Consultants at Palladium Group

Ref No: req8649

Project Overview and Role

• The Nigerian HIV and AIDS resource mobilization strategy was drafted in the year 2012 by National Agency for the Control of AIDS (NACA) with support from DFID (ENR project). The document addressed how the Government of Nigeria could ensure the predictable and sustainable availability of adequate financial resources for the AIDS sector over the next 10 years (by 2022). That strategy concluded that, under a baseline scenario, a shortfall of resources would exist for much of the period under consideration, with a total financing gap for HIV and AIDS of Naira 732 billion from 2013 to 2022. Due to an anticipated decline in international donor support and increasing resource needs, the financing gap would continue to grow reaching Naira 141 billion in 2022, equivalent to 0.12% of GDP. The strategy advocated for public sector mainstreaming, decentralization and private sector contributions, social health insurance and efficiency savings.
• A series of consultations were held with major HIV/AIDS stakeholders including NACA with corresponding review of several documents related to HIV & AIDS control and the Nigeria economy. A national HIV and AIDS resource mapping and strategy development document was developed and, after the results were validated at a National stakeholders meeting led by NACA, the following four strategic priorities were identified for the mobilization of resources for HIV and AIDS programming in Nigeria:
  • Increasing government allocation to HIV and AIDS programming through public sector mainstreaming and improved budgeting
  • Mobilizing resources from the private sector through alternate sources and direct contribution to HIV and AIDS programming
  • Increasing efficiency and equity in the management of HIV and AIDS resources
  • Strengthening the institutional arrangement for resource mobilization and capacity building for resource management, including financial reporting
• These strategic priorities constituted the basis for implementing the resource mobilization efforts for HIV and AIDS in Nigeria. Eight years later, in the light of current realities and emerging issues, this document needs to be reviewed and updated. In November 2019, NACA met with the Health Policy Plus project (HP+) to discuss a potential collaboration. It was agreed that the current DRM strategy requires a thorough review and update in order to identify and step-up renewed efforts to mobilize domestic and private sector funding to cover the financing gap.
• HP+ is a global USAID-funded project with a mandate across global, country, and sub-national levels to strengthen and advance health policy priorities in the areas of TB and HIV. HP+ aims to improve the enabling environment for equitable and sustainable financing of health services, supplies, and delivery systems through policy development, and implementation.

Primary Duties and Responsibilities

• Historically, the HIV response in Nigeria has received enormous resources from international donors. To be on course to end AIDS as a public health threat by 2030, the country needs to increase the amount of resources available for HIV programming. In recent years, major donors have reduced funding for the HIV response in low- and middle-income countries. This shows an urgent for countries like Nigeria to begin to mobilize resources domestically for HIV and AIDS.
• One of the key elements to ensure timely, coordinated and effective “home” driven HIV financing is the availability of a robust and innovative Resource Mobilization Strategy which succinctly articulates workable and practicable ways and means for growing the resource pool in-country. Some of the strategies included in the 2012 DRM strategy need to be reviewed and updated.
• To this end, HP+ in collaboration with NACA will engage a National Consultant to undertake the development of a Domestic Resource Mobilization Strategy by conducting a robust resource mapping study with a costed roadmap of actions for updating the DRMS from 2021 - 2025.

Objectives of the Consultancy
Conduct a robust mapping of expected financing sources through:

• Historical review of past performance on domestic resources to establish a baseline for DRMS 2021 - 2025 using desk review of relevant documents, and conducting a total of 12-15 key informant interviews (KIIs) with officers from NACA, FMOH, LSACA, NHIS, SHIS, private sector, and CSOs.
• Estimation of prospective available resources for 2021 – 2025 by conducting desk review of relevant grant application, NSP 2021-2025, and other relevant documents.
• Work with NACA to update DRMS 2021 - 2025 through:
• Creation and/or reactivation of a multi-sectoral HIV DRM Technical Working Group (TWG) that will review the findings from the resource mapping exercise.
• Facilitation of key stakeholders’ meeting to discuss and develop a revised DRM 2021 -2025.
• Establishment of additional systems and processes for monitoring implementation of the updated DRMS with a clear and integral monitoring and evaluation plan.

