Technical Assistant – for Provider Affairs and Quality Assurance 30 views

LonAdd HR Consultancy Plc (www.lonadd.com) is a Recruitment & Outsourcing Company based in Addis Ababa, Ethiopia, with branch offices in Dukem and Hawassa. We are looking to recruit a qualified candidate on behalf of our client.

Location   Ministry of Health (Addis Ababa).

No. Required – 1 (One)      

Background:

As part of universal health coverage, Ethiopia aims to promote financial risk protection through implementation of risk pooling mechanisms. To this end, the government designed to implement two types of health insurance schemes: Social Health Insurance (SHI) which aims and targets formal sector employees and Community Based Health Insurance (CBHI) which aims and targets communities who are in the informal sector mainly residing in rural, pastoral, semi pastoral areas, and urban dwellers who make their life not out of a formal employment.

CBHI system implementation was started as a pilot program in 2011 in thirteen woredas. Currently, the number of Woredas implementing CBHI has reached to 916, while the total number of households enrolled in CBHI schemes have reached more than 11.3 million of which 2 million members are indigents. Besides more than 3000 health facilities are contracted to deliver health services to the beneficiaries. Various program reviews and studies have showed that CBHI has helped in improving health service utilization, availing more revenue for facilities which could be used for health care quality improvement, in reducing financial hardship and enabling women empowerment. Routine report shows that the per capita health service utilization in CBHI woredas has increased from 0.36 in 2015 to 1.2 in 2021.

Furthermore, CBHI impact study report which was conducted in 2021 showed that per capita health service utilization for CBHI members has increased to 2.03.

To further strengthen health insurance system, the Ethiopian Health Insurance service provided due emphasis in its five-year strategic plan and set ambitious goals and targets to expand CBHI to 85 percent of Woredas of the nation and enroll 80 percent of the eligible Households by the year 2024/25. Moreover, it has planned to smoothly roll out Social Health Insurance.

Hence, to ensure effective implementation of the health insurance system and meeting the envisioned strategic objectives and targets set at all levels: it is crucial to build the capacity of provider affairs and quality assurance directorate to put in place strategic health purchasing system such as design and implement appropriate health insurance benefit package, provider payment mechanism, quality assurance mechanisms, assess and design appropriate system to strengthen scheme-health care providers relationship, enhance monitoring and evaluation system to generate accurate health service utilization related information.

Therefore, EHIS is looking to recruit competent candidates who can be able to provide technical assistance.

Purpose of the position: 

The Technical Assistants will be seconded and accountable to Provider affairs and quality assurance directorate of the Ethiopian Health Insurance Service and work closely with the Director, team leader and experts. Moreover, the technical assistant will closely work with relevant directorates to align and improve overall health insurance management system. Besides, the TA expected to work with and provide support to branch offices.

Specific Tasks:

• Support redesigning and implementation of health insurance (community-based health insurance and social health insurance) benefit package
• Support to design strategy for contracting and managing private health care providers,
• Support to strengthen clinical auditing, health care quality assurance mechanism, and propose policy recommendations,
• Support to conduct periodic health facility readiness assessment, analyze and propose policy recommendations to improve quality of care,
• Support to design provider payment mechanisms and reimbursement rates,
• Design appropriate system to strengthen scheme-health care providers relationship,
• Review and revise standardized operating procedures and tools required for effective implementation contracts management,
• Support to design tools to select health care providers to participate in health insurance system
• Design contracts management system,
• Build the capacity of staffs at head office and branch offices,
• Produce standardized health care provider training materials and support provision of capacity building training for health care providers,
• Provide technical support for branch offices,
• Perform other duties and responsibilities as requested by the directorate.

Reporting:

• The Technical Assistant – for Provider affairs and quality assurance will be directly recruited by third party HR firm and will report to Provider affairs and quality assurance Directorate at MoH & also Immunization team at CLIENT country office.

Payment Modality & schedule:

The fees for this contract shall be paid on monthly basis based on the submission of monthly reports against the deliverables indicated above.

Note:

• The consultants will be based at MoH level.
• The consultant will not be provided lodging and/or meals.
• The consultant will use his/her own materials, i.e., computer/laptop, phone etc.
• For the duty travel, the consultant will be provided vehicle and DSA from the assigned government counterpart/MoH as per the guideline.
• The consultant will be paid monthly by HR firm upon completion of deliverables as indicated on this TOR and approved by the supervisor.