National consultant to provide technical assistance in finalising the revised Results-Based Financing (RBF) support mechanism ,280 working days (Open to Zimbabwean Nationals only)

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Supporting the Government’s vision of a prosperous and empowered upper-middle-income society, the country programme is aimed at contributing to sustainable socioeconomic development that provides all children, including adolescents, with opportunities to fulfil their potential, lead a healthy life, access quality learning and protection and meaningfully participate in society.

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UNICEF Zimbabwe is inviting applications for a national individual consultant to provide technical assistance in finalising the revised Results-Based Financing (RBF) support mechanism

BACKGROUND

Result-based financing (RBF) is an approach that provides financial incentives to healthcare providers based on pre-specified performance targets, aiming to improve healthcare service delivery and strengthen the health system. The RBF programme in Zimbabwe was designed to improve both the supply and demand-side performance of health systems to achieve Universal Health Coverage (UHC) through improving availability, accessibility, and quality of health services with a focus on reproductive, maternal, newborn, child adolescent health and nutrition (RMNCAHN), and an expanded scope including NCDs, TB, HIV and malaria services and their optimal utilisation.

Specific Objectives of the RBF Program

1. Contract healthcare facilities to implement innovative strategies that increase access to and utilization of quality priority health services.
2. To improve the quality of care through an integrated national quality assurance and quality improvement (QA/QI) framework.
3. To foster community participation and ownership in the delivery of health care services through increased involvement of Health Centre Committees (HCCs), Community-Based Organizations (CBOs), and other services.
4. To strengthen the National Health Information System (NHIS) through improving data quality, reporting and utilization.
5. To motivate and retain qualified Health Care Workers (HCWs) through incentivizing performance and creating a conducive environment.
6. To strengthen managerial capacity at national and subnational levels for effective service delivery.
7. To strengthen accountability and ownership across all levels through enhanced monitoring and evaluation.

The Results Based Financing in Zimbabwe was first piloted in 2 districts in 2011 with support from the World Bank through Cordaid. This was scaled up to 16 districts in 2012 and finally 18 districts including 18 secondary and 4 tertiary hospitals in 2012 up to 2020. The Health Services Fund (HSF) input-based financing in 42 districts was commenced in 2013 which converted to the Health Development Fund- supported RBF for PHC facilities in only 42 districts in 2014. The HDF support towards RBF ended in Q1 2022.

The government of Zimbabwe has institutionalised RBF and has contracted all 60 rural districts, disbursing subsidies in local currency. Following an RBF policy dialogue held in March 2024, it was agreed that a revised partner-supported complementary layer be defined to guide the support from partners like the HRF. This consultancy is sought against this background to provide technical support to UNICEF in finalizing the modalities for the partner-supported layer, which will guide the utilisation of the approved HRF support to RBF for 2024 to 2025. The developed modality will be tabled for review and approval by the Health Financing TWG and the HRF Steering Committee.

ASSIGNMENTS:

The consultant will provide technical assistance in finalising the revised partner-supported Results-Based Financing Model and support during the initial phase of implementing the refined model for the partner- supported layer.

Programme development and planning: Partner-Supported RBF Layer

• Conduct desk review to synthesise evidence and ideas on the status of RBF in Zimbabwe
• Conduct Key Informant Interviews to get stakeholder views on RBF and recommendations on aspects to consider for simplifying the model – (Engage key stakeholders and beneficiaries during the process to understand the views of all the concerned parties)
• Develop revised RBF guidelines and model for HRF partner-supported RBF for the period 2024- 2025 collaborating with MOHCC, UNICEF and PMU
• Present the proposed revised model to the MOHCC.
• Facilitate revision of RBF contracts for urban and rural facilities in line with the revised model.
• Collaborate with the PMU, PCU, UNICEF, MOHCC, and any other implementing entity to develop an implementation plan for the revised/revised model.
• Develop policy brief for advocacy for performance-based financing mechanism.

