FINAL TERMS OF REFERENCE
NATIONAL CONSULTANT – ASSESS IMPLEMENTATION OF PROGRAMME-BASED BUDGETING IN THE HEALTH SECTOR IN NAMIBIA.
To be attached to the Stellis requisition
Please briefly describe why the work is needed and the context.
The Ministry of Health and Social Services (MoHSS) follows a programme-based budgeting approach as determined by the Ministry of Finance (Treasury) that is primarily based on the defined objectives of the main divisions within the MoHSS. However, one of the challenges has been the overlapping activities in a number of the divisions within MoHSS, making it difficult to project the long-term costs of programmes and evaluate different programme alternatives that could be used to reach long-term goals and objectives. In the recently conducted 2019 Public Expenditure Review of the health sector, it was recommended that the composition and implementation of programme budgets be reviewed to align them to the priorities of the health sector. In addition, it stated that the design of programmes should reflect national priorities and a shift from historical input-based budgets toward outputs and results and that budget execution protocols need to be adjusted to reflect the implementation of programmes.
The proposed analysis is particularly timely as efforts are made to improve the efficient and effective use of available resources, with a long-term objective of ensuring sustained improvements in the health of the population. The interface between health programmes and programme budgeting is critical in understanding how to reduce inefficiencies in health spend. It also provides an opportunity to accelerate progress in the transition to programme-based budgeting.
The objective of this assignment is to support the MoHSS to assess the status of the implementation of Programme-Based Budgeting (PBB) in the health sector within the broader context of PBB in Namibia. In the framework of the “Process Guide for National Budgetary Dialogue”, this analysis is expected to participate in informing national budget dialogue on strategies to reorient financing arrangements to better meet both Health Security and Universal Health Coverage (UHC) related objectives.
Outline clear tasks and deliverables, to be carried out in the framework of the background described above.
These need to be time-bound and specific.
The National Consultant will work with an international consultant to carry out the following tasks:
• Examine the impact of PBB on how funds are budgeted, allocated, used and the extent to which it enhances equity.
• Assess the current status of implementation of PBB within the MoHSS and provide a detailed situational analysis at all levels of the public health system and it is implemented in line with previous recommendations and government priorities
• Identify key bottlenecks associated with the current health budget structure in terms of capacity to allocate and spend effectively and efficiently on sector priorities, and possible misalignment between budget structure and expenditure management/reporting rules. This includes flexibility to respond to health emergencies such as the Covid 19 pandemic. Provide recommendations on how these can be addressed.
• Retrospectively document and assess the reforms introducing PBB in health: (a) expected goals, (b) role of key stakeholders, (c) process and output of programme definition in health, (d) effectiveness and relevance of the reform process from a sector perspective, (e) expected implications for expenditure management/ reporting.
• Ascertain the extent to which PBB has improved transparency and accountability for the use of resources.
• Assess the linkages between PBB and performance management within the MoHSS and how these can be further implemented
• Provide an understanding on how the current PBB system can be aligned to possible future health financing reforms in enhancing equitable and efficient resource allocation
• Inception report detailing proposed approach/methodology, timelines for the consultative processes and report completion by mid September 2022.
• Preliminary draft report with context analysis, the current status on implementation of PBB in Namibia within MoHSS by mid October 2022
• A detailed final report detailing current situational analysis, with apparent gaps and opportunities for strengthening the implementation of PBB and a roadmap for implementation of the recommendations with a clear monitoring framework to track progress by end of October 2022
• National policy dialogue report with outputs from stakeholder engagement on the analytical report with the implications/actions for the health sector.
3. Qualifications, experience, skills and languages
Identify the educational qualifications and expertise needed for the terms of reference outlined above.
Essential: An advanced degree in Public Financial Management, Economics, Health Economics and Development Finance.
Essential: A minimum of 10 years’ experience in Public Financial Management, Health Economics and Development Finance.
• Good understanding of the budgetary process and management systems at both national and sub-national level in Namibia;
• An understanding of the health budget programme and sub-programme areas;
• Good understanding of the functionality of the health system in Namibia across the building blocks;
• Excellent interpersonal and writing skills.
• Demonstrated ability of analytical and report drafting work.
• Experience working in research and analysis
Languages and level required
Essential: Expert knowledge of English.
4. Technical Supervision
Mary Nana Ama Brantuo – Health Systems Advisor, Participatory Governance & Policy
Please specify where the consultant will work:
On site: WCO/ Namibia, Windhoek, Namibia (please indicate office and duty station)
Off site: (please indicate location/address).
On site for insurance purposes :__Windhoek __(please indicate location/address). (This is where a duty travel is planned during the course of the consultancy but the consultant is being hired to work from home)
6. Travel - If travel is involved, full medical clearance is required
Please specify any expected travel(s): dates, location and purpose. To Windhoek, Namibia
7. Remuneration and budget (travel costs excluded)
Rate daily or monthly or for language and publishing services by word count or number of pages]: NAD per month
Work schedule (if applicable) : Full time