Objective of the assignment

The objective of this assignment is to carry out a comprehensive evaluation of NSSF Social Health Insurance and propose, on this basis, scenarios for reform / improvement. The main outputs of the assignment are:

• Report on analysis and present the results of the evaluation, including the articulation of the scenarios under consideration;
• Support the NSSF in organizing the necessary consultations with its Board and wider scope of stakeholders as relevant;
• Support NSSF in building an action plan for the implementation of the selected reforms.

These outputs will contribute to the national debate on the extension of health coverage.

Scope of work

The consultant team should conduct the assessment focusing on the following elements:

1. An assessment of the organization and administration of the SHI, comprising two dimensions:

-Framework

-Management and operations

This work will involve desk review, interviews and data extraction. This work will be the basis for the formulation of recommendations, both organizational and parametric, which will support the formulation of scenarios for reform and be integrated with a separate actuarial valuation.

2. An overview of the perceived strength and weaknesses of the NSSF from the perspective of protected persons on the one hand and service providers on the other hand.

Timeline

The consultancy is scheduled to start in February 2021 and completed in July 2021 with the expected working days to be no more than 90 days in total.

Requirements of team members

The assessment will involve the following team corresponding to the various expertise needed to conduct the different work items:

• Lead Expert responsible by the supervision of the process and by the production of the Final report.
• National expert in charge of liaising with the relevant institutions and supporting data collection on the ground.
• A local service provider in charge of implementing the survey.

For further detail please download the ToR attachment below.