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Background and Purpose:

According to the WHO 2015 report Investing in Community Health programming is one of the best buys in healthcare and has shown to result in positive returns that can be as high as 10:1 when accounting for increased productivity from a healthier population and creating short-term cost savings in other parts of the health system. Broader economic benefits reported include an economic impact of increased income generation and poverty alleviation- as would be the case for investments in community health programs in Uganda.

Despite the favorable return on investment (ROI) and the Community Health Platform (CHP) in its role in driving the attainment of universal Health coverage (UHC) and its knock-on effect on the development indicators, community health is yet to attract optimal attention and prioritization in healthcare financing and budgetary processes in Uganda as well as most low- and middle-income countries.

In 2001, the Ministry of Health established the Village Health Teams (VHT) strategy as an innovative approach to empower communities to participate in improving their own health as well as strengthen the delivery of health services at both the community and household levels. Despite implementing this strategy for 20 years, the disease burden from preventable causes such as malaria, malnutrition, HIV/AIDS, Tuberculosis, diarrheal diseases and diseases related to poor sanitation and personal hygiene, remains high, thus contributing to the poor health statistics of the country In 2014/2015, the National Community Health Program (CHP) through the VHT assessment was subject to an extensive evaluation to offer evidence based, independent reflections on its relevance, efficiency and effectiveness in a sustainable manner. A number of gaps and challenges were identified in the design and implementation of the strategy namely: Inadequate community involvement, insufficient initial and continuing training of VHTs , lack of a well-defined criteria for selection, insufficiencies and inconsistencies in program funding, poor coordination and supervision, lack of basic medical supplies and equipment for the VHTs to undertake their responsibilities, poor documentation and reporting, weak bi-directional community to health facility referral systems, and lack of standardization of incentives.

In February 2023, the Ministry of Health launched the National Community Health Strategy, which is anchored in the Primary Health Care (PHC) approach as a pathway to achieving Universal Health Coverage (UHC). The strategy aligns with the Third National Development Plan (NDP III) and emphasizes the need to strengthen resilient health systems from the community to the national level, with targeted investments in community health.

To sustain the remarkable work that the community health program has achieved, sustainable financing is required. The Ministry of Health initiated the development of an investment case focused on health financing and community health program delivery models, with financial support from USAID. However, the process was not completed following the closure of the USAID-funded Uganda Health Systems Strengthening Project, which had been the lead partner supporting this work in 2024. As a result, the Ministry is now requesting UNICEF’s support to finalize this critical upstream initiative and complete the investment case for sustainable financing of the community health program.

Justification

The Ministry of Health (MoH), with support from UNICEF, is seeking to complete the development of the Community Health Investment Case—an important initiative that was previously initiated with financial support from USAID under the Uganda Health Systems Strengthening Project. While significant progress had been made, the process was left incomplete following the project’s closure. The investment case is intended to provide a compelling justification for sustainable financing of community health in Uganda, presenting multiple investment scenarios to inform programming and resource allocation. It will outline the benefits and long-term impact of investing in community health and serve as a tool for MoH and other government bodies to make evidence-based decisions. In response to MoH’s request, UNICEF will support the identification and deployment of a consultant with the requisite expertise in health economics to work closely with the Department of Community Health, and the Community Health Technical Working Group (TWG) to complete this important piece of upstream work. Finalizing the investment case is critical to ensuring that past achievements are sustained and that future investments are strategically targeted to improve health outcomes for communities across Uganda.

Objective:

Finalize the development of a comprehensive community health investment case that takes into consideration the national and global developments in community health.

Outputs:

• Update the existing analysis of financial needs and gaps for community health programming, including a bottleneck analysis to identify barriers to increased financing for the community health program.
• Conduct a fiscal space analysis and identify key opportunities for health financing to strengthen the community health system in Uganda.
• Develop at a minimum two costed scenarios for long-term financial sustainability of the community health program.

The consultant will collaborate with the Community Health Systems Expert who has been leading this assignment with prior support from USAID, as well as with Health Financing Specialists from the Ministry of Health, UNICEF, and other partners involved in community health programming.

The consultant through the supervisor will

• Liaise with MoH and key stakeholders,
• Provide the minutes of any meetings,
• Discuss the outputs and outcomes with relevant MoH TWG members.

