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If you are a committed, creative professional and are passionate about making a lasting difference for children, the world's leading children's rights organization would like to hear from you. For 70 years, UNICEF has been working on the ground in 190 countries and territories to promote children's survival, protection and development. The world's largest provider of vaccines fordeveloping countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments. UNICEF has over 12,000 staff in more than 145 countries.

Consultancy Title: Consultant to analyze PHC and immunization spending in Africa in reference to regional commitments.

Division/Duty Station: Programme Group, Immunization/Health

Duration: 20 September 2025 – 31 December 2025

Home/ Office Based: Remote

BACKGROUND

Purpose of Activity/ Assignment:

The primary objective is to provide technical and analytical expertise to support the development of evidence-based recommendations with a particular focus on sustainable financing for primary healthcare and immunization programs.

Background

The Abuja Declaration on HIV/AIDS, Tuberculosis, and Other Related Infectious Diseases, adopted by African Union Heads of State and Government in April 2001, marked Africa's most significant health financing commitment of the modern era. The declaration's call for countries to allocate at least 15% of their annual budgets to improve the health sector arose from the urgent need to combat the devastating effects of communicable diseases, especially the HIV/AIDS pandemic that was taking millions of lives across the continent.

The declaration was groundbreaking for several reasons:

• Political leadership: It represented the highest level of political commitment to health financing in Africa's post-independence history.
• Continental Scope: Unlike fragmented, country-specific initiatives, it established a unified framework for all AU member states.
• Quantitative Target: The 15% benchmark offers a clear, measurable goal that can promote accountability and track progress.
• Crisis Response: It demonstrated Africa's ability to coordinate policy responses to health emergencies.

Twenty-three years after its adoption, the Abuja Declaration remains the primary reference for health financing commitments across Africa. However, healthcare has undergone considerable evolution since 2001. New challenges include emerging infectious diseases, the rising burden of non-communicable diseases, climate-related health impacts, demographic changes, and the need for universal health coverage through stronger primary healthcare systems. Most importantly, the external financing environment that existed in 2001 has degraded, forcing countries to adapt to very different resource realities.

 

The Numbers reveal a stark reality: Recent analysis indicates that fewer than 12 AU member states have consistently met the 15% Abuja target. At the same time, over 30 countries spend less than 10% of their budgets on health. Even more concerning, this performance gap is widening as countries face rising fiscal pressures and competing priorities.

 

Immunization programs under threat: 23 African countries are currently in or approaching Gavi transition, affecting immunization programs that reach over 300 million children across the continent. Countries are now facing immediate decisions about sustaining vaccine procurement and delivery systems without adequate preparation or transition support.

Primary Healthcare Financing in Crisis: Although universal agreement exists that PHC is the foundation of effective health systems, current financing methods remain fragmented, inefficient, and unsustainable. The COVID-19 pandemic revealed the disastrous effects of weak PHC systems, yet recovery efforts after the pandemic have failed to produce sustainable financing solutions. Countries are struggling to meet immediate health needs while also attempting to strengthen their health systems for the long term, amid unprecedented budget constraints

Donor landscape transformation: Traditional health sector donors have reduced their commitments by an estimated 30-50% since 2019, while shifting priorities toward climate change, conflict response, and domestic concerns. The bilateral aid architecture that supported Africa's health gains over the past two decades is undergoing fundamental changes, leaving countries with financing gaps that they are not prepared to fill independently.

Scope of work:

1. Review the assignment and develop a proposed methodology for UNICEF review
2. Conduct a systematic review of evidence on health financing commitments in the context of the Abuja Declaration
3. Analyze health spending trends across all 55 AU member states from 2000 to 2024 and analyze health spending by source (government budget allocation, donor funding, out-of-pocket expenditure, private sector) with particular attention to domestic resource mobilization trends.
4. Examine immunization financing patterns, identifying countries in different stages of donor transition and associated funding gaps
5. Assess primary healthcare investment levels and their relationship to progress in universal health coverage.
6. Review the best global practices in national health financing commitments and their implementation mechanisms, and analyze the effectiveness of existing accountability frameworks for health financing commitments.
7. Contribute to the development of policy options for updating AU health financing commitments that reflect contemporary health priorities.
8. Design a framework for sustainable primary healthcare financing that addresses UHC goals