Roles and Responsibilities of the National Consultant:
The National Consultant will work as part of the team of partners under NACA’s supervision and guidance while collaborating technically with HP+, UNAIDS, and WHO. S/he will be under the day-to-day supervision of the Deputy Director/Head, Government Resources Division and the overall oversight will be provided by the Director of Resource Mobilization, NACA. The Consultant’s responsibilities will be to:

• Conduct the resource mapping exercise and carry out approximately 15 KIIs, with technical oversight from HP+. The methodology for the resource mapping, the KII discussion guides, and the list of people to be interviewed will be developed by HP+ and provided to the Consultant. HP+ will directly source identified information required from PEPFAR and carry out compilation of reports at HQ.
• Work closely with NACA to update the DRMS, with technical oversight from HP+. The Consultant will develop detailed implementation steps for the DRMS and a comprehensive resource mobilization and partnership strategy that includes an analysis of past fundraising experience and best practice from different sectors, baseline assessment and projected cost versus available resources, the changing HIV financing landscape and the need to update the existing DRM framework, including HIV domestic funding through health insurance. This will also include support to structural, implementation and monitoring mechanisms for the DRM strategy.
• Support the activation and strengthening of the HIV DRM TWG. The Consultant will be expected to engage and strengthen the multi-sectorial HIV DRM TWG to drive the implementation of the DRMS and build capacity of DRM TWG and NACA’s Health Financing Unit (HFU) to increase the effectiveness of their resource mobilization efforts.
• Support the set up and activation of a dedicated HFU within NACA that will engage with the DRM TWG and other stakeholders, drive DRM efforts and serve as technical powerhouse for the DRM efforts.
• Provide guidance to NEWPHAN and CISHAN on how to design, implement and monitor their DRM activities.

Expected Outputs and Deliverables
The assignment will be for a duration of 40 business days to be completed within a period of five (5) months. This National Consultant will be responsible for these deliverables:

• A Resource mapping report, including a summary of all documentation reviewed to draft the report, and the detailed notes from all KIIs
• Submit inputs for, and a thorough review of, the Revised and finalized DRMS
• Provide support to HP+ coordinating validation meetings and workshops with key stakeholders
• Demonstrated support to the reactivation of NACA’s DRM TWG and a functional HFU, including organizing a roundtable with the DRM TWG
• Brief note on the support provided to NEWPHAN and CISHAN on their DRM strategies

Required Qualifications

• Advanced degree in Health Financing, Health Economics, Public Finance, Public Administration, Rural Development or other relevant discipline or relevant experience in fundraising. Possession of a Ph.D. is an added advantage.
• A minimum of 15 years’ experience in international development in progressively responsible roles, half of which in senior management position at national and international levels, preferably in large international organizations. At least 5 years consultancy in HIV/AIDS field. Additional experience of maintaining database of international and local donor organizations is an added advantage.
• Demonstrated experience in developing and executing successful revenue-generation and donor-management strategies in international complex, mission driven non-profit organizations.
• Ability to work with donors as well as manage and build strategic donor relations; sound understanding of donor financing landscape and processes.
• Experience in developing successful proposals and/or tender bids to EU, DFID, and USAID as well as other institutional donors.
• Demonstrated experience and skills in facilitating stakeholders’ workshops.
• Proof of costing social development of health strategic plans at National or State level.
• Excellent negotiation, coordination, reporting writing and presentation skills.
• Excellent communication skills with the ability to express ideas clearly, concisely, and effectively, both in oral and written English.

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Project Overview and Role

• The Social Health Insurance plan known as the Lagos State Health Scheme (LSHS) is in line with the Lagos State Health Scheme Law (Law No.4 of 2015), which makes Lagos State Health Scheme mandatory for all residents of Lagos State, including employees in the public and private sectors, self-employed and the unemployed.
• The Lagos State Health Management Agency (LASHMA) was established as a public-private partnership to promote, regulate and supervise the activities of the LSHS. Thus, LSHS is a system of advance financing of healthcare expenditure through contributions and premiums paid into a common pool, called the Lagos State Health Fund (LASHEF). It was created to provide a social security system that guarantees needed health services to people paying annual premium contributions. It is primarily a risk-sharing arrangement that can improve resource mobilization and equity in the healthcare sector.

