Health Economist at World Bank

Background / General description:

Established in 1944, the WBG is one of the largest sources of funding and knowledge for development solutions. It is governed by 188 member countries and delivers services out of 120 offices with nearly 15,000 staff globally.

The vision of the World Bank Group (WBG) is the eradication of extreme poverty by reducing the number of people living on less than $1.25 a day to 3 percent by 2030, and the promotion of shared prosperity by fostering income growth of the bottom 40 percent in each country. To achieve that vision, in 2013 the WBG Board of Governors approved a strategy for the organization. The strategy leverages the combined strength of the WBG institutions and their ability to partner with the public and private sectors to deliver customized development solutions backed by finance, world class knowledge and convening services. It has three components: (1) maximizing development impact by engaging country clients in identifying and tackling the most difficult development challenges; (2) promoting scaled-up partnerships that are strategically aligned with the goals; and (3) crowding in public and private resources, expertise and ideas.

On July 1, 2014, the WBG launched the architecture underpinning the strategy and instrumental to its success: the new fourteen Global Practices and five Cross-Cutting Solution Areas that, in concert with the WBG regions, will design solutions to address clients’ most pressing developmental challenges, and ultimately, enable the WBG to meet its twin goals of eliminating extreme poverty and boosting shared prosperity. The Global Practices perform the following functions:

• Defining Strategic Direction: (i) define strategic priorities to deliver solutions and achieve results based on country and regional demands and interactions and global priorities; (ii) define/implement integrated resource strategies, (iii) engage in selected, high priority partnerships, and (iv) establish robust monitoring and reporting systems.

• Developing and Deploying Expertise Globally: (i) lead the development and delivery of solutions to clients by deploying the right technical staff where and when needed; and (ii) invest in developing technical talent.

• Delivering Integrated Solutions: (i) deliver operations, while Regions ensure fit for purpose; (ii) develop public-private integrated solutions that draw on GPs, CCSAs, MIGA and IFC; and (iii) hold the “Concurrence” role in all project/AAA approval steps, ensuring that all technical quality, safeguard and fiduciary requirements (if applicable) are met.

• Capturing and Leveraging Knowledge Effectively: (i) ensure knowledge is used effectively to deliver solutions to clients; (ii) assign staff roles and accountabilities in creating, capturing, sharing and using knowledge’ (iii) reward knowledge sharing and learning, in performance management and career development; and (iv) develop knowledge base around key development challenges and solutions sets.

HEALTH, NUTRITION AND POPULATION GLOBAL PRACTICE CONTEXT

The central contribution of the HNP Global Practice to the World Bank’s twin goals is to enable the achievement of Universal Health Coverage (UHC), in which all people are effectively covered by essential health services, and nobody suffers undue financial hardship as a result of illnesses. In the quest for UHC, the HNP Global Practice is building on progress made in the framework of the Millennium Development Goals, an array of analytical and advisory services, strategic partnerships with partner institutions and other financing agencies, and an active lending portfolio. The HNP Global Practice includes staff members in Washington, DC and many country offices.

The HNP Global Practice is led by a Senior Director, who has overall responsibility for the GP. The Senior Director is assisted by the Director, who serves as the Chief Operating Officer of the Practice. The HNP Global Practice Leadership Team, which leads and manages the HNP GP, consists of the Senior Director, the Director, eight HNP Practice Managers  and six Global Leads (for Financing; Healthy Societies; Nutrition; Population and Development; Decision and Delivery Science; and Service Delivery). The HNP Global Practice works with and across multiple sectors, in recognition of the fact that HNP outcomes often depend on actions that lie outside the HNP sector. Accordingly, a capacity to work across GP boundaries, forge coalitions and influence multi-practice solutions is essential for achieving the major objectives of improving HNP outcomes.

NIGERIA COUNTRY CONTEXT
About 900,000 children and mothers die each year in Nigeria mostly from preventable causes. Over the last decade the trend in health, nutrition, and population (HNP) outcomes in Nigeria is mixed with a 36 percent decline in the under-five mortality rate (U5MR) but no change in the prevalence of malnutrition. Fertility and maternal mortality have also not changed. The limited progress on HNP outcomes is consistent with the picture in service delivery where over the last quarter century the coverage of key health interventions has stagnated at low levels. The limited coverage of important interventions is further aggravated by poor quality of care.

Input-related issues explain little of the problem, indeed Nigerians have better physical access to health facilities than their neighbors in West Africa. There are also more health workers per capita than in much of Sub-Saharan Africa. While much of the needed inputs are in place, the lack of significant progress is likely due to poor quality management, lack of incentives and inadequate accountability mechanisms. Thus the Bank’s HNP portfolio aims at increasing the focus on results, strengthening accountability, and building management capacity. This is exemplified by the Saving One Million Lives (SOML) Program for Results (PforR) and the performance-based financing (PBF) supported under the Nigeria State Health Investment Project (NSHIP)

Health care financing is mostly out-of-pocket and public expenditure is unlikely to increase much. It is difficult to get reliable information on health care financing in Nigeria as efforts by the Bank (which is currently carrying out a resource tracking survey) and other partners can attest. While keeping in mind the limitations of the data, there are a few salient points on which there is widespread agreement: (i) there is high out-of-pocket (OOPs) expenditure representing about two/thirds of total health expenditure. This is consistent with the wide use of the private sector, low levels of public expenditure on health, and limited use of risk pooling; (ii) public expenditure is inefficient, partly because there is little non-salary recurrent budget. What little there is does not end up at health facility level; (iii) public health expenditure, currently about 1.2 percent of GDP and about 7 percent of budget, may increase modestly as a result of economic growth and increased commitment to health (as exemplified by the recent signing of the “National Health Act”). However, the Government’s heavy dependence on oil (which accounts for about 75 percent of its revenues), makes it unlikely that overall public revenues will increase substantially over the medium term. In this context increases in public expenditure on health are likely to be modest in the next few years.

