Jordan’s goal to achieving universal health coverage (UHC) is clearly highlighted in its’National Health Strategy 2016-2020 (‘to provide health, financial and social protection to the entire population on fair basis’). The need to ‘develop a roadmap for achieving the goal of universal health coverage in the Kingdom’ is also indicated in the strategy.
The USAID Health Finance and Governance Activity (HFG) aims to improve health sector sustainability and resiliency in Jordan, in support of the Government of Jordan’s goal of achieving Universal Health Coverage (UHC). HFG’s two primary objectives in support of the GOJ’s UHC goal are to promote: (1) Increased spending efficiency of public resources for health to ensure long term sustainability; and (2) Strengthened governance of the health sector at both national and subnational levels to more effectively coordinate, plan, manage, and monitor the health system.
Scope of Work
This scope of work (SOW) is for a consultant to conduct multiple tasks related to health insurance and efficient use of healthcare resources in support of Universal Health Coverage (UHC) in Jordan:
1. Support the Essential Health Package (EHP) stakeholders’group (Estimated LOE: 25)
HFG will set up a stakeholders’group on EHP. This will include members from public payers but also the private sector, think tanks, and international organizations to name a few. Through this group, HFG will hold a number of focused discussions and policy sessions with input from international experts to present international experience and best practice models. The discussions will result in EHP scenarios that will guide an advocacy plan for the design of an EHP in Jordan.
The consultant will guide HFG team on developing an EHP in Jordan.1.1 Provide an introductory session for the EHP stakeholders group on EHP. Drawing on international examples, the international consultant will provide an outline for: What is an EHP? How is it defined? Why is an EHP necessary and how it is useful?
1.2 Develop brief discussion documents on EHP stakeholders’group.
The EHP stakeholders’group will engage in discussion sessions on more specific questions:
* How will the EHP be defined? Costed? What work needs to be done? Who should be involved in its development? And what are the institutional structures that will be put in place so that an EHP can be continuously updated/monitored to address evolving health needs, and financial constraints?
* How will the EHP be financed? Are new resources needed, or will resources be shifted away from existing programs or facilities? What is the plan if the costing vastly exceeds current resources?
1.3 Provide input into scenarios for developing an EHP in Jordan. HFG team will facilitate a number of scenarios for reaching an EHP in Jordan, the consultant will provide guidance for HFG team to finetune the scenarios.
1.4 Provide input on an advocacy plan for EHP in Jordan. Once the EH stakeholders design an advocacy plan for EHP, the consultant will provide written comments to the draft advocacy plan.
2. Support developing a policy brief on payer models (Estimated LOE: 15)
One of the main decisions to consider in Jordan is the appropriate payer model. Discussions around a single payer in the public sector is reiterated in some government documents, however, different stakeholders mean different things.
2.1 The consultant will deliver a presentation on payer models.
2.2 The consultant will help focus these narratives by providing a policy brief about payer models.
3. Strengthen the public sector insurance capacity (Estimated LOE: 50)
HFG conducted an operational review assessment of a number of public insurers. The assessment identifies capacity gaps in the areas of contracting, claims processing, communications mechanisms and data analysis.
The consultant will provide support to HFG in the following areas:
3.1 Deliver training workshop for Health Insurance Administration (HIA) on contracting taking into consideration quality and cost analysis methodologies.
3.2 Assist HFG to revise the claims processing conditions included in Health Insurance Administration contracting for private sector to improve cost containment.
3.3 Deliver a training workshop for public insurers to improve their communication mechanisms with the public taking into consideration the IO international standards
3.4 Assist HFG integrating insurance data analysis modules in national training entity data analysis modules to ensure sustainability
The consultant must have a solid understanding of best regulatory practices in insurance and health insurance and should have reviewed insurance laws and regulations in the past as well as knowledge about the principles and traits of robust health insurance systems and the regulations that support such systems. The consultant should have practical international work experience in health insurance, health finance, and private sector.
* Minimum 10 years of work experience in insurance and health insurance
* Experience working directly with, reviewing, analyzing insurance laws, regulations, and policies
* Strong analytical and report writing skills
* Work experience in Jordan and internationally in the areas of health insurance and private sector required
* Experience with public-private partnerships is strongly preferred
* Fluent in English (both written and oral)
* International consulting experience on issues of insurance is a plus
* Knowledge of Arabic is an advantage
About the Organization
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