Consultant – Fund Flow Analysis at Results for Development (R4D)

Results for development (R4D), a global nonprofit consulting organization with expertise in sustainable health financing, is collaborating with RTI on the Act | East program to carry out an assessment of the health financing landscape and fund flow analysis of the Cross River State Ministry of Health to receive fixed amount awards towards implementing NTD programs and strengthen CRS’ financial systems. The study employs a mixed-methods approach and will include the review of the current fiscal context for health financing to understand the implications for NTDs resource mobilization, analyses of how health and NTD funding is managed and flows through the system as well as examine local planning and budgeting processes for their incorporation of NTD services.

We are recruiting to fill the position below:

Job Title: Consultant – Fund Flow Analysis

Location: Calabar, Cross River
Employment Type: Contract

Background

• USAID’s Act to End Neglected Tropical Diseases (Act | East) program, led by RTI International, supports national governments to reach their NTD control and elimination goals through proven, cost-effective public health interventions. The program provides critical support to countries in their journey to self-reliance by helping to create sustainable NTD programming within a robust and resilient health system.
• The Act | East program, works with the government of Nigeria and partners to promote and build capacity towards sustainable NTD programs with a key focus on national planning and financing processes. Since 2016, USAID has supported the Cross River State (CRS) Ministry of Health’s Lymphatic Filariasis (LF) and Onchocerciasis (OV) program to make progress towards elimination goals. Currently, seven of the 10 LGAs endemic for LF have achieved the criteria to stop treatment and are getting ready to start surveillance. The remaining three LGAs are also well positioned to achieve this status in the next two to three years.
• In 2022, Act | East will support the CRS Ministry of Health to identify ways to sustain gains made and scaling up programs as appropriate. One key step is to strengthen the Ministry’s health financing systems to ensure financing for continued treatment and surveillance.
• However, a Public Expenditure Management Review (PEMR) conducted in 2012 by USAID-funded Health Systems 20/20 revealed that there are low investments in health, challenges in sustaining the State’s and LGAs’ development priorities, difficulties coordinating among the fragmented revenue resources, and discrepancies between budgets and spending across all LGAs[i]. These circumstances pose a major challenge towards ensuring sustained financing for NTD efforts. Act | East is therefore exploring the use of a fixed amount award (FAA) mechanism, an approach that channels donor funding through existing public finance structures, to attempt a revitalization of funding flow with a view to proving if this could strengthen government financial systems and ownership, thereby positively impacting support to the NTD program.
• Results for development (R4D), a global nonprofit consulting organization with expertise in sustainable health financing, is collaborating with RTI on the Act | East program to carry out an assessment of the health financing landscape and fund flow analysis of the Cross River State Ministry of Health to receive fixed amount awards towards implementing NTD programs and strengthen CRS’ financial systems.
• The study employs a mixed-methods approach and will include the review of the current fiscal context for health financing to understand the implications for NTDs resource mobilization, analyses of how health and NTD funding is managed and flows through the system as well as examine local planning and budgeting processes for their incorporation of NTD services.
• As of September 2021, the R4D Nigeria team based in Abuja has kicked off the project with an inception meeting with the CRS Ministry of health and other stakeholders at the LGA and PHCDA. A roadmap has been developed with timelines.
• The team is currently working on obtaining ethical approval for the assessment through the State’s ethics committee while concurrently gathering identified data sources for a desk review. The team is looking for a technical consultant based in Cross River state who would complete a health financing desk review, facilitate the data collection and analysis process and submit a final report on the findings from the assessment while working closely with the stakeholders at the Ministry, local government, and PHCDA levels.

Objectives
The objective of this study is to conduct a health financing landscape and fund flow analysis in CRS Health Sector that will inform the prospects for strengthening government ownership of the NTD Program by using FAAs to support activities at the LGA through the following sub-objectives:

• To understand how funding flows from state to LGA level to explain how FAA funding must flow in order to reach activities at the LGA.
• To understand the fiscal context for health financing and health expenditure trends in Cross River State.
• To understand the main sources of funding for health and NTDs at the National/State/local level
• To understand the feasibility of mobilizing domestic financing for NTDs.

Scope of Work
The Consultant will undertake all activities necessary to fulfill the objective and output of the project,including but not limited to the following

• Support facilitation of the stakeholder engagement forum
• Support the training of data collectors
• Conduct a comprehensive review of policy documents, state health financial data, and reports as well as relevant websites/databases from the state government and relevant literature (peer-reviewed and grey)
• Supervise qualitative data collection process across the different levels- State, Local Government, PHC and other donor/partners.
• Analyze data retrieved from both the review and interview process.
• Produce a high-quality report on the result of the assessment and a presentation on findings and recommendations.
• Facilitate validation and dissemination of findings.

Reporting:

• Consultant is to report to the Program Manager R4D Nigeria on progress updates, challenges, and deliverables.

Project Deliverables:

• A 10-page report addressing all the proposed questions including references, annex, footnotes, and figures. A copy of the report will also be submitted to the CRS MOH.
• The report will include a review of the current fiscal context for health financing to understand the implications forNTDs resource mobilization,analyses of how healthand NTD funding is managed andflowsthrough thesystem and examine local planning and budgeting processes for their incorporation of NTDservices.

The health financing landscape and fundflow analysis will seek to address the following questions:

• Describe the fiscal context for health financingandhealth expendituretrends.Describethe latestavailablehealth budget allocations for Cross RiverStateandextent of alignment to health priorities, including NTDs.Are some/allNTDscapturedwithin the health budget?
• Describethe main sources of funding for health and NTDs at theNational/State/local level?Howare theseresources allocated andmanaged at thevarious levelsof the system?Are there issues with fund flows to local governments fromthedifferent financing mechanisms?In the case of off-budgetdonor funds, how are NTD resources used/planned/accounted for withinthegovernment system?Is NTD service provisionintegrated within existing funding pools and purchasing arrangements?
• Discuss the implicationsof the aboveforAct|East’s response. More specifically,how could Act|East funding have to flowin orderto reach activities at the LGA? What are the pros and cons of each funding flow option?Are there LGAs in CRS where there is evidence of strongerfinancial capacitythat Act|East should consider? Are there other donor transitions that have happened/are happeningin CRSand what has their experience been?
• What are the prospects formobilizingpublicdomestic financingfor NTDs given current fiscal challenges?Are private sector initiativesan opportunity forNTDs?
• A presentation of findings and options or recommendations to be shared with R4D/RTI.

Qualifications / Requirements

• Master’s Degree in Health Economics, Health Policy and Management, or Public Health with a health financing focus.
• At least 3 to 5 years of field-based experience working on health financing and/or health economics evaluation and analytics, health policy, planning, public financial management (PFM), and/or financing.
• Experience in workshop facilitation and collaboration with government and non-government stakeholders.
• Familiarity with the Nigeria health financing mechanisms and health system, Nigeria Ministry of Health, NTD or vertical programs including HIV/AIDS, FP/RH, Malaria, EPI, MCH, TB, among others is necessary
• Full professional fluency in English, including excellent written communication skills; language abilities relevant to the project countries also valuable
• Ability to work independently and collaboratively as part of a team and deliver high-quality results within tight timeframes
• Excellent organizational skills and attention to detail.
• Must be based in Cross River State

Work Effort

• The level of effort available for this consultancy is 30 days.
• This should include time for the analysis, report writing, and revisions based on reviews and feedback from the country and HQ teams.
• The consultant will be compensated at an agreed rate per day. The consultant is expected to complete all the activities and submit deliverables within the agreed time frame.

Application Closing Date
Monday, 10th January 2022.