The HNP Global Practice is seeking a Senior Health Economist / Health Economist (Local hire) to be based in Abuja, Nigeria to support its portfolio and policy dialogue program at national and regional levels.

The job of the Health Economist will be to support the Nigerian government and the country team in addressing the difficult health financing challenges the country faces. The Bank plays a critical leadership role on communicable disease programming in Nigeria and the candidate is expected to dialogue with other key actors in the health and other relevant sectors, provide technical value-added support to government counterparts, and be able to manage donor relations towards a more systematic approach to combating communicable diseases in the country.  The Health Economist will also contribute to the Unit’s operational and analytic work programs as a tool to strengthen health systems and to improve health outputs and outcomes.

The Health Economist will be based in the World Bank Country office in Abuja and, working in close collaboration with the Bank team, including Lead Health Specialist and the task-team leaders (TTLs).

Duties and Accountabilities:

1. Play a lead role in supporting the Nigerian Federal and State Government and country health teams in strengthening health system performance including financial protection and resource mobilization;
2. Play a critical role in the HNP team’s evolving work program of analytical and advisory activities (AAA) related to health care financing in general and specific activities related to resource tracking, public expenditure reviews, and development of national health accounts;
3. Support the implementation of the National Health Act (NHA) by providing technical assistance to the National Health Insurance Scheme (NHIS) and National Primary Health Care Development Agency (NPHCDA);
4. Carrying out such AAA as would help strengthen the team’s ability to provide timely and effective advice to the Federal and State Governments;
5. Closely collaborate with the IFC to build effective public-private partnerships and help grow the private sector, especially in those parts of the country where it is under-developed;
6. Actively support the teams implementing the SOML PforR and the NSHIP by participating in supervision missions, providing analytical support to the task teams and clients, and spending time in the field to understand the real challenges facing implementers and beneficiaries;
7. Help ensure close coordination with: (i) government; (ii) a variety of international and local development partners; and (iii) the CMU and Bank team across other sectors;
8. Carry out such tasks as the Practice Manager assigns to support the development of the Bank’s work in health, nutrition, and population in Nigeria.

Selection Criteria:

1. Advanced degree in Health Economics (or social sector economics) and at least 5 years of relevant experience.
2. World class knowledge and experience of health economics in developing countries, preferably in a variety of country settings;
3. Strong knowledge and understanding of Health, Nutrition and Population issues, political economy, institutional economics, and governance;
4. Proven analytical and quantitative skills including significant journal publications. Knowledge of impact evaluation will be an asset.
5. Excellent English language writing and oral communications skills. Must be a compelling speaker and an effective advocate for effective health policies;
6. Strong diplomatic skills and success working in teams both as a team member and as a team leader.  Demonstrated ability to deal sensitively in multi-cultural environments and build effective working relations with clients and colleagues. Proven ability to function effectively in multi-disciplinary teams;
7. Knowledge of results-based financing (RBF) mechanisms would be an advantage.

COMPETENCIES
In addition to the above, the successful candidate is expected to demonstrate the following competencies:

Lead and Innovate
Encourages and works with others to identify, incubate and implement relevant solutions. Identifies opportunities in changing circumstances and energizes others to continuously improve, using intentional strategies to boost morale, team spirit, and productivity in context of WBG's values and mission. Helps others to understand problems, client needs and the underlying context.

Deliver Results for Clients
Develops and implements solutions that show understanding of how clients and/or own work achieves results that are financially, environmentally and socially sustainable. Shares new insights based on in-depth understanding of the client and recommends solutions for current and future needs of clients. Holds self and team accountable for risk management and outcomes.

Collaborate Within Teams and Across Boundaries
Collaborates across organizational boundaries, internally and externally with a sense of mutuality and respect. Consistently engages others in open dialogue, brings out any conflicting viewpoints and incorporates viewpoints into solutions, giving credit where credit is due. Leverages expertise of all team members to ensure successful outcomes. Makes choices and sets priorities with a WBG corporate perspective in mind.

Create, Apply and Share Knowledge
Ensures systematic sharing of good practice and learning from lessons from across WBG, clients, and partners. Is known across WBG in their subject area and is sought out by WBG colleagues to advise, peer review, or contribute to knowledge products of others. Seeks mentoring opportunities with more experienced staff to deepen or strengthen their professional knowledge and mentors junior staff. Builds networks across the WBG and as part of external professional groups/networks.

Make Smart Decisions
Applies critical thinking and seeks inputs and experience from others to recommend a course of action consistent with the WBG's strategy. Evaluates risk and anticipates the short and long term implications of decisions. Commits to a decision and takes action once a decision has been reached.