TERMS OF REFERENCE
Pre-pilot PBF Consultant
Lesotho Maternal Newborn Health Performance Based Financing Project
I. Introduction
The Lesotho Ministry of Health (MOH) will implement a Maternal and Newborn Health (MNH) Performance-Based Financing (PBF) project beginning in February 2014. The overall project development objective is to improve the utilization and quality of maternal and newborn health services in selected districts in Lesotho. The project has two components and will be implemented in three phases. During Phase I (February 2014 - December 2014), the project will be piloted in Leribe and Quthing; in Phase II (January 2015 – 2017), the project will gradually scale-up to 4-6 additional districts and in Phase III to an additional 1-3 districts, so for a total of 9 districts in the third and fourth years of the project. It is planned that a pre-pilot of the project will be carried out in Quthing District, which has one hospital, 8 health centers and one filter clinic, between now and February 2014. This pre-pilot and three-phased approach will allow for adjustments in design based on lessons learned.
The MOH has established the PBF Unit at the central level to handle the day-to-day management of the MNH PBF Project. The PBF unit consists of five (5) full time staff, including: PBF Unit Director, Financial Management Officer, Monitoring and Evaluation officer, Operations Officer, and Accountant. The MOH, cognizant of the fact that it will have to build an independent contract management and verification unit, is in the process of recruiting a Performance Purchasing Technical Agent (PPTA) to assist the MOH in the implementation of the project. The PPTA is expected to have been recruited by February 2014 for the initiation of the pilots in Leribe and Quthing districts.
II. Pre-pilot objective and activities
The objective of the pre-pilot is to improve the implementation arrangements and build the capacity of the Ministry of Health at the national and local levels for effective implementation of the Lesotho MNH PBF Project.
The specific pre-pilot activities are to:
(i) Update the Project Implementation Manual (PIM);
(ii) Develop the PBF training manual and curriculum;
(iii) Conduct the PBF training in Quthing District (including workshops for health centers (HCs) and hospital, Health Center Committees, District Health Management Team, and District PBF Steering Committee (SC)) and ensure that all entities sign performance contracts;
(iv) Provide technical assistance to HCs and district hospital to develop business plans;
(v) Provide technical assistance to the District PBF SC to sign performance contracts with HCs and the MOH-Director Clinical Services to sign with the district hospital;
(vi) Provide technical assistance to the MOH PBF Unit for PBF implementation in Quthing district as described in the PIM;
(vii) Build the implementation capacity of the MOH PBF Unit, including M&E and financial management; and
(viii) Verify PBF payments to village health workers, health centers, and district hospital.
III. Objective
The general objective of the consultancy is to assist the MOH in the preparation and implementation of the PBF pre-pilot in Quthing district.
IV. Specific activities
The Consultant will perform the following activities:
· Work under the guidance of the MOH PBF unit Director and coordinate with the PBF Advisor for technical backstopping.
· Assist the MOH to map all main primary contract holders and document the relevant bank account numbers for specific facilities and individuals (HC personnel and VHWs only).
· Assist the MOH and the Quthing PBF district administration to mount a PBF scheme:
o Mapping all health facilities – MOH and CHAL.
o Using the Project Implementation Manual, closely involving the MOH and partners, create (a) a 3-4 day PBF curriculum for health center in-charges, hospital management teams and chairs of health management committees and (b) a 2-3 day curriculum for the DHMT and the district PBF steering committee.
o With the PBF Unit to implement the PBF training curriculum in Quthing.
o Work with the MOH, the district PHC department and other stakeholders to put in place the PBF steering committee at the district level and assist in putting in place effective agenda setting and documentation of proceedings.
o Work with the MOH and the district administration to determine the primary contract holders.
o Liaise with the health facility management teams and the MOH to ensure that balanced local governance mechanisms are put in place.
o Work with the HMIS consultant recruited by the MOH to harmonize the patient registers and patient records to allow the verification of PBF indicators.
o Work with the district health management team to apply the quantified quality checklists for health centers and hospitals.
o Work with the MOH to manage strategic purchasing and the business plan approach.
· Carry out the monthly quantity verifications in collaboration with the MOH- PBF unit.
· Assist in the national PBF coordination efforts, assist in agenda setting and documentation.
· Carry out any other tasks as requested by the PBF Unit Director.
V. Deliverables
· Provide short and concise (half page and through email) once-weekly activity updates to the PBF unit Director.
· Provide a five page monthly activity report
VI. Required Qualifications and Experience
· Medical or Social Science degree with experience working in the medical field in front line health facilities
· At the least three (3) years’ experience as a verifier in a PBF project and/or PBF district focal point in a scaled up PBF system
· Experience in assisting local authorities in contract management; coordination for decentralized decision making; agenda setting for PBF district steering committee meetings; assistance in entering and extracting data in the management information system and data-analysis
· Trained as a trainer in PBF
· Ability to function independently
· Willingness to travel a significant portion of his/her time within Quthing district
· Willing to spend a significant portion of his/her time in Quthing district
· Good facilitation skills
· Good verbal and written English language skills necessary
VII. Contract Duration
The consultancy will be for 9 months from October 1, 2013 to June 30, 2014.
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