Technical and Operational support to the MoHCC

• Offer technical assistance and training sessions at national and provincial district levels in line with the revised model during the initial phase of implementation.
• Support MoHCC to set up procedures and guidelines for RBF in line with the revised model
• Assess the current functionality of supporting RBF structures e.g., Community-Based Organisations (CBOs), Health Centre Committee (HCC) and other MoHCC structures, and identify areas that still need capacity building and provide recommendations to improve their planning, implementation and monitoring of health services and activities
• Support MoHCC to monitor project progress throughout all levels of implementation as defined in the revised RBF model parameters and utilise lessons from the field to continuously refine.
• Support facilities receiving partner-supported RBF payments to produce quality Expenditure

Major tasks and deliverables:

Tasks/Milestone:

Deliverables/Outputs:

Timeline (% of total cost)

1. Programme development and planning: Partner-Supported RBF Model

Inception Report

Produce an Inception Report to demonstrate understanding of the task and proposed methodology on how to deliver on these ToRs.

7 Days (2.5%)

Key Informant Interviews and desk review

Report detailing the findings from the review and interview process

5 days (2%)

Develop revised RBF guidelines and Model for HRF partner-supported layer

• Draft a Revised RBF Model for the partner-supported layer
• PPT presentation delivered to HRF Technical Meeting, Health Financing TWG and HRF Steering Committee
• Final revised RBF model incorporating comments from HRF partners, HF TWG

20 days (7%)

and SC

Detailed implementation plan

Review of RBF Contracts

Revised RBF contracts for both rural and urban facilities

2 day (1%)

Develop Policy Brief

Two policy briefs developed on RBF in Zim

4 days (1.5%)

2. Technical and Operational support to the MoHCC

Support MOHCC in ensuring contracting processes are done as defined in the revised model

Produce a report/dashboard on contracts signed by health facilities.

2 days (1%)

Assess the functionality of the Health Centre Committee (HCC) and capacity-building gaps

Report on the current functionality of HCCs and recommendations

for capacity building

10 days (4%)

Support MOHCC to enhance the community feedback mechanism.

Strengthen community feedback mechanisms in line with the revised RBF model.

TBD30 days (11%)

Support MOHCC to strengthen verification processes in line with the revised model.

Revised verification in place and functional

60 days (21%)

TA on capacity building across all levels

Training reports

60 days (21%)

Support quality expenditure reporting.

Quality expenditure reports submitted timely by facilities.

40 days (14%)

Monitoring Progress and Reporting

Quarterly progress reports submitted.

40 days (14%)

Total Number of Days

280 days

To qualify as an advocate for every child you will have… 

Education:

Master’s degree in health economics or health policy and Financing or related qualification

Experience:

At least 5 years of demonstrated experience in implementing results-based financing in Zimbabwe.

Knowledge/Expertise/Skills required:

• Demonstrated experience in the implementation of results-based financing in health.
• Understanding of health systems strengthening approaches and service delivery within a constrained operational environment, with Zimbabwe experience desirable
• Understand the local political, economic, and cultural context.
• Understand, and show a willingness to implement, key principles of the human rights- based approach to programming and results- based management.
• Demonstrate ability to engage constructively with the Government of Zimbabwe
• Strong knowledge of the Zimbabwean health system.

Language requirements:

Fluency in English is required. Knowledge of the local language is an asset.

The detailed consultancy terms of reference is downloadable via this link:

ToR RBF Individual Consultancy-Final pdf.pdf

If interested and available to undertake the individual consultancy, please submit your application online and attach the required documents including the technical proposal and an all-inclusive financial proposal incorporating an approximate number of travel days for field (local) travel. 

Technical proposal: The Technical Proposal should articulate an understanding of the TOR and include the proposed Tasks/Milestones, Deliverables/Outputs, Timeline and level of effort by deliverable. The similar table provided in the TOR is indicative. Applicants may use the indicative table as a guide or deviate as per the proposed approach. The proposal should also cost-effectively propose the local travel proposed by the applicant to undertake the assignment.

Financial proposal: The Financial Proposal should include the costs (providing a daily rate as justification) for each task, including consultant fee, proposed travel costs and perdiem, communications costs and any other proposed cost.

For every Child, you demonstrate… 

UNICEF’s values of Care, Respect, Integrity, Trust, Accountability, and Sustainability (CRITAS). 

To view our competency framework, please visit here. 

UNICEF is here to serve the world’s most disadvantaged children and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, age, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, or any other personal characteristic.

UNICEF offers reasonable accommodation for consultants/individual contractors with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment. 

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check. 

Remarks: 

Only shortlisted candidates will be contacted and advance to the next stage of the selection process. 

Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures, and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws. 

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts. 

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