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UNICEF has been operating in Zimbabwe since 1982. We are a team of passionate professionals committed to the protection and fulfillment of children’s rights.

Supporting the Government’s vision of a prosperous and empowered upper-middle-income society, the country programme is aimed at contributing to sustainable socioeconomic development that provides all children, including adolescents, with opportunities to fulfil their potential, lead a healthy life, access quality learning and protection and meaningfully participate in society.

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https://www.unicef.org/zimbabwe/work-us

How can you make a difference?

UNICEF Zimbabwe is inviting applications for a national individual consultant to provide technical assistance in finalising the revised Results-Based Financing (RBF) support mechanism

BACKGROUND

Result-based financing (RBF) is an approach that provides financial incentives to healthcare providers based on pre-specified performance targets, aiming to improve healthcare service delivery and strengthen the health system. The RBF programme in Zimbabwe was designed to improve both the supply and demand-side performance of health systems to achieve Universal Health Coverage (UHC) through improving availability, accessibility, and quality of health services with a focus on reproductive, maternal, newborn, child adolescent health and nutrition (RMNCAHN), and an expanded scope including NCDs, TB, HIV and malaria services and their optimal utilisation.

Specific Objectives of the RBF Program

Contract healthcare facilities to implement innovative strategies that increase access to and utilization of quality priority health services.

To improve the quality of care through an integrated national quality assurance and quality improvement (QA/QI) framework.

To foster community participation and ownership in the delivery of health care services through increased involvement of Health Centre Committees (HCCs), Community-Based Organizations (CBOs), and other services.

To strengthen the National Health Information System (NHIS) through improving data quality, reporting and utilization.

To motivate and retain qualified Health Care Workers (HCWs) through incentivizing performance and creating a conducive environment.

To strengthen managerial capacity at national and subnational levels for effective service delivery.

To strengthen accountability and ownership across all levels through enhanced monitoring and evaluation.

The Results Based Financing in Zimbabwe was first piloted in 2 districts in 2011 with support from the World Bank through Cordaid. This was scaled up to 16 districts in 2012 and finally 18 districts including 18 secondary and 4 tertiary hospitals in 2012 up to 2020. The Health Services Fund (HSF) input-based financing in 42 districts was commenced in 2013 which converted to the Health Development Fund- supported RBF for PHC facilities in only 42 districts in 2014. The HDF support towards RBF ended in Q1 2022.

The government of Zimbabwe has institutionalised RBF and has contracted all 60 rural districts, disbursing subsidies in local currency. Following an RBF policy dialogue held in March 2024, it was agreed that a revised partner-supported complementary layer be defined to guide the support from partners like the HRF. This consultancy is sought against this background to provide technical support to UNICEF in finalizing the modalities for the partner-supported layer, which will guide the utilisation of the approved HRF support to RBF for 2024 to 2025. The developed modality will be tabled for review and approval by the Health Financing TWG and the HRF Steering Committee.

Assignments

The consultant will provide technical assistance in finalising the revised partner-supported Results-Based Financing Model and support during the initial phase of implementing the refined model for the partner- supported layer.

Programme development and planning: Partner-Supported RBF Layer

Conduct desk review to synthesise evidence and ideas on the status of RBF in Zimbabwe

Conduct Key Informant Interviews to get stakeholder views on RBF and recommendations on aspects to consider for simplifying the model – (Engage key stakeholders and beneficiaries during the process to understand the views of all the concerned parties)

Develop revised RBF guidelines and model for HRF partner-supported RBF for the period 2024- 2025 collaborating with MOHCC, UNICEF and PMU

Present the proposed revised model to the MOHCC.

Facilitate revision of RBF contracts for urban and rural facilities in line with the revised model.

Collaborate with the PMU, PCU, UNICEF, MOHCC, and any other implementing entity to develop an implementation plan for the revised/revised model.

Develop policy brief for advocacy for performance-based financing mechanism.

Technical and Operational support to the MoHCC

Offer technical assistance and training sessions at national and provincial district levels

Education

Master’s degree in health economics or health policy and Financing or related qualification

Experience

At least 5 years of demonstrated experience in implementing results-based financing in Zimbabwe.

Knowledge/Expertise/Skills Required

Demonstrated experience in the implementation of results-based financing in health.

Understanding of health systems strengthening approaches and service delivery within a constrained operational environment, with Zimbabwe experience desirable

Understand the local political, economic, and cultural context.

Understand, and show a willingness to implement, key principles of the human rights- based approach to programming and results- based management.

Demonstrate ability to engage constructively with the Government of Zimbabwe

Strong knowledge of the Zimbabwean health system.

Language Requirements

Fluency in English is required. Knowledge of the local language is an asset.