasing of Health Services
Terms of Reference FOR INDIVIDUAL CONSULTANT
BACKGROUND
The Ministry of Health’s vision is that all people living in Lesotho shall have productive life, access to affordable and sustainable quality health services with the aim of ensuring Universal Health Coverage. To ensure this, the Ministry of Health is committed to promote, prevent, cure, rehabilitate and control diseases at all levels with special focus on the primary health level; through well-developed health systems and competent health workers. Thus, contributing to the attainment of improved health status and quality of life with all partners to ensure responsiveness to the health sector clientele’ needs.
Strategic purchasing of health services must be more active or strategic in order to realize progress towards universal health coverage. Strategic purchasing of health services should be an active system rather than the current passive where resources are allocated without consideration of the provider’s performance and for a package that is not clearly defined. Strategic purchasing of these services must be evidence based, should define which specific health services must be purchased and from which providers, how the services should be paid for and at what rate in order to maximize health objectives. For the past 5 years the Ministry of Health (MOH) has been allocated a budget of around 14% of the total Government of Lesotho (GoL) budget. A substantial amount of MOH budget is towards operations which are recurrent in nature and include purchases of health services from various organizations in the country. The Institutions which are allocated funding under the MOH include Lesotho Red Cross Society (LRCS), Blue Cross, Baylor Pediatric Center of Excellence, Lesotho-Boston Health Alliance, Lesotho Nursing Council and Christian Health Association of Lesotho (CHAL).
The relationship between the GoL and the mentioned institutions is governed by Memorandum of Understanding (MOUs) specifically designed for each institution depending on the health services they provide to the public. There are no defined guidelines on how to allocate funding and to monitor some of the deliverables for some of the agreements. The GoL has memorandum of understanding with CHAL and LRCS for provision of defined essential health service across the country. The MOUs have not been revised in a long time and no longer fully address the needs of both the purchaser and provider of the services. CHAL is the largest private-non–profit making health services provider, and for this reason will be the main focus for this assignment.
It is against this background that the Ministry of Health seeks to establish a robust Strategic Purchasing environment to avoid providers automatically receiving funds (budget allocations) or payment independent of performance. With performance monitoring strategies in place, the government will be able to influence the quantity or the quality of health services. There is also need to develop guidelines, Standard Operating Procedures (SOP) and agreement for strategic purchasing and to develop the new agreement between CHAL and the Government of Lesotho. The revised service level agreements will be informed by the developed strategic purchasing guidelines in an effort to implement the Health Strategic Plan to attain universal health coverage, and strengthen government stewardship and health systems.
To efficiently carry out the assignment, the services of a suitably qualified consultant will be engaged through the Lesotho Nutrition and Health System Strengthening Project supported by the World Bank.
OBJECTIVES OF THIS CONSULTANCY
The Government of Lesotho aims to engage a consultant that will provide technical support to the Ministry of Health to review the current purchasing system of health services in order establish a robust strategic purchasing environment that involves several interrelated areas, which need to be aligned and addressed jointly. The government seeks to get TA in identifying and specifying services and interventions to purchase, choice of providers to be engaged and the design of financial and non-financial incentives (including provider payment mechanisms and contractual arrangements) with the aim of providing efficient, and equitable delivery of quality healthcare services. The purchasing landscape covers all non-governmental/private healthcare providers, including for-profit and not-for-profit providers.
SCOPE OF WORK
- The consultant will play a critical role in reviewing the current state of purchasing, developing guidelines, Standard Operating Procedures (SOPs) for strategic purchasing of health services in the ministry of health.
- Provide technical expertise, support and coordination for the review of the current Memorandum Of Understanding/service (MOUs) between the ministry and health service providers and then design an appropriate model for running of Queen Mamohato Memorial Hospital (QMMH).
- Capacity building and/or guidance of the relevant staff on strategic purchasing of Health Services.
