Health Consultant(Re-Advertized) at Nina Jojer Limited

Job Summary

Nigeria is expanding domestic financing for health to advance Universal Health Coverage, reduce out of pocket expenditure and strengthen sustainable funding for priority services. This has become more urgent as external financing for HIV becomes increasingly uncertain and the country prepares for a more domestically financed response. State Social Health Insurance Agencies are therefore important vehicles for purchasing essential services and protecting vulnerable populations from financial hardship. The National Blueprint for Integration of HIV into State Health Insurance Schemes provides a foundation for integrating HIV services into insurance purchasing. The key issue is now whether PMTCT, paediatric HIV and adolescent HIV services are translated into visible, costed, coded, claimable, provider understood, client understood and routinely monitored entitlements within state insurance systems. This matters most for the mother and infant pair, because PMTCT is not a single service. It is a continuum across pregnancy, delivery, breastfeeding, infant follow up and Early Infant Diagnosis. Where benefit packages, tariffs, claims manuals and provider instructions are unclear, states may experience informal payments, weak claims processing, poor provider confidence and limited data visibility. UNICEF will support government to move this work beyond a policy gap review into a practical operationalization and systems strengthening process. The consultancy will document what currently exists, clarify institutional roles, support enrolment and awareness, and strengthen routine tracking of enrolment and service use through existing facility and insurance systems without creating parallel reporting structures. Problem statement In most states, HIV programme data and health insurance data are held in separate systems that are not routinely linked. Programme records capture PMTCT, HIV-exposed infant, paediatric HIV and adolescent HIV services through facility registers and reporting channels, while SSHIAs hold information on enrolment, eligibility, claims and reimbursement. The same pregnant woman, infant, child or adolescent may appear in both systems, but without a common link between the records. As a result, states may know how many clients are receiving HIV services and how many people are enrolled in health insurance, but still be unable to determine whether target clients are enrolled, using covered services, protected from out of pocket payments and reflected in claims and reimbursement systems. This initiative will help states build the operational bridge between policy, enrolment, service delivery, claims and monitoring.

Scope of Work

The consultancy will cover national level engagement and six states: Rivers, Kaduna, Oyo, Bauchi, Adamawa and Kwara. The work will focus on the

following populations:

• Pregnant women, with special attention to pregnant women living with HIV and those eligible under vulnerable group or maternal health financing
  arrangements.
• Breastfeeding women living with HIV and mother and baby pairs requiring follow up through the breastfeeding period.
• HIV-exposed infants, including EID, sample movement, result return, postnatal follow up and linkage where required.
• Children aged 0 to 14 years living with HIV, including ART continuity, paediatric formulations, monitoring and follow up.
• Adolescents aged 10 to 19 years living with HIV, with reporting adaptable to national programme age bands and scheme categories.
  Service Continuum to be Mapped

Service Continuum to be Mapped
Continuum area: Areas to test

• ANC and pregnancy entry point:- Whether pregnant women are enrolled, how insurance status is captured, what ANC services are covered,
  and how HIV-related needs are handled within the maternal package.
• HIV testing and PMTCT : - Whether HIV testing, counselling, ART initiation and PMTCT follow-up are visible, claimable, understood
  and documented.
• Laboratory and diagnostics:-  Whether EID, viral load, baseline tests and relevant MNCH diagnostics have a claims or financing route, and
  where clients may still pay.
• Delivery and postnatal period:-  Whether insurance coverage continues through delivery, PNC, breastfeeding and mother-baby pair follow-
  up.
• Infant and child follow-up: Whether HEI, EID, paediatric linkage and ART monitoring can be tracked through existing registers and
  insurance systems.
• Adolescent HIV care:- Whether adolescents are visible in insurance enrolment, service utilization, claims and programme
  monitoring.
• Client awareness:- Whether women, caregivers and adolescents know their insurance rights and where to report charges or denial of service

Education:

• Advanced degree in Public Health, demonstrated experience with PMTCT programme design or implementation, and health financing, Pediatrics Health Economics, or related field

Language: 

• Fluency in English language and good English writing skills.

Work Experience:

• Seven to ten years of experience in HIV/AIDS and/or health financing , with demonstrated knowledge of PMTCT, paediatric HIV, and MNCH programming
• Experience in policy review and stakeholder engagement in Nigeria
• Strong analytical and technical writing skills - Familiarity with pediatric and adolescent HIV/TB data systems (e.g., DHIS2, NDARS) is an advantage