The Community Health Department of the Ministry of Health will be the counterpart, and the consultant will work closely with the focal point from this department in the execution of this assignment:

Major Tasks

1. Develop an inception report with a detailed implementation workplan outlining methodology, timelines and key activities.
2. Update and refine at least 2 costing scenarios(following a comprehensive review of the current draft Community Health Investment Case, incorporating an in-depth analysis of financing dynamics within the context of a contracting funding environment) for integrated community health interventions in rural and urban areas. Apply economic modeling to propose an affordable CHW remuneration package and conduct a 10-year financing needs and gap analysis. Develop national financial projections and propose innovative financing mechanisms to ensure sustainability.
3. Incorporate feedback to produce a revised (second) draft of the Investment Case. Present the draft to HPAC for review and prepare materials for internal dissemination across MoH line departments. Facilitate the presentation of the revised draft to MoH senior management upon HPAC approval.
4. Produce the final version of the Community Health Investment Case, incorporating all validated inputs. Ensure the document is ready for typesetting and design, including a compelling narrative, updated costing and financing scenarios, and a clear implementation roadmap.

Deliverables

1. An inception report including a detailed implementation workplan outlining, methodology, timelines and key activities.
2. Two refined costing scenarios for rural and urban community health interventions, including an economic model for an affordable CHW remuneration package, a 10-year financing needs and gap analysis, national financial projections, and proposed innovative financing mechanisms.
3. Revised second draft of the Community Health Investment Case incorporating stakeholder feedback, presented to HPAC for review, with supporting dissemination materials prepared for MoH line departments and senior management engagement.
4. Final version of the Community Health Investment Case (including a power point slide deck and infographics), incorporating all validated inputs, with a compelling narrative, updated costing and financing scenarios, and a clear implementation roadmap, ready for typesetting and design.

 To qualify as an advocate for every child you will have…

1. Education background: Advanced university degree in health economics, public health, or health financing with extensive and progressive professional experience in design of health strategy/plans and financing reform.
2. Work-experience:
   • Minimum of 8 years of relevant professional work experience at national and international level in analysis and/or research and/or communication/advocacy in health economics, public health, primary health care, digital health, emergency response, community health programming.
   • Extensive experience producing timely and high-quality reports for UN systems.
   • Experience working with international development organizations and/or government institutions is an asset.
3. Technical knowledge

• Experience with developing community health program investment case, health sector strategy plan, costing and M&E plan in developing countries.
• Capacity of the consultant team to conduct the scope of work with similar complexity.
• Demonstrable experience producing similar documents.
• Data collection expertise including interview and focus group discussion with at least five years’ experience.
• Demonstrated successful experience in evidence-based publications, cost effective analysis, financial sustainability plans, policy briefs, strategies, guidelines, reports; etc.
• Demonstrated experience with analysis of complex data using advanced software and costing.
• Fluency in English with excellent writing, analytical, conceptual and communication skills.
• Knowledge of Uganda health system is an asset.
• Primary health care and Health System Strengthening

For every Child, you demonstrate… 

UNICEF's values of Care, Respect, Integrity, Trust, Accountability, and Sustainability (CRITAS). 

To view our competency framework, please visit  here. 

UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious or ethnic background, and persons with disabilities, to apply to become a part of the organization. To create a more inclusive workplace, UNICEF offers paid parental leave, breastfeeding breaks, and reasonable accommodation for persons with disabilities. UNICEF strongly encourages the use of flexible working arrangements. Click here to learn more about flexible work arrangements, well-being, and benefits.

According to the UN Convention on the Rights of Persons with Disabilities (UNCRPD), persons with disabilities include those who have long-term physical, mental, intellectual, or sensory impairments which, in interaction with various barriers, may hinder their full and effective participation in society on an equal basis with others. In its Disability Inclusion Policy and Strategy 2022-2030, UNICEF has committed to increase the number of employees with disabilities by 2030. At UNICEF, we provide reasonable accommodation for work-related support requirements of candidates and employees with disabilities. Also, UNICEF has launched a Global Accessibility Helpdesk to strengthen physical and digital accessibility. If you are an applicant with a disability who needs digital accessibility support in completing the online application, please submit your request through the accessibility email button on the UNICEF Careers webpage Accessibility | UNICEF.

UNICEF does not hire candidates who are married to children (persons under 18). 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 based on gender, nationality, age, race, sexual orientation, religious or ethnic background or disabilities. UNICEF is committed to promote the protection and safeguarding of all children. All selected candidates will, therefore, undergo rigorous reference and background checks, and will be expected to adhere to these standards and principles. 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, and selected candidates with disabilities may be requested to submit supporting documentation in relation to their disability confidentially.

Remarks:  

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

Individuals engaged under a consultancy or individual contract 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 and Individual Contractors. Consultants and individual contractors 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 for ensuring 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.