REQUEST FOR PROPOSAL FOR SUPPORT TO THE NATIONAL DEPARTMENT OF HEALTH FOR COSTING OF THE NATIONAL HEALTH INSURANCE
The following terms of reference define the follow up costing work that is informed by the revised NHI Green Paper which provides details of the envisaged design and institutional arrangements. The terms of reference relate to the detailed costing of the NHI pilot activities in the selected districts as described in the NHI pilots proposal and the needs of each particular district. This work must build on all previous NHI costing exercises performed by the NHI Ministerial Advisory Committee and by the NDOH including the work carried out on costing a basic package under the SARRAH programme in 2011.
Detailed Costing in NHI Pilot Districts: The costs of fully implementing NHI pilots need to be established based both on the overall NHI pilot proposals and the individual pilot district requirements.
Such costs need to be established using a bottom up approach which entails the following activities:
• Establishing the specific intervention requirements for each pilot district using the proposed district pilot activities for all NHI phases
• For each of the pilot interventions, anticipate all resource requirements and precisely cost them
• The interventions to be costed will, amongst other things, include the following:
o Strengthening District (and sub-district) Management Teams and creation of District Health Authorities
o Comprehensive service benefits at district level
o Strengthening service delivery platforms in the Districts at clinic, CHC, and district hospitals, the new PHC Streams (that include district specialist support teams, family health outreach teams, and school health services), contracting private providers, and emergency medical services
o The costs of a strengthened referral systems between levels of care within and outside of the district health system (taking into account PHC Reengineering and contracting of private providers) including links to emergency medical services.
• Any other NHI preparatory activities that are related to the specific district which need to be implemented as part of the piloting and roll -out of these reforms
Overall, costing will include actuarial work to inform global and service benefits related costs and activity-based or bottom up costing of the individual pilot district interventions in preparation for and testing specific components of National Health Insurance.
Scope of the work
1. Agree with NDOH what is the benefit package to be delivered by NHI and what norms and standards will be applied e.g. staffing level, quality and timeliness
2. Undertake costing of the service benefit in the pilot districts
3. Align the costing models to supply and demand side constraints and contexts
4. Be available to the Department of Health, other ad-hoc meetings and interactions with Treasury
5. Provide on-going consultative advice to the Department of Health, respond to specific requests, and upgrade estimates as the NHI implementation plan forms
Tasks: A work programme will be developed and delivered to cover the following areas:
1. Expansion of the existing costing approach and models to integrate the current demand driven costing approach with supply side realities and capacity building including:
o On-going work on updating the costing of the current strategic plan for the NHI
o Alignment of costing to both the Treasury budgeting processes and practical rollout of NHI in the pilot districts
o Refinement of assumptions and methodology as necessary to inform the above work including more detail at line item level for the service benefit, including the re-engineered Primary Health Care, human resources requirements, etc.
o Decomposition of the additional benefits and services arising from increased funding and investment.
2. Refinement of epidemiological projections and costs taking into account interventions contained in the HIV and AIDS NSP 2011-2016
3. Refinement of population and exposure projections including updating of population statistics and non-permanent migrants, urbanisation and the impacts thereof
4. Unpack alternatives with respect to rationing, gate-keeping referral, contracting and budgetary/payment rules and development and impact of preventive health services and estimate their financial impact
5. Investigate the need for, and if necessary, the type and size of inflation in respect of various layers of cost, including demand driven factors
Competencies of Consultants: The consultancy company must demonstrate expertise and a track record in actuarial modelling, costing and public health and in the development of social health insurance schemes.
Submissions: The consultancy company must submit a short technical proposal, a detailed financial proposal with time bound inputs, identified personnel, their daily fee rates and any associated direct costs. Please include the CVs of all identified team members, including the proposed Team Leader, whether full time or part time.
Scoring Criteria: Total Financial Proposal 30%
Technical Proposal 10%
Team Members 40%
Team Leader 20%
Timetable: The aim is to have the team start its work in October 2012 and have it completed by February 2013.
NB: Please note that only electronic submissions will be accepted for review but an additional hard copy can be sent to the HLSP offices.
Requests for purposes of clarification on this request for proposal should be submitted by email, to Catherine Brown, [email protected] on or before 12 October 2012
Proposals to be submitted by email to Catherine Brown, Operations Lead, SARRAH Programme [email protected]. HLSP, Lady Brooks Complex, Unit FO3, No 14 12th Avenue, Cnr Charles/Brooklyn Roads Menlo Park, Pretoria 0181, South Africa. Bid Closing Date: 15 October 2012. Bid Closing Time: 17h00