Health Sector Resource Allocation Advisor (2), short-term

  • Job Type: Temporary
  • Location: Lusaka, Zambia
  • Date Posted:

Website Company Name: Nathan Associates Inc.

Company Summary:

Job Description:

POSITION TITLE: Health Sector Resource Allocation Advisor (2), short-term
The USAID Revenue for Growth Project: Background
The USAID Zambia Revenue for Growth Project (R4G) implemented by Nathan Associates, Inc. is a five-year project that was awarded on June 14, 2021. R4G aims to support the Government of the Republic of Zambia (GRZ) in improving domestic revenue mobilization and expanding the fiscal space for public spending and investments in service delivery and poverty reduction. R4G engages government and non-government stakeholders to build capacity in tax policy analysis, improve tax compliance and administration, and strengthen the tax culture in a manner that facilitates private sector growth and relationships between taxpayers and the GRZ.
Zambia Ministry of Health: Background
To help operationalize the Ministry of Health (MOH)’s Health Care Financing Strategy 2017 – 2027, R4G is supporting the MOH to (i) explore strategies to increase the share of resources for health and (ii) increase efficiency and equity in resource allocation and utilization. Resource allocation for health care services is a predominant area of concern and attention in Zambia’s health sector. The MOH considers the development of resource allocation criteria a key sub-component of health care financing that is intended to ensure that there is an efficient and effective funding and payment system for health care. At the hospital level, the need for a resource allocation mechanism that adequately reflects hospital operational costs continues to be central to the planned hospital reforms in the MOH. The current practice for funding hospitals may be broadly described as being based on an incremental historical budgeting system. This approach is not responsive enough to the changing disease burden and thus does little to promote equity.
At the district level, the MOH utilizes the District Resource Allocation criteria based on material deprivation indices which serve as weights on the district population. From an equity point of view, the district resource allocation criterion has been hailed as an appropriate tool for allocating both GRZ and Cooperating Partners (Basket Donors) resources to address health inequalities. However, the formula has not been updated since 2017. The need to update the resource allocation formula (RAF) is necessitated by several factors that include: (i) the changing demographics and disease patterns at the district level; (ii) the changing district parameters such as poverty levels and administrative costs; and (iii) the increase in the number of districts from 105 to 116 that have resulted in smaller districts with relatively smaller populations.
Nathan Associates is seeking two short-term Health Sector Resource Allocation Advisors (“Advisors”) to provide services aimed at (i) developing the hospital resource allocation formular taking into account the disease burden for each hospital (ii) updating the MOH’s district resource allocation formula taking into account the changing district level demographics, socio economic characteristics and the health needs of the population. The specific tasks to be performed by the Advisors are described below.

Review the current RAF for districts and hospitals to identify gaps and weaknesses in the current formula.
Review hospital costing work done in 2011 and adapt and use the results for the development of hospital resource allocation criteria.
Review databases, e.g., Living Conditions and Monitoring Survey, Demographic Health Surveys, and the Housing and Population Census among other datasets, which will provide information needed to update the current RAF.
Derive new variables needed from raw data sets and perform other data mining activities in order to identify all necessary data elements required to complete the derivation of the RAF.
Identify the required statistical techniques required to derive the RAF and perform the necessary statistical analyses required to revise the RAF.
Evaluate hospital costs in selected Zambian hospital facilities based on functional areas.
Group the basic health care interventions (and other interventions as may be appropriate) within the international classification of diseases that will form the basis of health care/diagnosis related groups.
Review and update the cost of the basic health care interventions grouped by diagnosis or health care variables.
Develop and formulate per diem (bed day cost) and diagnostic related group (DRG) based costing options for hospital reimbursement in Zambian health facilities.
Prepare a report that will be used by the MOH to revise its resource allocation criteria for districts and hospitals.

All tasks will be conducted in Zambia. The Advisors will be required to attend regular, in-person meetings to update R4G and MOH staff on the status of the tasks described above. This activity is projected to start in August 2023 and run for a period of up to 30 workdays per Advisor, ending on or before September 30, 2023. The timing and payment of the deliverables will be agreed with the candidates selected for this position. The Advisors will report to the R4G staff HCF Advisor. This position is open to Zambian and non-Zambian residents.
The Advisors will produce the following deliverables:

a detailed report including revised indices for resource allocation for districts and hospitals; and
an Excel database with all the data used in the computation of indices.

Qualifications & Skills
Each Advisor will possess the following qualifications and skills.

A masters degree in Statistics, Mathematics, Demography, Public health or related quantitative field.
At least 8 years of experience working with large databases and using data modelling techniques.
Experience in selecting appropriate databases, combining them, and deriving necessary data elements or variables required as input into a Principal Component Analysis (PCA).
Experience working on similar tasks, including formulation and updating resource allocation formulas for social sectors, is desired.
Knowledge of aspects of current health sector planning and resource allocation criteria.
Ability to compile deprivation indices for districts using various parameters and undertaking a PCA to derive deprivation indices.
Excellent written communication skills.

Submission Instructions
Qualified candidates are requested to submit: 1) a preliminary outline of how the tasks described above will be conducted, including the specific analytical methods and datasets to be used; 2) detailed CVs clearly stating prior experience on similar tasks; and 3) a detailed budget for the tasks to be performed to [email protected] on or before August 4, 2023. Please include “R4G Health RA Advisor” in the subject line. Only finalists will be contacted. No phone calls please.

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