Assessing Capacities for Contracting Services at Somali Health Authorities (WHO)

[Admin]

Title: Assessing Capacities for Contracting Services at Somali Health Authorities (SHAs)
Contract type: Consultancy for Senior Consultant (s)/ Team of Consultants
Duration: 45 days
Starting: January 2014
Original published date: 06 November 2013
Application deadline: 20 November 2013
Reporting to: HSS Country Programme Advisor

Background

Decades of conflict led to the near collapse of Somalia’s health system with little remaining functional infrastructure and a dilapidated health work force (one physician per about 25 000 and a nurse/midwife per 9000 people). Considered as one of the most fragile states Somalia’s levels of child and maternal mortality are among the highest in the world, coupled with malnutrition, low enrollment rates for primary schools and limited access to safe water and sanitation. Cultural barriers, the lack of awareness, the remoteness of many villages and high levels of poverty contribute to the very low utilization rate of health services with an average of one visit to a health facility per person in eight years. Public health management structures are only now being restored with the reestablishment of the Ministry of Health and Human Services, following the appointment of the Federal Government and security gains in the South Central of Somalia, as one of the mile stones to regain governance functions in the health sector. Another major achievement has been the formulation of Health Sector Strategic Plans (HSSP) 2013 to 2016, demonstrating the determination of the Somali Health Authorities (SHAs) to clearly be in the sector’s driving seat and their commitment to “ensure equitable, affordable and effective essential health services to all people in Somalia”. Capacities for providing public services are limited and the private, unregulated sector is growing. Numerous national and international NGOs are providing services resulting in unequal geographic coverage, varying scope and levels of quality. Medical supplies for the public sector are provided through UN agencies and NGOs, operating a push system that is mainly designed to meet emergency needs.

To tackle the urgency of rapidly increasing access to services, an Essential Package of Health Services (EPHS) that is gradually been rolled out. Donor funded programmes either provide direct support to EPHS implementing NGOs or to UN agencies within a Joint Health and Nutrition programme (JHNP), a multi-donor funded health system development programme that is aligned to the HSSPs.
The Somali Health Authorities (SHA) seek to closely work with national and international organizations to consolidate ongoing projects and gain the maximum output from limited resources to expand service coverage. They plan to engage in contracting service providers for implementing and expanding the provision of the EPHS. Currently most of contractual arrangements are managed by and held between donors or UN agencies and NGOs. Few contractual arrangements with non-public partners are being operated under the discretion of the Ministries of Health. A separate procurement agency with transparent systems for tendering and public procurement is not in place.

The Somali public sector lacks managerial, technical and administrative skills. The existing legal framework for Public Financial Management (PFM) is more than 40 years old, does no longer meet modern practices and requires up-dating. At the same time institutions for planning and budgeting still need to be established and respective staff capacities built. Existing mechanisms for ensuring transparency and addressing fiduciary risk are insufficient.

Work is ongoing on developing a legal framework for the health sector. Special focus is been given to building pubic financial management structures as part of the New Deal on Somalia. One of the cornerstones of the JHNP is the roll-out of the EPHS and contracts for service implementation are being managed by one of the implementing UN agencies. Zonal Working Groups in Somalia that are led by the respective Ministry of Health are carrying out the selection process of applying non-public service providers.

The three SHA are a strong interest in building their capacities to gradually engage in the contracting process. To fully resume respective functions, a long term process of institutional capacity development and investment in administrative structures is required, in line with the overall strategy of the Government for its public administration reform. Activities planned to be funded under the JHNP envision assessing and supporting the financial management system at the three Ministries as well as procurement and contracting services for the provision of supplies.

This consultancy addresses the contracting of health services. It will assist the SHAs in fulfilling a stronger stewardship role in this process, delineating a gradual approach to build required institutional capacities and identify areas for resuming more responsibilities.

In current arrangements, the largest proportion of funds for contracting services are being held and managed by UN and donors agencies. Areas for an increased Ministries’ stewardship role in the various steps of contracting could explore their involvement in the designing of contracts; options for an incremental proportion of payment made by the Ministry to service contractors or defining the Ministries’ role in monitoring and evaluating.

Thus, the purpose of this consultancy is to assess the current status of the various contracting process components and outline a road map for addressing each of these. The consultancy should also familiarize the SHAs with key principles and various models of contracting health services enabling them to create a vision on the subject.

Objective of the Consultancy

The overall objective of the assignment is:

• Assessing the current capacities of the Health Ministry in all three zones relevant to contracting of services, including aspects of procurement and financial management, the legal and policy framework, available human resources and needs, planning, monitoring and evaluation;
• Guiding the formulation of a strategy to build required institutional capacities for awarding and managing service contracts;
• Identifying areas at the Health Ministries to gradually execute functions of the contracting process;
• Familiarizing SHAs with key concepts and models of service contracting and its components;

Expected deliverables

1) An inception report five days after the start of the assignment;
2) An assessment report of current Ministry of Health capacities in contracting of health services;
3) A road map as part of the overall strategy (objective II) for each related area such as HR requirements, FM, procurement, M&E, etc.;
4) Areas identified for the SHAs to take more responsibilities and their respective defined roles;

Duration and Timing

The consultancy is planned to be conducted within 45 days but can include more consultancy days as required. Initial work will take place in Nairobi to review of back ground documents and meet with relevant partners. The consultant(s) will visit each zonal Ministry of Health to consultant and work with the Ministry team and, if relevant, other Ministries and stakeholders. A debriefing workshop is supposed to be organized at the end of the assignment. Its location is to be determined.

Competencies

The assignment envisions the engagement of an experts or team of experts as follows. Selected candidate(s) should have:

• Substantive knowledge of key public health challenges in transitional and fragile states environment;
• Proven capabilities in assessing governmental management processes and procedures relevant to service contracting;
• Track record of assisting health authorities in formulating strategies relevant to contracting;
• Strong facilitation skills with particular attention to transfer of knowledge and skills to MoH public health managers;
• Ability to work under pressure;
• Excellent communication and facilitation skills;

Qualifications and experience

• Advanced university degree in Public Health or Health Policy or Health Economics;
• Demonstrated expertise in establishing contracting capacities in fragile states;
• Experience in similar programmes related to health sector reform in post-conflict countries;
• Ability to provide practical methodological and technical advice and guidance to Ministry staff;
• Excellent English writing and presentation skills;

How to apply:
Additional information

Qualified female candidates are encouraged to apply.
Interested candidates are kindly requested and strongly encouraged to apply in writing sending their CVs and motivational letters to:

Administrative Officer
WHO Somalia
recruitment@nbo.emro.who.int

Deadline for applications: November 20, 2013
WHO is committed to workforce diversity.
Any appointment/extension of appointment is subject to WHO Staff Regulations, Staff Rules and Manual.
Only qualified candidates under serious consideration will be contacted.
WHO has a smoke-free environment.