Niger: Consultancy for developing an investment case for community health system strengthening

UNICEF Niger Country Office
Terms of Reference
Consultancy for developing an investment case for community health system strengthening

1. Background & Purpose:
   Niger has made significant progress in child mortality reduction during the period 1990-2015 and is one of the countries in Africa that has reached the Millennium Development Goal target for under five mortality reduction. Despite significant progress, the current level of child mortality remains very high and a significant gap remains to reach the new Sustainable Development Goals target of 25 deaths per 1,000 live births by 2030. Additionally, the health system in Niger fails to deliver universal health coverage, with significant inequalities
   faced in accessing health care, especially for interventions protecting children against the main causes of death.
   To narrow the equity gap and increase access to maternal and child health interventions for the most vulnerable, in 2006 the Government of Niger created a health outreach strategy, with health posts (Cases de Santé) delivering a basic package of interventions managed by certified community health workers. Nevertheless, this network of health posts has not managed to bridge the access gap and a significant proportion of the population remains outside of the catchment area of the facility-based health system. In order to further bridge the equity gap, additional lay community health workers, usually supported through specific programs such as nutrition, family health or malaria, have been trained and posted in their communities to deliver specific community-based preventive and curative interventions. The Government of Niger is
   currently preparing its third National Health Plan, as well as a specific plan for scaling up community health worker programs.
   The purpose of this consultancy is to develop an investment case that will provide an evidence base and practical recommendations to support investment in community health system strengthening.
2. Objective(s) of the consultancy:
   There are two primary objectives of the consultancy:
   1) To prepare a strategic document covering:
   • An equity focused health system bottleneck analysis.
   • Priority strategies to strengthen community health systems.
   • Estimated cost of implementing the identified strategies.
   • Estimated results of implementing the identified strategies especially for the most vulnerable.
   • A fiscal space analysis and financing opportunities.
   • A series of recommendations for investing in community health system strengthening.
     2) To build the capacity of Stakeholders in Niger in:
   • Equity and community health system strengthening.
   • Evidence-based planning.
   • Costing and budgeting.
     Methodology (if required)
     The detailed methodology will need to be developed and submitted by the candidate. It is expected that the methodology presented for the strategic document and the capacity building entails specifically:
   • A description of the approach to health system bottleneck analysis.
   • A proposition of tool or combinations of tools to be used for estimating cost and impact.
   • A proposed methodology for capacity building.
3. Specific activities to be completed to achieve the objectives:
   • Desk review of existing key documents to create the background, rationale and detailed methodology.
   • Presentation to senior policy makers in Niger of the investment case development for validation of the
     process.
   • Present the content of the key objectives of the strategic document presenting the investment case to a working group consisting of government counterparts and international and national civil society organizations.
   • Prepare a model presenting cost and estimates as per the agreed methodology.
   • Facilitate with the working group the health system bottleneck analysis
   • Present and validate the results of the study with senior officials in Niger and senior management of UNICEF.
   • Submit for review a draft written version of the investment case.
   • Produce a final report after consolidating feedback of reviewers.
4. Specific outputs/products/results (with delivery dates to be defined):
   • A detailed methodology for the investment case
     o Delivery date: 2 weeks after the inception of the consultancy
   • Preliminary results
     o Delivery date: 4 weeks after validating the methodology
   • A final document
     o Delivery date: 2 weeks after validation of the preliminary results
5. Qualifications and/or specialized knowledge/experience required and desirable for undertakingthe assignment:
   Profile of the consultant
   Required:
   • A minimum of 10 years of experience in health economics, public health or any other relevant field of expertise.
   • Expertise in equity focused health system bottleneck analysis.
   • Expertise in evidence based planning and budgeting.
   • Proven record of developing health system investment case.
   • Proficiency in French.
     Desirable:
   • Advanced degree in health economy, public health or any other field of expertise.
   • Technical expertise on community health.
   • Working knowledge of English.
6. Duration of the assignment:
   45 working days within three month.
7. Supervision:
   The consultant will be under the supervision of the Chief of CSD section.
8. Fees:
   As a general principle, the fees shall follow the “best value for money” principle i.e. achieving the desired outcome at the lowest possible fee.
   Candidates are requested to submit their daily rate for this consultancy
9. Travel:
   Economy class and lump sum amount in lieu of DSA depending of the duration of the assignment.
10. Duty Station and work arrangements
    The Consultant will works at home with a 10 days mission in Niger. He/she will work with his own equipment, but will have vehicles, office space, and secretarial services when in Niamey.

Qualified candidates are requested to submit their applications including cover letter, their highest
academic degree, a CV and P 11 form (which can be downloaded from our website at www.unicef.org) to
nigrecruit@unicef.org no later than 26 September 2016.
Please indicate your ability and availability to undertake the terms of reference above.