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Overview
The Promoting Results and Outcomes through Policy and Economic Levers (PROPEL) Health project aims to improve the enabling environment for equitable and sustainable health services, supplies, and delivery systems. Results will be achieved through (1) policy development and implementation, (2) adequate, predictable, and sustainable health financing, (3) enhanced government stewardship, transparency, and accountability, and (4) the use of evidence-based approaches at global, national, and subnational levels. Areas of focus are family planning, primary healthcare, and the integration of family planning with HIV and maternal and child health (MCH).
Zambia has demonstrated a commitment to improving its healthcare sector. The National Strategic Plan 2022-2026 and the 2024 National Decentralization Plan both specifically identify PHC as the prime modality for implementation through district decentralized structures. PHC and decentralized health service delivery are also viewed as essential vehicles to achieve Universal Health Coverage (UHC) by 2030. The country’s health system comprises three levels of health facilities, with primary health care facilities accounting for 95% of all health facilities, including health posts, health centers, and mini hospitals. Zambia has been a strong supporter of PHC, participating in international initiatives including the Ouagadougou Declaration on Primary Health Care and Health Systems in Africa in 2008, the 2018 Declaration of Astana and most recently the Lusaka Agenda, launched in December 2023, which prioritizes five key shifts for the future of global health, including stronger investment in PHC.
Zambia faces persistent challenges with implementation of PHC, including inefficiencies in the allocation of resources and underspending of disbursed resources, which is indicative of capacity constraints. PHC guidelines were last updated in 1996 and supportive diagnostics and essential drug kits, which are essential to support PHC modes of care, are also out of date and in urgent need of updating. Additionally, systems supporting diagnostics and the procurement and distribution of drugs in the PHC setting are also in need of review and recommendations for revision.
Also, as the country approaches HIV epidemic control, it is critical to integrate HIV into PHC to achieve efficiencies in healthcare delivery and assure sustainability of the national response. Given this background, this activity will assist the Ministry of Health (MOH) to update the PHC Guidelines and Operational Framework for Zambia and facilitate integration of HIV into PHC.
Purpose and Description of Consultancy:
The objective of this activity is to assist the MOH to update policies, guidelines and frameworks around the delivery of PHC, and facilitate the integration of HIV into revitalized PHC. Over two phases, the activity will focus on identification and update of core services (including HIV) that make up the PHC Package of Care, and the related systems, especially diagnostics and essential drug selection, procurement, and distribution. The activity will also produce recommendations on how HIV services may be better integrated into this updated PHC service delivery system. Phase One, scoping and baseline assessment, will run from August to September 2024. Phase Two, with analysis and development of the guidelines and recommendations for HIV integration, will run from October 2024 to later in 2025.
The Zambian-based local consultant will initially be recruited for Phase One. She/he will work with and be part of a three-person team, including one international consultant and one full-time Palladium senior associate. The Zambia-based consultant will coordinate directly with this team as well as PROPEL Health staff as needed.
For Phase One, this consultancy assignment will focus on (a) supporting an initial review of local PHC service delivery and quality trends relevant for updating the essential PHC package of interventions (including HIV); (b) collecting qualitative information from local sources, especially through key informant interviews; and (c) engaging with MOH stakeholders and partners to gain agreement on the methodology for Phase Two including defining the desired end product (deliverable). Specific tasks in Phase One may include:
· Obtain and support review of documents on lessons learned from PHC service delivery in Zambia in last five years, including delivery of HIV care cascade services.
· Obtain disaggregated HIS and other routine health systems data which will serve the review and analysis of indicators that help to determine PHC service delivery trends over the last five years, including facility level service load, quality audits, health workforce availability, and others.
· Support the analysis of key trends in PHC in Zambia, and challenges faced in line with the ongoing major developments in the health system, including the scale-up of HIV care cascade services.
· Support the development of a methodology and its socialization with MOH stakeholders, that will yield locally acceptable recommendations on updating the interventions in the PHC package at each level of service delivery, including identifying opportunities to better integrate HIV prevention, care and treatment.
· Facilitate consultation with key leaders in the PHC service delivery ecosystem in Zambia, such as subnational health system leaders, managers of public and private laboratory services, and others; in order to develop and refine the methodology for Phase Two;
· Conduct rapid review, including through convenience sample of PHC facilities (including laboratories) to validate the methodology and to identify critical questions which should be addressed in Phase Two (e.g., covering challenges in PHC-related diagnostic services, including available laboratory tests, commodities, sample transport systems, etc., also covering HIV needs).
Required Qualifications
· Consultant MUST be a full-time resident of Zambia and/or Zambian country national.
· Advanced degree in Public Health, Health Policy, Medicine, or a related field.
· Extensive experience (minimum 7-10 years) in health policy analysis and development.
· Extensive knowledge of Zambian health systems and key public and private stakeholders.
· In-depth knowledge of health systems strengthening, primary health care models, and integration strategies, including HIV/AIDS.
· Familiarity with current global and regional guidelines on HIV/AIDS and other communicable diseases.
· Excellent oral communication (both written and spoken) in English.
· Experience working on USAID-funded or donor-funded projects strongly preferred and knowledge of USAID’s priorities related to primary health care services.
Anticipated Period of Performance and Level of Effort
This scope of work is estimated at 20 person days. The work is expected to be performed between August 15th and September 30th, 2024. Based on performance and needs of the activity, additional effort may be contracted from the consultant for Phase Two.
Application Instructions:
Interested applicants are invited to submit their CVs through this portal by August 1st, 5:00 PM
U.S. Washington DC time
. Any questions or clarifications should be sent to the above email address no later than August 1, 2024.
This consultancy is only for individuals currently residing in Zambia full-time or Zambian residents.
Individuals who are NOT Zambia-based need not apply.
Our company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics.