Terms of Reference. Adviser (Health Spending Policy)

Transcription

1 Terms of Reference Adviser (Health Spending Policy) DFAT Remuneration Framework: 1 Counterparts: Work Location: Reports to: Duration of inputs: Budget Source (AP# & Description): Spending Review (AP 9) Disciple Group D, Job Level 4 (or NRF equivalent) Ministry of Finance (MOF), Ministry of National Development Planning (Bappenas), President s Staff Office, Coordinating Ministry of Economic Affairs Ministry of Finance, Jakarta Lead Adviser, Spending Engagement Area 60 input days between approximately August and December 2018 Summary of Expertise Required Prospera seeks to an engage an Adviser (Health Spending Policy) to primarily: a) assess the performance of existing health spending programs; and b) provide recommendations for improved policies and budget reallocations to ensure more effective and efficient spending. The Adviser will support established spending review processes conducted by MOF as well as provide advice to other stakeholders. The advice is expected to inform future budgets and the next National Medium-Term Development Plan preparation. Scope of Services The key roles and responsibilities of the position are to provide the following: 1. Data compilation and review: data will be drawn from budget documents (Financial Note, realisation reports, line ministry budget documents), planning documents (National Medium-Term Development Plan, Government Work Plan, Line Ministry Work Plans), line ministry performance reports and other relevant databases. Data compilation will require reviewing the structure of government health spending, including central, regional, and other spending such as universal healthcare payments and health-related infrastructure. The review should examine changes in spending patterns over time, particularly identifying the proportions of overhead/administrative costs and benchmark these costs with other countries. 2. Performance assessment: conduct research/analysis to assess the performance of government health spending. This analysis will examine the extent to which government spending is: a) Directed toward policy priorities (appropriateness); b) Achieving stated government policy targets (effectiveness); 1 To be negotiated with the preferred candidate based on skills and experience and within funding limits.

2 c) Focused on the best policy interventions and providing the most appropriate mix of goods and services (allocative efficiency). This analysis should also examine the relevance of the geographical distribution of government spending considering the location of health needs and rural poverty; and d) Providing goods and services in the most efficient manner (technical efficiency). This aspect will also examine budget execution performance and the extent to which proposed services are actually being delivered. The precise coverage of the performance assessment (priorities/programs/sub-sectors to be addressed) will be agreed with the Spending Engagement Area and counterparts. It is likely the assessment will cover the extent to which government spending has improved: a) The availability/quality of health services (numbers of health professionals, clinics, hospitals); b) Health outcomes (lower maternal mortality, reduced stunting, etc.); and c) Geographical and distributional equity. In particular, the accessibility of services by women, the disabled and remote communities should be addressed. The performance assessment will include comparisons with other countries, as well as the relative performance of Indonesian sub-national governments to identify national and international best practices. It should attempt to assess the types of spending that have been most effective and the relative importance of central versus regional government spending. In this regard, the assessment will build on existing Prospera spending efficiency analysis. The assessment should also highlight any current policy inconsistencies. 3. Policy recommendations: provide a practical set of policy recommendations and proposed budget reallocations to improve the effectiveness and efficiency of spending that can be implemented over the short to medium-term. The recommendations should be based on the performance assessment above and national/international evidence of best practices. The recommendations should be accompanied with medium-term expenditure costings. Of particular importance will be identifying ways to release funds from non-priority expenditure and/or improvements in technical efficiency that can be redirected to higher value programs that are more directly beneficial to the community. The recommendations should also address ways to improve the equity/location of spending and access to services by women, disabled and remote communities. 4. Capacity building: working collaboratively with counterparts to gather and analyse data, and gain a deeper understanding of the relevant programs. This includes assisting with the design of surveys to be used by counterparts (particularly those working in MOF regional offices) to undertake field research and training as part of existing GOI-led spending review processes. Furthermore, mentoring counterparts on the techniques used to prepare the analysis is required.

3 5. Consultation: consulting with a broad range of stakeholders and policy experts (such as other donors, academic experts and line ministry program managers). This also includes regular presentations to counterparts to seek feedback and refine the scope of the analysis. In addition to the above, the Adviser will be expected to actively seek opportunities to disseminate the analysis/recommendations; consult widely with stakeholders and experts; provide solutions and overcome data limitations; and conduct other duties as directed by the Lead Adviser, Spending Engagement Area. Output/Deliverables The position is expected to deliver the following outputs over the term of the contract to the satisfaction of the Prospera Lead Adviser: Output 1: Detailed work plan and timetable for the activity (after 3 input days). Output 2: Data compilation and review: as described in item 1 under the Scope of Services. This requires compiling and consolidating spending and performance data over time, analysing the structure of spending and comparing it with output and outcome information. The review should also identify overhead/administrative costs. The review should highlight data gaps and quality issues (after 15 input days). Output 3: Initial performance assessment and literature review of issues surrounding health spending in Indonesia, as described in item 2 under the Scope of Services. Building on Output 2, conduct an initial performance assessment applying appropriate analytical methodologies (e.g. cost effectiveness analysis), highlighting limitations of the analysis and suggestions for improvements/refining the scope of analysis. This should also include suggestions for focus areas for field research that will improve the analysis. The assessment should be presented to key counterparts and other policy experts to refine the analysis and gain a deeper understanding of the issues (after 20 input days). Output 4: Training/mentoring of counterpart officials and development of survey tools to assist counterparts to conduct field research in identified areas (after 25 input days). Output 5: Literature review covering international evidence on successful policies that have been implemented in other countries or within regions in Indonesia. The review should also attempt to quantify and benchmark the ratios of overhead/administrative costs of other countries' health programs. This work will build on the above outputs and Prospera's existing efficiency analysis to identify relevant countries and regions (after 35 input days). Output 6: Initial policy recommendations based on the previous outputs, and develop an initial set of policy recommendations as described in item 3 under the Scope of Services. This should also include medium-term budget costings. Present to counterparts/policy experts to gain feedback and refine recommendations (after 40 input days). Output 7: Compile and analyse field research conducted by counterparts and incorporate findings into the assessment and refine policy recommendations (after 50 input days). Output 8: Draft report and presentation to counterparts (after 55 input days). The remaining input days will be used to finalise the report incorporating feedback. Output 9: Input Completion Report in a format supplied by Prospera and approved by the Prospera Lead Adviser at the completion of the assignment.