The regulatory functions of LASHMA are:

• Registration of Lagos State Residents, Employers and Employees. Subject to the guidelines made under the Law, all residents should be registered under the Scheme. The LASRRA registration number is a pre-requisite for registration into the Scheme and itself grants eligibility and access to all benefits available under the Scheme. All employers from public and private sector are expected to register with LASHMA to obtain a Corporate Identification Number (CIN) and shall register their employees with the Health Maintenance Organization (HMOs) of their choice.
• Registration of HMOS, Mutual Health Association (MHAs) and Allied Association
• The Agency is also expected to register NHIS accredited HMOs, MHAs, and Allied Associations. The Law recognizes the existence of the contributory Health Insurance Organizations (including HMOs) and prepaid health plans before the commencement of Lagos State Health Scheme. Such organization operating in the state shall be registered, licensed, and monitored by the Agency.
• The operationalization of the regulations unit of the Agency would enable many Lagosians who require the benefits of the health scheme but lack the necessary awareness and opportunities to get healthcare insurance for themselves and their families to onboard unto the scheme through domestication of the LASHMA regulatory functions. More so, monitoring and sanctioning of erring HMOs and healthcare facilities would further strengthen the health scheme and increased accountability and advocacy to encourage more Lagosians to utilize the LSHS.
• To this end, HP+ wishes to engage a Consultant to undertake the development of a framework of operations for implementing the Regulatory role established by the Law in line with relevant stakeholders and policy framework of the Lagos State Health Scheme.
• HP+ is a global USAID-funded project with a mandate across global, country, and sub-national levels to strengthen and advance health policy priorities in the areas of TB and HIV. HP+ aims to improve the enabling environment for equitable and sustainable financing of health services, supplies, and delivery systems through policy development, and implementation.

 Primary Duties and Responsibilities

• The objective is to develop and formalize a framework and Standard Operating Protocol that would inform the framework for Registration, Monitoring, Licensing, Sanctioning and Customer Relations of the Agency.

The consultant will work and collaborate with LASHMA under supervision of HP+. The Consultant’s scope of work and responsibilities include:

• Engage the Ministry of Justice and interpret the LSHS Law in line with the proposed Regulatory Functions for the Agency.
• Carry out stakeholder analysis to highlight the roles and responsibilities of relevant organizations in Lagos State
• In consultation with the Regulations Team, prepare a comprehensive list of contents that should be included in the framework and SOPs
• Draft specific, detailed, and practical steps for Registration, Monitoring, Licensing, Sanctioning and Customer Relations
• Facilitate working group consultations with Lagos State House of Assembly (LAHA), Lagos State Residents Registration Agency (LASRRA), HMOs, Corporate Organizations, Healthcare Providers
• Present the draft SOP to LASHMA; finalize the SOP incorporating all inputs and feedback
• Produce a well-written and comprehensive Framework of Operation highlighting:
  • Standard Operating Procedures for Registration, Monitoring & Compliance, Licensing, Sanctioning, Customer Relations activities
  • Recommendations on the SOPs to strengthen linkages between organizations involved in the process
  • Resource Directory of all the relevant stakeholders with focal points
• Coordinate and conduct a detailed presentation before completion of the project

Duration and Expected Deliverables
The duration of the contract will be August 17 - September 30, and the Consultant will be responsible for two deliverables:

• Written documentation on the interpretation of the LSHS Law, outlining LASHMA’s regulatory roles, responsibilities, and rights.
• Written framework of the implementation of the LSHS Law and LASHMA’s regulatory functions, including SOPs for each identified function and how linkages between organizations will be ensured

Methodology:

• The consultant will strictly follow a workplan and timeline to be proposed by HP+ before signing of the contract. An appropriate methodology will be discussed between the consultant and the HP+ team.
• The consultant will work closely with the LASHMA Regulations Team and HP+ and will share progress on activities when requested.
• The consultant will be responsible for undertaking collection of all the required data/information from various sources, including Government departments, Ministries, and other relevant sources. LASHMA will be expected to facilitate data and information whenever necessary.
• The Consultant will also be expected to facilitate presentations and coordinate stakeholder workshops or consultations as per agreed on HP+ workplan.

Required Qualifications

• A post-graduate or equivalent qualification/ degree in Public Health, Law, Political Science, Development Study, Humanities, or any other relevant discipline, or with bachelor’s degree with a minimum of 15 years of professional relevant experience in the HMO industry is required.
• At least 10-15 years of prior work experience in dealing with social health insurance regulations setup and operations, especially in the subnational context. Knowledge of HMO practices in Nigeria is strongly preferred.
• Demonstrated knowledge and experience doing research in the area of Social health Insurance.
• Demonstrated experience and skills in facilitating stakeholder/working group consultations.
• Knowledge and experience developing SOPs, especially in the area of Health Insurance.
• Solid knowledge of LASHMA’s mandate and goals.