National Health Insurance Management Authority (NHIMA) Advisor Nathan Associates Inc.

The objective of the U.S. Agency for International Development (USAID) Revenue for Growth Activity (R4G) is to support the Government of the Republic of Zambia (GRZ) in its efforts to improve domestic resource mobilization (DRM), which can help to expand Zambia’s fiscal space for public spending and investments in service delivery and poverty reduction. R4G is engaging both government and non-government stakeholders in building capacity in tax policy analysis, improving tax compliance and administration, and strengthening tax culture in a manner that facilitates private sector growth and promotes effective relationships between taxpayers and the GRZ. The R4G is organized around four Objectives: 1) Improve Tax and Non-Tax Administration and Compliance; 2) Strengthen Tax Policy; 3) Enhance Public-Private Dialogue; and 4) Enhance Capacity to Address Emerging Fiscal Policy and Management Issues.

Objective of the Assignment

Improved DRM will provide additional fiscal space for health care to support implementation of the National Health Insurance Scheme (NHIS). Although other countries have designed and implemented such schemes, it is a new health financing option for Zambia. In order for the NHIS to be successfully implemented it must have attributes of a good health financing mechanism: feasibility, equity, efficiency and sustainability. The NHIS Act lays the foundation on which the NHIS will operate through the development of carefully designed operating procedures and regulations that meet the expectations of all key stakeholders.

To help operationalize the Ministry of Health (MOH)’s Health Care Financing Strategy 2019 – 2027, USAID is planning to support the hiring of one Advisor to be embedded at the National Health Insurance Management Authority (NHIMA) and another Advisor to be embedded at the Health Care Financing (HCF) Unit at the MOH. The NHIMA Advisor will provide technical, strategic and process management expertise to support the successful implementation of the NHIS. The NHIMA Advisor will be expected to collaborate with the MOH HCF Unit, develop strategic plans for NHIMA, source and deploy administration systems to support the efficient execution of NHIMA functions, and support the Director General with advisory and technical assistance in line with NHIMA functions, the NHIS Act and subsidiary regulations. The NHIMA Advisor is expected to establish effective working relationships with the MOH and other key stakeholders.

The roles and responsibilities of the NHIMA Advisor are outlined below. The NHIMA Advisor will be embedded at NHIMA and will be employed by R4G for a period of three years (contingent on successful performance), after which time the Advisor is expected to be hired by NHIMA. The NHIMA Advisor will report to NHIMA and R4G.

Roles and Responsibilities of the NHIMA Advisor

The NHIMA Advisor’s roles and responsibilities include, but are not limited to, the following.

1. In coordination with NHIMA and the MOH’s HCF Unit, conduct a pragmatic review of: a) the status of Zambia’s current health care financing initiative, including the information base on which it rests and the ways in which its activities are monitored and evaluated, in order to establish a benchmark of current coverage, data, and funding, and; b) the current status of health care financing initiatives (both successful and problematic) adopted in other countries.
2. Support the development of a system to enroll individuals from the informal sector and those who are exempted. Developing the system may include identifying GRZ public service activities that are intended to reach Zambian citizens, determining their strengths and weaknesses, and adapting lessons learned to increase enrollment.
3. Support the design and implementation of research related to NHIMA.
4. Cooperate with staff of the Ministry of Finance, the Statistics Agency, Parliamentary bodies, and outside organizations in conducting analyses, such as financial sustainability modelling, to inform tariffs, subsidies, benefits and contribution rates.
5. Support capacity-building initiatives for staff working across different directorates of NHIMA as well as units in the MOH and other organizations that are involved in health care financing, including the Ministry of Finance and the Parliamentary Budget Office.
6. Work with the MOF HCF Unit Advisor employed by R4G to create a bridge between NHIMA and the MOH to address issues common to both organizations.
7. Comply with all R4G project reporting requirements, including but not limited to preparing monthly, quarterly and annual reports, work plans, and monitoring, evaluation and learning (MEL) reports.

Qualifications

The NHIMA Advisor will possess the following minimum qualifications. Note that some of the public sector experience may have been earned concurrently.

• An undergraduate degree in economics, statistics, or a closely related field.
• A graduate degree in economics, public administration, or a medical degree.
• 5 years’ experience in working within, or directly advising, public sector agencies on the delivery, costing, and/or evaluation of human services.
• 5 years’ experience in health care delivery.
• 5 years’ experience in insurance programs.
• 5 years’ experience in cross-cutting public sector activities (i.e. involving two or more units of the same ministry or across two or more ministries).
• 5 years’ experience working with international organizations and/or two or more countries.
• 5 years’ experience in health insurance programs.
• Excellent English written and verbal communication skills.