Location
Consultancy will be home-based with no travel.
Starting Date & Initial Contract Details
December 2021 – February 2022. Estimated 50 days.
BACKGROUND
Medair is a well-established international NGO, currently operating in 12 countries. Medair has been operational in Jordan since 2012, when it established a base there in response to the crisis in Syria. Medair has been providing cash for health (C4H) in Jordan for vulnerable host and refugee populations since 2015 to remove the financial barrier to accessing health services for reproductive health, non-communicable diseases, and emergency hospitalisations and surgeries. This has been a well-received and successful approach with 65,000 refugee and Jordanian households assessed, 8,848 individuals receiving C4H, and based on post-distribution monitoring over 90% having utilized the CVA for its intended purpose over a recent period of 18 months. Despite the success in addressing financial barriers for the vulnerable groups, the approach is not sustainable for the long-term as the nature of the Syrian crisis remains protracted. There is a need to further explore and identify barriers that can be addressed through alternative funding schemes for these vulnerable groups. Organisations must identify a more sustainable approach to the well-defined need for access to health services amidst frequently changing health care policies for refugees in Jordan. In addition, the needs of these refugees and their access to health services has been costly, with higher caesarean section rates (37.8%) and a high burden of disease from non-communicable diseases (NCDs) requiring ongoing visits, estimated at 31% of Syrian refugees with a chronic disease. Medair would like to systematically explore ways to transition towards more integrated and sustainable approaches such as health insurance schemes and other funding mechanisms while avoiding fragmentation of health services for refugees especially in the critical areas of maternal health and NCDs.
PURPOSE:
The purpose of this research is to strengthen the evidence for potential transitional funding solutions for access to health care amongst refugees in Jordan. A practical and logical transitional approach within the framework of the humanitarian/development nexus has yet to be identified. This research will seek to engage key stakeholders around activities that lead to the identification, analysis, and feasibility of transitional approaches that show potential in the Jordanian context. In turn, it will also shape Medair’s approach toward program development in the health sector.
OBJECTIVES:
The research proposed will aim to answer the following questions:
- For Syrian and non-Syrian refugees in Jordan, are there alternative healthcare provision modalities beyond C4H that could be used to facilitate access to primary health services in more sustainable and cost-efficient manners?
- From the perspectives of key stakeholders, what are the barriers and enablers for these alternative healthcare provision modalities?
- Among the alternative healthcare provision modalities, which ones show promise for potential use in Jordan.
- What are the recommended next steps Medair should take to begin testing and implementing the most promising approach(es)?
OUTPUTS:
The final outputs would include a summarised report identifying what is known to date, potential future transitional or longer-term funding mechanisms for primary health care including child health, sexual and reproductive health and NCDs, and the recommended next steps for a trial of implementation in Jordan.
SCOPE:
The funding schemes to be explored should broadly include at least the following: insurance and bonds (private, public and blends), grants and loans to refugee hosting governments, and pay for performance. The consultation will include primary and secondary data analysis and formative survey involving key informant interviews, focus group discussions. Stakeholders invited to formative survey should be representative of the targeted population of refugees and host communities as well as will include Ministry of Health, donors, other health NGOs, etc. Qualitative data collected from formative survey will be thematically analysed to identify themes and patterns in the data including use of a coding scheme. Analysis of the data may be facilitated using qualitative data analysis software. Interviews are intended to be face-to-face but depending on the evolution of the Covid-19 crisis in Jordan may need to occur remotely. The final outputs would include a summarised report identifying what is known to date, potential future transitional or longer-term funding mechanisms for primary health care including sexual and reproductive health and NCDs, and the recommended next steps for a trial of implementation in Jordan.
KEY STAKEHOLDERS:
Medair will engage several key stakeholders including – but not limited to – the following:
- Global Health Cluster (GHC)
- CaLP
- WHO Representatives
- UN agencies: UNHCR, UNFDA, OCHA
- Donors: DG-ECHO, BPRM, USAID
- Health actors in Jordan: IRC, IMC, TdH, HI
- Local authorities: MoH
- Beneficiaries both from refugee and vulnerable Jordanian communities
- Community leaders
METHODOLOGIES & TOOLS:
The proposed study will follow qualitative methodology and will obtain the necessary ethical permissions and informed consent from all participants Medair will engage DG-ECHO as a stakeholder in the research process.
KEY ACTIVITIES:
- Literature review on funding mechanisms for health services for refugees including grey literature.
- Formative surveys: Key informant interviews and focus group discussions using a semi-structured questionnaire will be conducted to collect stakeholder views on potential funding schemes and enablers and barriers to adaptation in Jordan.
DELIVERABLES:
- Inception Report and questionnaire for formative survey*
- The analysed report which should meet the consultation objectives*
- Facilitate the sharing of key findings and recommendations through a Jordan based in-person event with key stakeholders, or through an alternative online method.
* The draft questionnaire and the report are to be approved by Medair before finalization through engagement with Medair Jordan’s Program Coordinator (who in turn will be advised by Medair’s Program Manager, Regional MEAL advisor and GSO Senior Health Advisor).
CONSIDERATIONS:
Authorship and ownership will be solely with Medair (the funding party).
Special recognition of the consultant and donor (ECHO) to be included under the paper’s acknowledgements.
MILESTONES & PAYMENT SCHEDULE:
Milestone 1: Inception report – 10 days
Milestone 2: Draft report – 30 days
Milestone 3: Final report & presentation of key findings & recommendations to key stakeholders – 10 days
How to apply
ESSENTIAL PROFILE OF THE CONSULTANT:
For this piece of work, Medair is looking for the following expertise:
- Relevant qualifications, preferably to master’s level or beyond, with health qualification an advantage.
- Previous experience working in the MENA region.
- Demonstrated work experience in the health sector.
- Demonstrated work experience in Cash and Voucher assistance, both at a strategic and technical level.
- Knowledge of humanitarian coordination architecture for health; an understanding of it in Jordan an advantage.
- Knowledge of health financing and funding mechanism in a broad array of socio-political contexts.
- Strong understanding of the themes and analytical frameworks linked to the humanitarian and development nexus.
- Proven research, analysis and writing skills.
- Fluency in English (Arabic an advantage).
HOW TO APPLY:
Interested applicants are requested to send their CV and cover letter that clearly illustrates their required expertise and availability to perform the requested services to [email protected] by 14 November 2021 11:59pm.
Late or incomplete submissions will not advance to the shortlisting phase. The subject line of the submission should be: “Application for Consultancy: Exploration of Transitional Funding Schemes for Health Care for Refugees in Jordan”.
Following this invitation for Expression of Interest, interested candidates will be shortlisted against the essential profile requirements. Qualified candidates will be formally invited within 14 days after the submission deadline to submit proposals.
The interested candidates will not be entitled to claim from Medair any costs or expenses which may be incurred in preparing and/or submitting the expression of interest also if Medair cancels this Expression for Interest request.
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