AFIDEP Hiring Consultants

About AFIDEP

AFIDEP is an African-led, non-profit research and policy institute, established in 2010 to institutionalise a culture of evidence use in the public sector and to bridge the gaps between research, policy and practice in development efforts in Africa.

AFIDEP is registered as a non-governmental organisation in Kenya and Malawi and as a non-profit institution in the USA, with 501(c)3 status. AFIDEP contributes to the realisation of the Sustainable Development Goals (SDGs) and other development strategies by enabling the use of evidence in the formulation and implementation of development policies and programmes. To do this, we undertake activities that fall in two broad categories:

1. Research generation, synthesis and translation for decision-making
2. Capacity development for increased research use and evidence-informed decision-making (EIDM), including strengthening individual and institutional capacity for research synthesis, analysis, translation, packaging, communications and policy engagement.

AFIDEP implements work in five thematic areas:

1. Population dynamics and demographic dividend;
2. Health and well-being;
3. Transformative education and skills development;
4. Environment and climate change; and
5. Governance and accountability.

B. About the Advance Domestic Health Financing Project

The Advance Domestic Health Financing (ADHF) project aims to contribute to enhancing domestic political will, resource investments, adaptation and implementation of evidence-informed policies, and effective utilization of available health financing resources (ODA and domestic) in Africa. The project is funded by the Bill and Melinda Gates Foundation (Gates Foundation).

The project seeks to build on the government’s economic recovery and debt management efforts, the African Union (AU)’s Africa Leadership Meeting (ALM) declaration commitments, other domestic, regional, and global commitments related to PHC, family planning (FP), girls and women’s health including the Abuja declaration, ICPD+25, FP2030, the 2021 generation equality forum, and SDGs.

All these require political will, good governance and leadership, and evidence-informed decision-making at the domestic level for tangible commitments to increase the salience of “spend enough and spend well on health” with particular attention to PHC, girls and women’s health “as a driver of human capital for economic growth, not a cost”.

The ADHF project is leveraging the momentum of the ALM declaration of 2019, political influence moments as they arise in front runner countries including Kenya and Zambia.

C. Efficiency Analysis and Data Availability and Use

• Efficiency Analysis

Health sector efficiency is a critical measure of how effectively inputs are transformed into quality health services. In light of declining donor funding and limited domestic fiscal space, there is an urgent need to explore innovative financing mechanisms to bolster domestic health financing and ensure the sustainability of the health sector. Increasing the efficiency of health allocation and expenditure can make a larger contribution to closing the funding gap than simply increasing revenue over the next decade. Consequently, enhancing efficiency has become a primary objective for policymakers and managers, aiming to maximise health outcomes relative to expenditures. When used appropriately, efficiency indicators serve as vital instruments for optimising the allocation and utilisation of limited resources, thereby improving overall health financing.

Improved efficiency does not simply mean saving money but entails getting better results from available resources, that is “more health for the money”. Inefficient health systems result in poor health outcomes that hinder the attainment of SDGs and UHC.

In the Lower-and Middle-Income Countries, health systems are faced with challenges such as poor leadership and governance, extreme shortages of health workers and delayed salaries, corruption in procurement systems for medical products and technologies, poor information systems, inadequate health financing resources leading to increased out-of-pocket payment (OOP), lack of effective service delivery and limited research and development to inform decision making.

• Data availability and use

Data availability and use is one of the many possible factors that undermine evidence-based decision making. In many instances, information is not always available for decision making -or if it is available- it is not always used.

This can be traced to limited demand for information, lack of data ownership by decision makers, perception that the available data is of poor quality, and lack of technical capacity and organizational infrastructure to make the available data user-friendly and useful to decision maker.

In 2019, the African heads of state including Kenya, endorsed the Africa Leadership Meeting (ALM) commitments. During the high level dialogue, Kenya committed to address the data and digitization need by strengthening all areas of PFM for health, including budget formulation, execution, and budget monitoring, evaluation, and accountability; accelerating strategic purchasing to strengthen the linkage between health sector performance and investments; digitization across all health sector building blocks for enhanced efficiency, accountability and transparency; and address disparities in the efficiency of providing health services between counties through peer-to-peer learning.

To address the pressing efficiency challenges faced by healthcare systems at county level, AFIDEP purposes to identify and comprehend the inefficiencies that hinder optimal performance by the counties and to explore how enhancing efficiency can alleviate some of the financial constraints impacting the sector. In addition, AFIDEP will carry out an assessment of data availability and use at county level to enhance evidence-based decision making.

Therefore, the study will devise potential efficiency and data utilization mechanisms that can be applied by the counties to improve their performance.

