The Objective of this Short-Term Consultancy (STC) is to produce an assessment on the performance of the Armenian PHC system, as well as on the integration of service delivery between PHC and higher levels of care, with a focus on urban areas. The assessment will be based on the Vital Signs Profile of the PHCPI and the Vertical Integration Diagnostic and Readiness Tool of the JLN, and it will inform the formulation of coherent policy recommendations based on its findings.
The Consultant will have primary responsibility for a) data collection, analysis, and completion of the Progression Model, b) data collection, analysis, and completion of the Instrument 1 of the Vertical Integration Diagnostic and Readiness Tool (i.e. National Policies, Regulations and Leadership Supporting Vertical Integration), c) data collection, analysis and completion of a short case study on the role of PHC during COVID-19, and d) completion of the final report illustrating the findings of the Vital Signs Profile and of the integration of service delivery assessment, and outlining policy recommendations. Data collection for the VSP and Vertical Integration Diagnostic and Readiness Tool will be supported by a firm. The STC will be tasked with quality assurance of this data collection process, in discussion with the Bank team.
The final report will include findings from the Instrument 2 of the Vertical Integration Diagnostic and Readiness Tool (i.e. Vertical Integration in the Healthcare System, Organizational Environments and Front-Line Service Delivery Settings). The World Bank will provide the STC with readable processed outputs for the Instrument 2, as well as with quality indicators at the facility level for the Performance Pillar of the Vital Signs Profile. The final assessment and recommendations must consider both the data directly collected by the STC and the data provided by the World Bank. Note that, given the key role of the private sector in health financing and delivery in Armenia, the overall assessment must consider the private sector.
The STC will be responsible for proactively keeping the World Bank apprised of any threats to the completion or accuracy of the assessment process through regular check-ins. With respect to the Progression Model/ Vital Signs Profile, the STC will adhere to an agreed upon process, based on a standard methodology developed by PHCPI. Specific activities included in the scope of work for the STC include:
- Propose a project plan to the Working Group (please find below more details on the Working Group);
- Conduct any needed outreach and consultations with MOH to ensure buy-in and approval on the proposed plan;
- Review the VSP indicators and the 33 measures included in the Progression Model with support from PHCPI; map relevant data sources, including official documents, quantitative indicators, and key informants to obtain the relevant data to complete the VSP;
- Build an action plan for obtaining needed data;
- Facilitate logistics for meetings with the relevant Working Group for service delivery in the to review and approve the action plan for the assessment process;
- Conduct data collection, including document review, quantitative indicator mining, and qualitative data collection. Some in-country travel may be necessary. Some VSP indicators, especially on the Performance Pillar of the VSP, will be directly provided by PHCPI;
- Ensure thorough and appropriate documentation of all data collected;
- Maintain regular communication with the Working Group to update on progress and troubleshoot, as needed;
- Synthesize all evidence per measure into a standardized format and share this summary with the Working Group for internal scoring;
- Facilitate logistics for meetings with the Working Group to review evidence and complete the internal scoring of the Progression Model. This includes recording and sharing minutes, particularly on the rationale for scores assigned, any new evidence presented, etc;
- Support to PHCPI team in conducting external verification, as needed;
- Provide support for additional quantitative indicators, if any, to be used for generating the VSP;
- Otherwise liaise with the MOH, data collection firm, and other stakeholders as needed.
With respect to the case study on PHC and COVID19, the STC will collect, analyze and synthesize data on the role that role primary care has played during the current COVID-19 pandemic in Armenia. The consultant will collect information about the role of PHC in Armenia during COVID-19 and document the source of this information (e.g. name of document, author, year, publisher, etc.). The methods of data collection will be primarily in the form of a desk review. The consultant should examine documents and data sources such as:
a) Existing pandemic plan;
b) Any policies, directives and guidelines publicly available from the MOH at national or state level;
c) Any information on the role of PHC in service delivery, communications or surveillance from the websites of the MOH or other Government institutions;
d) Any information on the role of PHC in service delivery, communication or surveillance from the websites of key stakeholders working in PHC (NGOs, development partners, think tanks, academia, etc);
e) Press releases, statements, news pointing to availability or lack thereof services at PHC level, role of PHC in communication or lack of it, and role of PHC in surveillance and testing or consequences of a lack of a role;
f) If possible, the consultant may interview 2-3 key informants (e.g. within the Ministry and/or the key organizations mentioned in point; b.). It is recognized that availability for such interviews may be very limited due to the COVID-19 response.
The Consultant will address the questions below with bullet point or written notes (approx. ½ to 1 page per question) and prepare a four-page overall summary of the role of PHC in COVID-19 response in Armenia, based on the information collected. The consultant will also provide some brief comments (e.g. ½ page) on opportunities for policy dialogue with governments on strengthening primary care in the midst of the fight against COVID-19. Questions to be addressed include:
- How is PHC and its functions presented in the pandemic preparedness plan? How has this evolved since the onset of the pandemic?
- What do we know about the role of PHC in the delivery of services during the pandemic? This includes how PHC has supported services for COVID-19 patients, as well as essential services for non-COVID-19 patients;
- What do we know about the role of PHC in the communication of risk and coordination within and across sectors?
- What do we know about the role of PHC in surveillance and service tracking?
- What are the differences between what was planned and what has happened? - some reflections;
- What modifications in governance, financing, and health information systems have been undertaken to support the role of PHC in the pandemic?
