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Organization: Options Consultancy Services
Country: Kenya
Closing date: 12 Jun 2016
Terms of Reference: Facilitating the development of a Public Expenditure Review (PER) and Health Financing Strategy in Bungoma
Overview of the MANI Project
With support from the UK Department for International Development, the Maternal and Newborn Improvement (MANI) project is working with the Bungoma County Health Management Team (CHMT) to strengthen core health systems and increase survival of mothers and newborns in Bungoma County. Technical assistance is being provided across three core areas:
Strengthening health systems to manage and deliver quality MNH services, focusing on health planning, governance and leadership and supply chain management;
Working at the community level to increase demand for and uptake of MNH services for mothers and newborns;
Leading the County Innovation Challenge Fund (CHIF) to provide funding for innovative projects, which offer local solutions to local problems in reducing maternal and newborn mortality (across DFID’s 6 priority MNH counties).
MANI is being implemented by an Options-led consortium. Other consortium partners include AMREF, Care, IMPMR, KPMG, MannionDanniels and Population Council.
Context
Bungoma County has the lowest facility density (<1 per 10,000 persons) in Kenya, and, with only 9.6 staff per 10,000 population, is in the bottom quartile of counties for human resources for health (HRH)[1]. Just over half of all facilities (53%) were considered functional when surveyed through SARAM. Over half of Bungoma’s population lives in poverty (53%).
The Constitution of Kenya 2010 ushered the introduction of devolution of the Health Sector from 2014. This is a positive step towards allowing the County Governments to have both the power and resources to deliver quality health services. There is need, however, to support the County Department of Health (CDOH) in Bungoma to map the sources of revenue and debts in the sector as well as the allocation and utilisation of financial resources for health. The CDOH also needs support in identifying opportunities to raise additional revenues for the sector and to develop essential policy and legal framework. This process would help build a firm foundation towards strengthening the health sector to meet the health needs of the residents of Bungoma County.
Proposed approach
A) Develop a Public Expenditure Review (PER)
The first part of this assignment is to undertake a Public Expenditure Review (PER) to assist the county Department of Health to gain a better understanding of each of the sources of funding, how they are channelled through the system and how they are spent. This exercise will help to shed light on the the total volume of funding available for the health sector in Bungoma, by source eg GoK budget allocation, FMC, NHIF, donor funds. Where possible, the time period under review should be the FY 2014-15 and 2015-16. In particular, this process should seek to answer the following questions:
How is the Bungoma county health budget spent and how does this compare to the annual budget allocation?
How are free maternity care funds being channelled from national to county to facility level and what bottlenecks are preventing these funds from flowing in a timely manner?
What is the total volume of reimbursements made under the NHIF, how are they being channelled and what are they being used on?
What donor funding is being spend on health in Bungoma and where and what types of activities is it being spent on?
If the FMC is channelled through the NHIF from July 1st 2016 as expected, this exercise will serve as a baseline for this new funding modality.
B) Facilitate the development of a health financing strategy in Bungoma
The Bungoma Health Financing Strategy will be rooted in the national health financing policy and strategy context, including linkages to:
The Kenya RMNCAH investment framework (2016), health financing strategy and roadmap for UHC (when available);
Kenya Health Sector Strategic and Investment Plan (KHSSP), July 2014 – June 2015
The National Health Policy 2014 – 2030
The draft Health Financing Strategy 2009
It will also build on existing policies and strategies developed for Bungoma county under the guidance of the health financing Technical Working Group (TWG).
It will be developed through a county DoH-led consultative process involving all 10 sub-counties and the county Department of Finance. The health financing TWG will be fully engaged at each stage of the strategy’s development. The process will include the following steps:
Key informant interviews: Based on the findings of the PER, the consultant will conduct key informant interviews to understand the health financing priorities of the various stakeholders in the county.
Discussion paper: based on the findings of the PER and the key informant interviews, the consultant will develop a discussion paper setting out the health financing options in Bungoma county.
Consultative meeting – the consultant will facilitate a meeting to agree on the health financing strategies that Bungoma will commit to.
Draft health financing strategy – the consultant will work with their focal point in the TWG to develop the health financing strategy.
Deliverables
The consultant will be paid against the following deliverables:
Draft Public Expenditure Review for Bungoma, by 15th July 2016;
Final Public Expenditure Review for Bungoma by 30th July 2016;
Discussion paper, articulating the health financing options in Bungoma, by 15th August;
Meeting report outlining the key decisions taken, by 15th September
Draft health financing strategy by 15th October.
Final health financing strategy by 30th October.
Time
The consultant will propose the number of days required to undertake this assignment in his/her application. It is expected that up to half of these days will be in Bungoma while the remaining may be desk-based or may involve meetings in Nairobi. The consultant can use up to four domestic flights in order to carry out this assignment; the MANI project will provide accommodation and per diem in Bungoma according to project rates.
Key relationships
The consultant will report to Sarah Fox in Options, UK office and will maintain regular contact with the Deputy Team Leader and HCF Advisor in the MANI office in Bungoma as well as the designated focal point in the county health financing TWG. The HSS Advisor from the MANI office will facilitate access to key stakeholders as well as important data and documentation.
Person specification
Essential:
Solid understanding of Kenya’s health financing landscape particularly in the context of decentralisation;
Experience developing a health financing strategy at the national or county level
Excellent interpersonal and facilitation skills, with experience working with government officials at the national or district level;
Strong written and analytical skills, with ability to convey technical concepts in easy to understand language;
Ability to work independently;
Fluent in spoken and written English.
Desirable:
Post graduate degree in health financing or health economics
Relationships with key donors working in the area of health financing in Kenya including the Health Policy Project (USAID), GIZ and the World Bank
Detailed understanding of public financial management
Applications
Suitably qualified individuals are invited to submit their CV, technical and cost application to m.cavanagh@options.co.uk by Sunday 12th June 2016. Only shortlisted applicants will be contacted for interviews.
How to apply:
Applications
Suitably qualified individuals are invited to submit their CV, technical and cost application to m.cavanagh@options.co.uk by Sunday 12th June 2016. Only shortlisted applicants will be contacted for interviews.
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