ThinkWell is a global health organization focused on using tailored health financing approaches to help low- and middle-income countries achieve universal health coverage. We believe that effective health financing systems are essential to ensuring health services are well-resourced, high quality, accessible, and do not cause financial impoverishment by those who use them. ThinkWell employs a "whole-of-systems" approach to health financing. We specialize in five practice areas that intersect with health financing: governance, human resources for health, the private sector, public financial management, and research and evaluation. ThinkWell seeks a part-time consultant based in Kenya (Nairobi is preferred) with 5+ years of experience in health financing and/or private sector engagement (PSE) in Kenya. The consultant should have a broad understanding of health financing and universal health coverage reforms and how these reforms impact the private health sector's willingness to engage with public purchasing programs. The consultant should be well-versed in qualitative data collection methods, including independently identifying key informants, conducting outreach, and conducting interviews. Period of Performance: as soon as possible – September 30, 2024 Level of Effort: part-time, 40-60 days, dependent on consultant skills and expertise Location: Nairobi, Kenya BACKGROUND Over the past three years, Kenya has been actively reforming its health sector to achieve universal health coverage (UHC). These reforms include establishing Primary Care Networks (PCNs) and transitioning from the National Hospital Insurance Fund (NHIF) to the Social Health Authority (SHA) in 2023. The private sector in Kenya has significant potential to enhance family planning (FP) and reproductive health services within PCNs. However, private providers are hesitant to engage with NHIF/SHA and PCNs due to limited financial incentives. Additionally, private health insurance and employer-based schemes offer limited coverage for FP services, making them less affordable for women who must pay out of pocket. ThinkWell, through the MOMENTUM Private Health Care Delivery (MPHD) project aims to improve PSE in Kenya's FP services by conducting a rapid assessment to identify barriers and partnering with a local intermediary to support long-term sustainability. The goal is to increase access to FP services by increasing the number of FP providers engaged in the scheme and making services more affordable for Kenyans. OBJECTIVES ThinkWell seeks a Kenya-based PSE consultant to support a rapid assessment to understand the barriers that private FP providers in Kenya face and opportunities to improve their participation in PCNS and the SHA. The assessment will seek to inform the design and implementation of UHC reforms to encourage private sector engagement in PCNs and purchasing arrangements under the SHA. The assessment will: 1. Describe the current function, governance, and financing (as relevant) of PCNs as they relate to private sector providers, according to applicable laws, regulations, SHIF benefit package, administrative orders, guidelines, and policies. 2. Assess self-reported gaps in the readiness and willingness of: The public sector to engage private sector providers in the delivery of FP services in the context of PCNs in three counties. The private sector to participate in the delivery of FP services in the context of PCNs in three countries. 3. Examine how new financing arrangements under the SHA impact private provider engagement in FP service provision. 4. Understand how the above 1-3 contribute to the inherent challenges that limited private provider provision of FP in the three counties. SCOPE OF WORK To achieve the objectives of the rapid assessment, ThinkWell seeks a Kenya-based PSE consultant to undertake the following activities: 1. Desk review: Conduct a comprehensive desk review of publicly available documents, including but not limited to research papers, program reports, government policies, regulations, guidelines, and administrative orders related to PCNs, SHA, and private sector engagement in FP service delivery. Describe the current mechanisms for public financing of FP services and commodities in Kenya, with a focus on the three selected counties. Assess the extent to which private sector FP providers are engaged in these financing mechanisms and identify potential barriers and opportunities for improving their participation. Synthesize findings from the desk review into a concise report that will inform the development of interview guides for key informant interviews. 2. Key informant interviews (KIIs): Based on the findings from the desk review, collaborate with ThinkWell to develop semi-structured interview guides for KIIs with key stakeholders, including decisionmakers in private sector FP providers, county health officials, and representatives from the SHA and PCNs in the three selected counties. Identify and recruit a diverse range of key informants, ensuring representation from various types of private providers (e.g., for-profit, non-profit, faith-based) and different levels of the health system (e.g., primary, secondary, tertiary). Schedule and conduct KIIs, either in-person or via telephone/video conferencing, depending on the availability and preference of the key informants and considering any COVID-19 related restrictions. Document and transcribe the KIIs, ensuring that the data is accurately captured and organized for analysis. 3. Data analysis and synthesis: Develop a analytical framework based on the assessment objectives and emerging themes from the desk review and KIIs. Analyze the qualitative data from the KIIs using appropriate software (e.g., NVivo, ATLAS.ti) or manual techniques, identifying key themes, patterns, and insights related to private sector engagement in FP service delivery within PCNs and the SHA. Triangulate findings from the desk review and KIIs to develop a robust understanding of the barriers, opportunities, and potential strategies for improving private sector participation in FP service delivery under the UHC reforms. 4. Report writing and dissemination: Draft a comprehensive assessment report. Develop a concise summary slide deck that presents the key findings and recommendations in an engaging and visually appealing format. Incorporate feedback from ThinkWell and other relevant stakeholders to finalize the assessment report and slide deck. Support the dissemination of the assessment findings and recommendations to key stakeholders, including the MPHD project team, county health officials, private sector representatives, and other relevant parties through presentations, workshops, or other appropriate channels. Requirements Bachelor's degree in health financing, health sciences, public health, health policy, or another related field. A minimum of 5 years of relevant experience, e.g., health financing, qualitative research, health service research, private sector engagement, etc. Full professional fluency in English. Strong capacity to present complex data in reports and presentations. Advanced computer skills, including Microsoft Word, Excel, and PowerPoint. Good interpersonal skills, multi-tasking skills, and ability to work under pressure.
