Costing and cost-effectiveness analysis of health services in Cambodia

Item Description:

Universal health coverage (UHC) means that all people in a society are able to obtain the health services they need, of high-quality, without fear that the cost of paying for these services at the time of use will push them into severe financial hardship. UHC has become a major policy priority in many countries, and a significant and growing focus of attention at the international level, forming one of the targets of Sustainable Development Goal 3.

There are a number of benefit packages currently in effect in Cambodia. The Ministry of Health has in place the Minimum Package of Activities (MPA), and the Complementary Packages of Activities (CPA) 1 to 3 for the different levels of service providers. These packages incorporate interventions which not all public health facilities in Cambodia are able to provide, due to lack of human or physical resources. In addition to the MPA and CPAs 1 to 3, the Health Equity Fund (HEF) benefit package was developed over the last couple years, and has recently been officially endorsed. The new package defines specific services to provide clarity to providers that they will be reimbursed by the HEF in lieu of charging user fees for providing those services, as well as providing clinical guidelines for those services in order to improve quality of service provision. The formal sector schemes (workers, and public servants) have their own benefit packages. Thus there is a package for the formal sector, a package for the poor, and a package for the non-poor informal sector.

Explicit health benefit packages fulfil several roles. In terms of accountability and transparency, they can provide clarity to beneficiaries and providers as to the services which they are entitled to, and must provide, respectively. Closely linked to that, they can improve equity, by defining a socially-acceptable minimum set of services available to all. They can make clear to providers exactly what is expected of them for the payments they receive. And they allow payers to allocate financial resources to priority health interventions. Lastly they can be a tool to improve the quality of services provided by clearly stating the clinical guidelines and protocols to be followed.

PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY

WHO has been tasked with supporting the Royal Government of Cambodia to think through scenarios for creating a basic benefit package for the country. Putting together these scenarios will involve looking at the present and future burden of disease in the country, compiling a proposed list of priority services taking into account criteria to be defined (including cost-effectiveness), and undertaking budget impact analysis.

There has been little work done to date in country to cost interventions, or to carry out cost-effectiveness analysis. Costing work based on actual financial cost is underway in country by government and one of its partners, which this work should build on if appropriate.

There may be need to collect further actual cost data on health services for which data is missing, and estimate costs for services which are not routinely provided but which may feature in the list of services for analysis. There may also be need to think through guidelines as a basis to establish normative costs. Much of the evidence on effectiveness will rely on internationally-available resources which have applicability to Cambodia.

DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT

Under the supervision of the Health Economist, WHO Cambodia, the consultant will undertake the following tasks:

1. Develop a work plan for the activities detailed here;
2. Input into list of services to be prioritized for analysis;
3. Identify a costing tool to be used for costing interventions suitable to the purpose;
4. Perform a review of costing information specific to Cambodia already available either through global resources, or which has been collected by other parties in country in the last few years;
5. Identify which costs are missing, or which clinical protocols need clarifying, for the list of services identified;
6. Finalize a protocol for the collection of data or information on clinical protocols for the missing services not yet costed;
7. Implement data and information collection activities for cost data (travel may be required within country);
8. Perform a desk review of global effectiveness resources which could have applicability to Cambodia and the list of health services (and delivery channels) identified;
9. Produce report summarizing cost data, including components thereof, and of cost-effectiveness analysis;
10. Ensure that all collected and modeled cost and cost-effectiveness data is retained in an accessible format for handover to the Ministry of Health.

METHODS TO CARRY OUT THE ACTIVITY

• Desk reviews
• Meetings / interviews with government and development partner counterparts
• Data collection from health facility, national and sub-national health service providers and health system administrators

QUALIFICATIONS & EXPERIENCE

EDUCATION

Essential: Master’s or PhD in public health, health economics, or related.

EXPERIENCE

Essential: Minimum seven years of working in health systems and / or health financing, including in low-income or lower-middle-income countries. Demonstrated work on costing health services, and in cost-effectiveness analysis in health. Work samples which the candidate has authored or co-authored will be requested.

Desirable: Experience specifically with health benefit package development. Experience using the One Health and Spectrum tools. Experience working in Cambodia on health systems issues. Previous experience working for WHO or another international organization in the field of health.

TECHNICAL SKILLS & KNOWLEDGE

• Costing tools, data collection, data analysis.
• Cost-effectivenss analysis of health services.
• Analysis and presentation of complex quantitative methods and data to non-technical audiences.
• Project management, including ability to liaise effectively with colleagues and country counterparts and development partners

LANGUAGES

Fluency in English (writing, reading and speaking) is essential.

COMPETENCIES

• Communicating in a credible and effective way.
• Good writing skills.
• Producing results.
• Moving forward in a changing environment.
• Fostering integration and teamwork.
• Knowing and managing yourself.

APPLICATIONS

Qualified and interested specialists should submit their CV {for individual contractors} or Company Profile {for institutional applications} and Expression of Interest {cover letter} to the Supply Officer through WPRO UNGM at  wproungm@who.int by
8 February 2019.

The cover letter should outline how their experience and qualifications make them a suitable candidate for this position and should include their proposed daily consultancy fee and availability.

Please use Tender Notice No. 83038 as subject to all submission.  Only successful candidates will be contacted.

Contacts

Peter Ellison – wproungm@who.int, Tel: +63 5289653, Fax: +63 5252512
Email: wproungm@who.int
First name: Peter
Surname: Ellison
Telephone country code: Philippines (+63)
Telephone number: 5289653
Telephone extension: 89653
Fax country code: Philippines (+63)
Fax number: 5252512