With respect to the implementation of the Instrument 1 of the Vertical Integration Diagnostic and Readiness Tool, the STC is responsible for all activities related to the application of the tool, as described in its official guide. Specific activities include:
- Design the survey, adapting the Instrument 1 to the context of Armenia. PHCPI can provide support with survey design. The final survey must be approved by the Working Group;
- Identify the survey respondents, which should be approved by the Working Group;
- Collect the necessary data / interview the selected respondents;
- Analyze data and produce readable processed outputs;
- Develop, with guidance from the World Bank team, illustrative narratives of current patient pathways across levels of care in Armenia for up to five selected conditions.
The Consultant is responsible to lead the production of the final report summarizing all processes and results of the assessment and providing recommendations, organize a final multi-stakeholder workshop (if agreed upon with the Working Group) and, in collaboration with the Working Group, steward the approval of the assessment through the MOH.
The Working Group will be responsible for approving the proposed assessment process; liaising with their respective organizations to ensure buy-in to the assessment process and results; liaising with key stakeholders; facilitating the STC access to key informants and documents, as needed; completing the internal scoring process; and stewarding the assessment through MOH approval process. In addition to the STC, the Working Group will likely include:
- A Ministry of Health Representative and focal point (Deputy Minister Lena Nanushyan);
- Armenia World Bank team lead (Adanna Chukwuma);
- The PHCPI Leads for Armenia (Federica Secci, Huihui Wang, Gianluca Cafagna).
The STC will report to the PHCPI Leads at the World Bank Group for assessment of deliverables and payments.
- Master level degree in Health Policy, Heath Systems Research, Health Service Organization, Health Care Management, Public Health or equivalent discipline; Ph.D. is preferred;
- At least 8 years of work experience in the health sector;
- Fluency in English and Armenian languages;
- Strong organizational skills and attention to detail;
- Experience working in or with the Armenia health system;
- Experience working with a range of high-level stakeholders and teams, possibly in PHC;
- Knowledge of the Armenian primary health care system; familiarity with primary health care structure and service delivery is strongly preferred;
- Strong mixed methods and qualitative research skills, with experience in the development of guides for interviews, conduction of key informant interviews and/or facilitation of focus groups;
- Basic quantitative skills and data literacy;
- Ability to synthesize complex information effectively;
- Good writing skills and ability to generate clear reports in English language.
ПРОЦЕДУРА ПОДАЧИ ЗАЯВОК:
Qualified candidates are welcome to send their CV and motivation letter in English language to Gianluca Cafagna at: email@example.com
indicating the position title ("STC - Primary Health Care and Integration of Service Delivery Assessment for Armenia") in the subject line of the email.
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As part of the broader engagement to support the design of Universal Health Coverage (UHC) reforms in Armenia, the World Bank Group and GAVI, the Vaccine Alliance, have responded to a request by the Ministry of Health (MOH) to provide technical assistance and recommendations for improving the performance of its primary health care (PHC) system and integration of service delivery, with an emphasis on urban areas. This assistance is also aimed to inform the ongoing response to the COVID-19 pandemic, for which PHC plays a central role.
To mobilize technical and financial resources for this engagement, the MOH has accepted the World Bank Group’s proposal of joining the Primary Health Care Performance Initiative (PHCPI). PHCPI is a partnership that aims to bring together country policymakers, health system managers, practitioners, and other development partners to catalyze and accelerate improvements in PHC systems performance through better measurement and knowledge sharing. Formed by the Bill and Melinda Gates Foundation, the World Bank Group, the World Health Organization, UNICEF, with technical support from Ariadne Labs at Harvard School of Public Health and Results for Development, the PHCPI provides technical assistance to countries to carry out systematic assessments of the performance of their PHC systems. The PHCPI assessment will be complemented with an assessment of health system readiness to support the integration of vertically-funded services, such as immunization, as well as coordination across providers working in different tiers or settings of the health system (e.g., PHC facilities, hospitals, diagnostic units, and community settings) to provide appropriate, timely and high-quality care.
PHCPI’s core tool, the Vital Signs Profile, is a national scorecard that will support the MOH in assessing the performance of the Armenian PHC system and identifying its strengths and weaknesses, potential areas of improvement, and gaps in monitoring. The development of the Vital Signs Profile followed a standardized methodology, validated by technical experts and used in more than 12 countries across different regions. Three countries in Europe and Central Asia are participating in PHCPI: North Macedonia, Moldova, and Georgia. Armenia would thus join a growing number of trailblazer countries in the region to apply the Vital Signs Profile. In addition to compiling quantitative indicators, a critical part of completing a VSP is conducting a Progression Model assessment, a mixed methods evaluation of the functional capacities, like governance, inputs and population health management, of a country’s PHC system.
To inform policy recommendations on the integration of service delivery, the PHCPI assessment will be complemented with items from the "Vertical Integration Diagnostic and Readiness Tool - A Survey Instrument for Countries Working Toward Health System Integration". This tool was developed by the Joint Learning Network for Universal Health Coverage (JLN), with support from the Bill and Melinda Gates Foundation and Results for Development, to assess vertical integration, which is defined as the way and means in which care is deliberately and systematically coordinated, including communication and learning, across providers working at different tiers or settings. Specifically, the assessment will be based on the Instrument 1 of the JLN tool “National Policies, Regulations and Leadership Supporting Vertical Integration”, whose items cover system-wide policies, regulations and leadership supporting vertical integration at the national level, and on Instrument 2 “Vertical Integration in the Healthcare System, Organizational Environments and Front-Line Service Delivery Settings”, whose items cover organizational policies and features of vertical integration in the respondents’ healthcare organization and the degree to which vertical integration is incorporated into the delivery system.