TERMS OF REFERENCE by fionan

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									                         BENAZIR INCOME SUPPORT PROGRAM

              TERMS OF REFERENCE FOR DIRECTOR (HEALTH PRODUCT)

A.   Background

The Government of Pakistan has launched the Benazir Income Support Program (BISP)
as its main social safety net program. The objective of this nation-wide program is to
provide Income Support to the poorest families to cushion the negative effects of the food
crisis and inflation. The program will provide cash transfers of Rs. 1000 per month to
eligible families. BISP demonstrates the Government’s intention to increase social
assistance spending significantly. The current BISP budget allocation for 2009/10 is Rs
70 billion, which is intended to cover over 5 million families. or 13.6 million people. The
Government intends to expand the BISP budget in the coming fiscal year to cover around
7 million families.

The BISP program, instituted as a consumption led cash transfer program, is evolving
into a long term engagement that will also invest in human capital to enable its
beneficiaries graduate out of the ultra poor segment and into a stratum with improved
economic prospects. The graduation and exit strategy for the BISP beneficiaries will
provide employment, vocational training, and credit facilities to connect beneficiaries
exiting out of the cash transfer program to government’s human development initiatives.
Moving ahead on this agenda, the GoP has announced dispensation of health insurance to
the poor under BISP. The budget speech 2009-10 states that "the BISP will also serve as
a platform for complementary social assistance program, the main being health insurance
for the poor and vulnerable. This will cover full hospitalization, pregnancy, day-care
treatment, diagnostic tests, and accident compensation for earning members of the family
to a maximum limit of Rupees 25,000/- per family per year." The objective of providing
health insurance is to “support the ultra poor in managing the catastrophic health shocks
besides improving their general health condition". The coverage of the program will be
limited to target population (ultra poor being identified through poverty scorecard) only.

However, the specifics of the health insurance program pertaining to the business model,
benefit package, compensation modalities, and delivery systems are yet to be worked out.
In order to translate the federal Government’s objective on health insurance into a
workable model that suitably integrates into the BISP program, BISP Secretariat seeks
services of a qualified and experienced practitioner to lead the health insurance product.

Objective of the Consultancy

Director Health Insurance Product will be engaged to take charge of and guide the
design, development, and delivery of the BISP health insurance program. The prospective
candidate will also ensure that the health insurance product synchronizes with BISP’s
core mandate of income cash transfers, and complementary graduation programs directed
at human capital development.

Specific objectives are:

     i. Provide regular counsel to BISP on the health insurance and lead the development
        of the Health Insurance Product.

 ii. Engage all relevant stakeholders (public and private) in the development and
     management of a health insurance program that capitalizes on the available health
     service infrastructure and expertise (local and international) to generate innovative
     and efficient mechanisms to deliver health insurance to the poor.

 iii. Coordinate the development of the health insurance model with Ministry of Health,
      Provincial Departments of Health, Local level health facilities, technical advisors
      on health insurance, and relevant donors.

 iv. Lead the program strategy planning and will be accountable to BISP senior
     management in terms program quality and performance.

B.       Responsibilities of the Consultant

The Director Health Insurance Product will report to the Director General Special
Projects on product development, delivery, and progress. Specific responsibilities of the
subject position are listed as follows:

               Lead the design of the health insurance model for BISP, process flows,
                and implementation plans to execute health insurance to the BISP
                beneficiaries.

               Furnish expertise on health sector and health insurance from a local
                context, which will feed into the information requirements of the technical
                advisors in the design of the health insurance model for BISP.

               Supervise consultants and program team in developing detailed guidelines
                for responsibilities at federal, provincial and state level in dispensing
                health insurance. Also define roles and responsibilities of the insurance
                companies in the health insurance model.

               Ensure the design of the health insurance product integrates and is
                complementary to other programs of BISP.

               Produce briefing materials for use with the BISP board, Federal and
                Provincial governments and agencies, to assist the relevant officials
                understand the scheme of activities and the interaction between the state,
           health insurers (if in the model), intermediaries, and hospitals in the health
           insurance model.

          Liaise and coordinate with relevant stakeholders (Ministry of Health,
           Provincial Health Departments, insurance companies, actuarial experts,
           etc.) to facilitate dialogue and garner specialist input for the health
           insurance model, implementation design, and plan.

          Extend timely advisory services to the BISP management and facilitate
           their understanding of health insurance technicalities as and when
           required. This will also entail presentations, documented submissions,
           concept briefs, and reports.

          Engage with actuarial experts to ascertain details and the type of insurance
           cover that can be provided with an annual premium of Rs. 25000. Using
           this information, also facilitate BISP discussions with the insurance
           companies.

          Update BISP and other relevant entities on the progress of the health
           insurance model and program.

          Select the BISP team on health insurance products, based on purely merit
           and credentials.

          Supervise and manage the health insurance team in attaining the program
           targets by inculcating a practice of regular planning and performance
           assessment at program and individual level.

          Stipulate specific targets for the program in lieu of the health insurance
           product design and implementation plans, and take ownership of the
           performance and outputs.

          Follow and implement operational and financial guidelines of BISP and
           ensure compliance on every aspect of it.

C.   Deliverables

          Timely delivery of a health insurance model for BISP complete with
           process flows, and implementation plans.

          Unit structure established and functional. Also ensure that the selected
           team is an efficient mix of expertise, experience, credentials, and best
           suited to attain the BISP goals on health insurance.
             Unit work-plans complete with periodic targets and verifiable indicators
              for program progress and performance.

             Concept notes on various models of health insurance (e.g. RSBY-the
              health insurance program in India), along with detailed analysis of their
              suitability to the local context. Also provide recommendations on the
              health insurance model (or a mix of various models) best suited to the
              local conditions.

             Detailed guidelines for institutional roles and responsibilities at federal,
              provincial and state level, including those of the private sector (insurance
              companies, hospitals, NGOs etc.).

             Briefing material on health insurance for the consumption of various
              clients, which may be the BISP management, BISP Board, relevant
              government agencies, and the World Bank.

             Conduct stakeholder dialogues at federal and provincial levels for input
              into the design of the health insurance model and also to cultivate
              ownership of the BISP health insurance program among relevant public
              agencies and provincial governments.

             Presentations, documented submissions, concept briefs, and reports to
              develop understanding of BISP on various aspects of health insurance.

             Actuarial assessment of the costs involved in the provision of health
              insurance, and work out details of the medical package to be provided
              under BISP.

             Bimonthly reports to BISP management on the progress of the health
              insurance model and program.

D.     Qualifications & Experience

The selected candidate must have the following qualifications:

             Masters Degree in Public Health, Public Administration, Development
              Planning or similar fields.

             At least 5-7 years experience in the area of public health insurance, Health
              sector development and policy.

             Demonstrated experience of coordination with a range of stakeholders in
              health sector in pursuit of project delivery.
   Should have an in-depth understanding of program and project designing.
    Practical knowledge of tools for developing design frameworks would be
    an added advantage.

   A thorough practical knowledge of the Project Management Knowledge
    Areas and project lifecycle concepts and approaches.

   Demonstrated expertise in team management and large scale projects.

   Should have excellent command on MS Office, complementary
    knowledge of project management soft wares would be an added
    advantage.

   Good understanding of Government of Pakistan systems and procedures,
    specifically with reference to the federal and provincial health structures
    and service delivery systems.

   Proficiency in English and Urdu language.

   Good communication, people management, and writing skills.

								
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