Recently, there has been increased interest especially from the government of Afghanistan, to explore the possibility of implementing a national health insurance programme in Afghanistan as an alternative risk pooling mechanism towards improved healthcare delivery as well as a means towards reducing out-of-pocket expenditures. For instance, in March 2016, the President’s office issued a directive to the Ministry of Public Health (MoPH) to prioritize investigating how to implement health insurance for government employees in Afghanistan. In light of this, a new health insurance law has been drafted and currently being reviewed by the Ministry of Justice. Also, a Phase I health insurance feasibility study has been conducted which primarily assessed stakeholders’ opinions about health insurance and the enabling environment. Assessment of the demand-side of the health insurance market was not covered in this study.
Therefore, the Phase II feasibility study is conducted to provide further information on feasibility of health insurance in Afghanistan and outline a roadmap for implementation of the same.
The Phase II feasibility study contains the following key activities:
* Carry out a further situational analysis of the country context to examine the enabling environment for the introduction of health insurance in Afghanistan;
* Define a Health Insurance (HI) benefit package;
* Recommend a strategic purchasing mechanism for health insurance;
* Conduct a willingness and ability to pay study for health insurance;
* Train and provide relevant health insurance implementation tools to the Health Economics and Finance Directorate (HEFD) of the Ministry of Public Health (MoPH); and
* On-an-ongoing basis, engage and mobilize stakeholders’ commitment towards the introduction of a health insurance programme in Afghanistan.
A total of 31 consulting days are allocated for these activities and related deliverables
The Actuary is therefore expected to contribute to these efforts including;
* Develop a methodology for actuarial analysis of health insurance benefit package;
* Contribute to the definition of the 3 Health Insurance benefit packages
* Contribute to the costing of the health insurance benefit packages
* Undertake financial modelling of the 3 health insurance benefit packages;
* Undertake the actuarial analysis of the benefit packages
* Conduct an actuarial analysis training for the staff and partners of HSR;
* Propose a financial and auditing system to ensure sound financial management of the intended health insurance program
The Actuary must have at least these qualifications and expertise:
* Be a qualified actuary from a recognized actuarial body and or has a higher degree (Master or PhD) in Actuarial Science. An actuary with specialisation in health insurance is a plus;
* At least 10 years of experience in major health insurance related projects;
* Strong actuarial and financial expertise
* Extensive experience in conducting health insurance actuarial assessment and analysis in developing countries
* Good understanding of health insurance processes and costing
* Good understanding of public sector financial set-up and processes
* Excellent at facilitating high-level meetings and trainings
* Strong analytical, technical, and problem-solving skills
* Experience in working for international organizations such as USAID, UKaid etc.
* Excellent report writing skills
* Excellent English communication skills, both verbal and written is strongly desired
* Prior work experience in Afghanistan and or other developing countries will be a plus.
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