SPECIFIC ROLES AND RESPONSIBILITIES FOR THE CONSULTANT
- To review the current health services purchasing function and define its objectives to be more coherent and strategic in nature for maximum health benefits to Basotho in relation to efficiency and quality of services;
- Research, Prepare and present analysis of services purchased by the Government of Lesotho through the Ministry of Health, and development of guiding documents including performance monitoring of services purchased by the MOH;
- To design the packaged and incremental strategic health services package to manage expected growth in service provision as new services arise (e.g COVID19) and to include any other health service reform;
- To clearly define which services to purchase depending on the MOH priorities and what referral arrangements and cost-sharing mechanisms are appropriate for these service at all levels of care;
- To review the costing models and define clearly the payments methods, contractual obligations and other possible incentives (Financial/non-financial) depending on the GoL fiscal space to increase provider performance at each level of health service delivery;
- To develop Strategic Purchasing of Health Services guiding documents (guidelines and Standard operating procedures) and revise the agreements templates with clear contractual obligations between Ministry of Health as the purchaser and all the health services providers depending on the services they are contracted to provide;
- To design appropriate and support strategic purchasing unit adequate to undertake implementation of strategic purchases of health services;
- To design standard operating procedures and tools to monitor provider’s performance and provision of oversight by strategic purchasing unit;
- To design standard operating procedures to ensure accountability for each service delivery level;
- To develop strategic purchasing function/agency Monitoring and Evaluation framework;
- Review the Funding formula for CHAL and the staffing patterns to address the current and future staffing needs in CHAL facilities in line with GOL staffing structure. Review the classification of the facilities in line with recommended GOL facility and level of care (Typology);
- Lead the development and execution of a program for consultation and feedback by key stakeholder groups in the public sector, private sector, civil society and International Development Partners on the review of current partnerships with the Government including an appropriate model for management of QMMH.
DURATION
The assignment is for a period of 12 Weeks and the consultant is expected to work full time.
DELIVERABLES
| Ref # | Activities | Timelines |
| 1 | Inception report | 1 week |
| 2 | Analytical Report on services purchased by the Ministry of Health | 2 weeks |
| 3 | Draft Guidelines, SOPs, Monitoring and contract/agreement templates/models/management structures/ for Strategic Purchasing of Health Services | 3 weeks |
| 4 | Final Guidelines, SOPs, Monitoring and contract/agreement templates/models/management structures/ for Strategic Purchasing of Health Services | 1 weeks |
| 5 | 1st Draft report | 4 weeks |
| 6 | Final Assignment report | 1 week |
SCHEDULE OF PAYMENT
The consultant will be paid upon presentation of invoices and contingent upon timely submission of agreed deliverables as approved by the Director Health Planning and Statistics Department.
REPORTING
The Consultant shall report to and receive technical guidance from the Director Health Planning and Statistics department. The LNHSSP Project Coordinator will be responsible for managing the contract.
RESOURCES
The Consultant will be provided with the following resources:
- Office space for the development work with office related accessories (reliable Wi-Fi, office furniture);
DUTY STATION
The consultant shall work mainly from the MOH head office.
PROFILE OF THE CONSULTANCY
Required qualifications and experience
- At minimum, a master’s degree in Health Economics, health financing, Masters of Business Administration in health care or relevant discipline. A PhD will be an added advantage.
- 10 years working experience in contracting and contract management for health services and strategic health financing
- At least 5 years’ experience in planning, evaluation, development and management of strategic contracts especially in the Health Sector.
- Demonstrate experience in conducting similar assignment especially in Southern Africa (Provide a link for such work)
- Demonstrate a thorough understanding of the methods of price and cost analysis.
- Excellent public speaking, presentation, report writing and facilitation skills
- Excellent leadership, motivational skills and Team work.
- Competence in the use of computers application software such as Word, Excel and Power Point.
- Proficiency in the use of statistical software’s such as Stata, E-Views and others.
- Experience in working with the health sector in Lesotho or any Southern African country
REPORTING
The consultant shall report to and receive technical guidance from the Director Health Planning and Statistics Department in the Ministry of Health. The Project Coordinator will be responsible for managing the contract.
SELECTION OF CONSULTANTS
Individual Consultants will be selected in accordance with the procedures set out in the World Bank’s Guidelines: Selection and Employment of Consultants by World Bank Borrowers, January 2011 (revised July 2014).
SUBMISSION OF THE PROPOSAL
Interested and suitably qualified individual consultants should submit their expression of interest to [email protected] or hand delivered to the undersigned not later than
28th September, 2022 1200hour to:
Procurement Officer’s Office, Procurement Unit Ground Floor, Ministry of Health, Corner constitution & Linare Roads, Kingdom of Lesotho, Telephone: (+266) (+266) 27323277.
Only shortlisted and successful candidates will be contacted within two weeks from submission deadline. If you do not receive a call and email from us consider application not successful.