D. Objective of the Assignment

The purpose of the study is to examine the efficiency levels in the selected counties health care systems and services and devise strategies for improvement. The study will focus on health systems and services geared towards improving PHC and women’s and girls’ health. Specifically, the study will;

1. Carry out efficiency analysis of the health sector in the selected counties of Nyandarua, Laikipia, Homa Bay, Tana River and Taita Taveta and devise ways for improvement to create more resources for health
2. Model the efficiency levels for the select counties health care systems and the PHC and RMNCAH interventions/activities that are undertaken at the county level
3. Assess the level to which research and development including data availability and use influence decision making in the select counties

E. Methodology

Methodology and Approach

The study will involve a consultative process with the counties departments of health, AFIDEP team and the consultant to establish the efficiency levels and data needs and gaps for PHC and women’s and girls’ health.  The consultant will be expected to:

1. Provide a plan for conceptualisation and measurement of efficiency levels in health systems to increase the understanding of the nature and magnitude of system’s efficiency level in the select counties and devise ways for improvement to create more resources for health
2. Assess the efficiency level in the utilisation of the available resources for health in the select counties and the effect of the efficiency in providing quality health services with the allocated health resources
3. Analyse the fundamental concepts of efficiency including allocative efficiency (AE) and technical efficiency (TE) in health sector in the select counties and give evidence-based and actionable recommendations for improvement.
4. Identify and analyse the successes and challenges in improving efficiency in health systems in the select Counties.
5. Identify the context of data use in the select counties and the constraints that may affect the use of data
6. Assess the level to which research and development including data availability and use influence decision making in the select counties
7. Devise ways to improve the inefficiencies and enhance data availability and use for decision making

The Consultant will therefore:

1. Carry out literature review to inform the efficiency analysis
2. Propose and justify the appropriate study design, efficiency model and data collection techniques to be used in the efficiency study.
3. Give a detailed description of the data tools of choice and their relevance in informing the final outputs
4. Provide sampling design, data collection and analysis procedures, quality assurance and ethical considerations.

F. Expected Period of Performance

August – November 2024

G. Summary of Deliverables

	Task	Output/Deliverable	Approx. 25 consultancy Days
	Efficiency Analysis and Assessment of Data Availability and Use
	Task	Deliverable/Output	Expected Timelines
1	Develop inception report outlining the approach of undertaking the assignment	Inception Report	Aug 23, 2024
2	Conduct literature review	Literature Review	Aug 30, 2024
3	Design study tools	Investment case reports	Sep 5, 2024
4	Map interview respondents together with AFIDEP team in consultation with County leadership.	List of interview respondents	Sep 9, 2024
5	Lead the interview processes for the select counties as well as transcription and data entry	Interview notes, Transcripts, recordings and data collected	Oct 11 2024
6	Lead data analysis and write the report	Final Report	Oct 25, 2024
7	Together with AFIDEP team, host virtual validation meetings to discuss results emerging from the study	Report of validation meeting and revised final report and policy briefs	Nov 15,2024
8	Dissemination of the report to the counties for uptake of the findings by the policy makers at County level	Feedback from the Counties	Nov 29, 2024

H. Qualifications and Experience of the Consultant

We are looking for a consultant with extensive experience on Efficiency and Data Gap Analysis. Specifically, the consultant should have the following qualifications;

• Master’s degree in Economics, Health Economics, Health Financing, Public Health, Health Planning, Health Systems Strengthening and Management, and related fields
• At least 10 years- of progressive professional experience related thematic areas
• Demonstrated successful experience in developing evidence-based publications, efficiency analysis, data management and monitoring, financial sustainability plans, policy briefs, strategies, guidelines, and reports
• Fluency in English with excellent writing, analytical and communication skills.
• Evidence of publication of research study articles in refereed journals.
• Ability to work with a multi-disciplinary team of experts;
• Experience working with different stakeholders/counterparts at national and global levels.
• Demonstrated experience with writing and editing project plans, policy briefs and policy reports.

I. Expression of Interest

To apply, please submit the following:

1. A one-page application letter of expression of interest, outlining your previous experience and how it is relevant to the proposed assignment. It should also indicate your availability and consultancy rates.
2. Brief technical proposal with clearly outlined methodology, assessment approach and techniques and tools to be employed.
3. Detailed budget for conducting the study.
4. A sample of at least 3 recently written reports of similar or related research assignments.
5. Updated CV, including references of at least three institutional clients you have recently conducted research for.
6. Detail work plan.

All expressions of interest should be clearly marked with the following statements, “Efficiency Analysis and Assessment of Data Availability and Use for Decision Making in Laikipia, Nyandarua, Tana River, Taita Taveta and Homa Bay Counties” and must be sent by email to the following email address by: [email protected], with a copy to: [email protected]. Kindly note that this position will remain open until filled, and the selection process will be on a rolling basis. Please note that only shortlisted candidates will be contacted.

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