4 In addition to these formal deliverables, the position is expected to regularly communicate with the Prospera Engagement Area on progress and seek input where required. Selection Criteria Qualifications and Experience The candidate will possess strong qualifications and experience in the following areas: 1. Bachelor degree in a relevant field such as economics/health economics, medical science, public policy/administration/finance (with relevant postgraduate qualifications highly desirable). 2. At least 15 years experience in, and significant technical knowledge of, health spending policies and programs in a developing/emerging economy context. Experience with/detailed knowledge of Indonesia's health sector and polices is highly desirable. 3. Strong financial and spending program analysis skills. 4. Proficiency in statistical/econometric software, public sector financial management IT systems and Microsoft Office software, particularly Excel. 5. Experience working with/detailed knowledge of the central and regional Indonesian government budgets (desirable). 6. Strong relationship management skills, particularly in dealing with senior government officials. 7. Ability to operate effectively and sensitively in a cross-cultural environment. 8. High level communication skills and ability in written and spoken English, and proficiency in Bahasa Indonesia (desirable). Overview of Work Unit Improving access to health services and health outcomes is a national priority for the Government of Indonesia (GOI). Research indicates that Indonesia has performed relatively poorly in achieving health outcomes compared with other countries. Furthermore, Prospera analysis shows that health spending is very low by international standards, leading to comparatively low numbers of health professionals and subsequent low provision of health services. The GOI has made efforts in recent years to increase spending on health, now at the mandated five percent of the central government budget. In addition, a universal healthcare scheme has been introduced. However, as the fiscal outlook becomes increasingly constrained, the ability to provide additional resources to the health sector appears limited. Nevertheless, Prospera analysis has found a number of countries with the same level of spending who have achieved higher health outcomes. As such, there is potential to expand access to health services and improve outcomes within existing resources. The Spending Engagement Area works closely with GOI counterparts to develop policies, frameworks and capacity to improve the quality of Indonesian government spending. This support mainly focuses on improving budget processes, particularly in implementing a more performance oriented and medium-term focus for budgeting. More recently, the Spending Engagement Area has focused on evaluating spending programs and conducting policy analysis to support GOI-led spending reviews. A key to improving the quality of spending is through providing a stronger evidence base for spending decisions and providing recommendations on how spending can be reallocated to higher value investments. The health sector is currently a key concern and major priority for GOI policy makers,

5 thus Prospera is seeking the services of an Adviser (Health Spending Policy) to provide further support to GOI efforts to improve the quality of health-related spending and improve health outcomes. Relationship Management The Adviser (Health Spending Policy) will be expected to maintain effective and productive relationships with counterparts across a range of levels, from working with junior level staff to gather and analyse data; to more senior level staff on conceptual and policy aspects. The Adviser will be expected to work collaboratively with other Prospera teams (Economics & Inclusion and Markets Engagement Areas), and other donors and policy experts. Overview of Prospera Prospera is a new partnership facility between the Government of Australia (through the Department of Foreign Affairs and Trade) and the Government of Indonesia. It aims to foster strong, sustainable and inclusive economic growth in Indonesia. Commencing from 1 March 2018, Prospera is a planned five-year investment that draws together the former Government Partnership Fund (GPF) and Australia Indonesia Partnership for Economic Governance (AIPEG). Prospera will be responsive to the needs of a wide range of agencies in the Indonesian government, covering six thematic areas: (i) Markets improving product and factor market efficiency; (ii) Finance delivering financial stability and development; (iii) Spending improving the quality, delivery efficiency, and access to public services; (iv) Revenue mobilising revenues without unduly impeding private activity; (v) Public Sector Reform strengthening economic institutions; and (vi) Economics & Inclusion providing analysis to boost the evidence for economic policy. The following standard requirements apply for all Prospera team members: Confidentiality Due to the sensitivity of much of the information the position will encounter, there is an obligation, pursuant to the contract of engagement to maintain full confidentiality of information and to not disclose this to third parties without the express written approval of Prospera. In some cases, a separate confidentiality agreement may be required authorising the review of sensitive material. Conflict of Interest The team member will use her/his best endeavours to ensure that a situation does not arise which may result in a conflict of interest. Where a conflict of interest or a potential conflict of interest arises in the performance of the obligations under this Terms of Reference, the team member must immediately notify the Chief of Operations.

6 Knowledge and Performance The team member will support Prospera s Knowledge and Performance team through reporting and communication products for knowledge capture and learning purposes. The team member will also support monitoring and evaluation through the supply of high quality data, participation in data collection methods and case studies that may arise from the inputs. Code of Conduct The team member is to conduct themselves in a manner consistent with the Public Service Act 1999 (Cth), (including the Australian Public Service Values and Employment Principles, and Code of Conduct) and the employer s professional standards. Diversity and Inclusion Prospera recognises the importance of embracing workplace diversity, specifically valuing the unique qualities, attributes, skills, and experience all employees bring to the workplace. Prospera is committed to supporting a positive work environment based on respect. These values should be reflected in the function and behaviour of all team members. Policy Compliance The team member will work within Department of Foreign Affairs and Trade policy and Prospera guidelines on gender, child protection, poverty, the environment, human rights, and governance.