Terms of Reference / Key Deliverables:

Work Assignment Overview/Deliverables and Outputs/Delivery deadline

1.  Review the assignment and develop a proposed methodology for UNICEF review 

-  One Inception report with detailed methods developed

September 25, 2025

2.  Conduct a systematic review of evidence on health financing commitments in the context of the Abuja Declaration

-  One comprehensive report presenting early findings and a systematic review of evidence on the implementation of the Abuja Declaration has been prepared

October 10, 2025

3.  Analyze health spending trends across all 55 AU member states from 2000 to 2024 and analyze health spending by source (government budget allocation, donor funding, out-of-pocket expenditure, private sector) with particular attention to domestic resource mobilization trends

-  one report presenting early findings of the spending analysis was presented

October 20, 2025

4. Examine immunization financing patterns, identifying countries in different stages of donor transition and associated funding gaps

- One report was developed presenting immunization financing patterns, identifying countries in different stages of donor transition, and associated funding gaps.

October 30, 2025

5.  Assess primary healthcare investment levels and their relationship to progress in universal health coverage

-  One report presenting primary healthcare investment levels and their relationship to progress in universal health coverage was created.

November 5, 2025

6. Review the best global practices in national health financing commitments and their implementation mechanisms and analyze the effectiveness of existing accountability frameworks for health financing commitments.

-  Two policy options paper with implementation frameworks presented in a detailed report

November 15, 2025

7.  Contribute to the development of policy options for health financing commitments that reflect contemporary health priorities

- One report presenting summary findings from the Technical Working Groups meeting

November 25, 2025

Qualifications

Education: Advanced University Degree in a relevant field (Health Economics, Economics, Mathematical Modelling, Public Health, Epidemiology, or Statistics)

Knowledge/Expertise/Skills required *:

• Advanced degree qualification in Health Economics, Economics, Mathematical Modelling, Public Health, Epidemiology, or Statistics 
• At least 20 years of the following demonstrated experiences are required:

- In health economic modelling, it is mandatory and desirable.  

- with household-level datasets in low- and middle-income country contexts. 

• Proficiency in statistical and health economic modelling software, such as R, Advanced Excel, and STATA, is mandatory. 
• A strong commitment to delivering timely and high-quality results.  
• Advanced knowledge of African Union procedures, functioning, working groups, and commissions

Requirements:

Completed profile in UNICEF's e-Recruitment system and

- Upload copy of academic credentials

- Financial proposal that will include/ reflect :

• • the costs per each deliverable and the total lump-sum for the whole assignment (in US$) to undertake the terms of reference.
  • travel costs and daily subsistence allowance, if internationally recruited or travel is required as per TOR.
  • Any other estimated costs: visa, health insurance, and living costs as applicable.
  • Indicate your availability

- Any emergent / unforeseen duty travel and related expenses will be covered by UNICEF.

- At the time the contract is awarded, the selected candidate must have in place current health insurance coverage.

- Payment of professional fees will be based on submission of agreed satisfactory deliverables. UNICEF reserves the right to withhold payment in case the deliverables submitted are not up to the required standard or in case of delays in submitting the deliverables on the part of the consultant.

U.S. Visa information:

With the exception of the US Citizens, G4 Visa and Green Card holders, should the selected candidate and his/her household members reside in the United States under a different visa, the consultant and his/her household members are required to change their visa status to G4, and the consultant’s household members (spouse) will require an Employment Authorization Card (EAD) to be able to work, even if he/she was authorized to work under the visa held prior to switching to G4.  

Only shortlisted candidates will be contacted and advance to the next stage of the selection process

For every Child, you demonstrate…

UNICEF’s core values of Commitment, Diversity and Integrity and core competencies in Communication, Working with People and Drive for Results. View our competency framework at: Here

UNICEF offers reasonable accommodation for consultants/individual contractors with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment. 

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check. 

Remarks:  

Individuals engaged under a consultancy will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants. Consultants are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws. 

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts.