Duration: 15 days
Starting: 15 October, 2014
Original published date: 12 September, 2014
Application deadline:26 September, 2014
Background
In Somalia, a new environment is emerging from decades of conflict and violence that left the health sector dilapidated of infrastructure, human resources, availability of supplies and functioning public health administration structures at zonal and sub-zonal levels. Only 20% of the population has access to health services, mainly in urban areas, through the unregulated private sector.
The Somali Health sector is largely depending on external funds with an increasing trend (reaching 7 to 10 US $ per capita in 2006) and around 30% flowing into emergency health projects. Although this allocation is higher than in other fragile states, current funding levels are not sufficient to meet basic health needs. Substantial funding is still going into vertical programmes and the allocation of scarce resources needs to be better aligned to health priorities and existing health plans and strategies. A tracking system for external resources is not in place and funds are largely directly disbursed to implementing agencies such as the UN and NGOs.
Following the Bustan conference 2011 on the “New Deal in Fragile States”, the Federal Government of Somalia singed the “New Deal for Somalia” Compact at the Brussels conference in September 2013 that defines priorities for the next three years, including six “Peace and Stability Goals (PSG)” of which PSG 5 addresses revenue and services and is relevant to the health sector. The Compact builds on the South-Central six pillar programme, Puntland’s second “Five Years - ” and the “Somaliland National Development Plan”.
Priorities under PSG 5 include: 1) increase the provision of equitable, accessible, and affordable social services by creating a regulatory environment that promotes decentralized delivery and prioritizes key investments that extend and increase access to services; 2) enhance transparent and accountable revenue generation; 3) strengthen PFM to enable the different levels of government to better manage financial resources in a transparent and accountable manner, in support of national priorities.
Security gains especially in South Central Somalia and increased peace and stability across the country are giving the space for opportunities to engage in strategies towards economic development and the building of solid governmental structures and processes. 2014 is a critical year for the legitimacy of the Government and success in the health sector as the Essential Package of Services (EPHS) is being rolled out and the HSSPs are being reviewed. The SHAs have included health financing as well as building robust systems for financial management as priority areas for governing successfully the health sector. Processes for transparent financial management are critical for the implementing of the health sector strategy if donors are targeting to channel funds thought government processes.
There is little analytical data to support formulating a strategic vision on how to finance the health system. External funds are not channelled through governmental systems and a funding tracking system is not yet in place. Work is on-going on decentralizing public services to regional and districts teams but the degree of decentralizing functions, especially budgeting still needs to be worked out in in light of existing limited capacities at sub-zonal levels.
Hospitals and private clinics generate a large part of their income from charging for medical tests and medicines. The Government share in the GNP is only 5% with an allocation to the health sector of only 1%. An estimated 35% of health financing results from taxes and 50% is being collected through user fees. Out-of-pocket expenditure is estimated at 80% and health expenditure per capita at 114$. However, authorities in all three zones have committed an increase of health sector allocation in the current fiscal year (6% in SL, 4% in PL; 1-2% in SC).
Substantial work on public financial management and plans for its reform has been carried out at Ministries of Planning and Finance in Somaliland and South Central Somalia. In Somaliland, a public expenditure review was performed and a PFM Reform Strategy for 2013 to 2017 formulated. Alignment of assistance to Government processes and emphasis on capacity transfer to support strengthening and building key government functions are reflected in on-going joint programmes and Global Health Initiatives’ projects. As such, the health sector stands out as an example for being the first sector with a solid sector coordination mechanism in place and a multi-year strategic plan (the Health Sector Strategic Plans 2013 – 2016 for each zone) developed with respective zonal annual work plans and budgets.
However, in Puntland little work has been done so far in addressing a public financial management reform. Therefore, this consultancy will be carried out at the Ministry of Health in Puntland and support it in performing financial management functions which should be aligned to the financial system, including coding utilized by the Ministry of Finance and contribute to improved health planning and budgeting processes. If required, this work or specific related tasks will also be carried out in other zones.
General Objectives
The objective of the consultancy is to undertake a public financial management (PFM) assessment in the Somali health sector and to suggest practical recommendations for the SHAs to align to Government systems and processes and to improve efficiency and transparency.
An emphasis is to be given that Somalia health authorities are actively involved in the process and skills and knowledge are being transferred.
Specific Objectives
I. Evaluation of the planning and budget process:
a. Identify main actors;
b. Describe different steps and products of the budget preparation;
II. Description of the budget execution process in terms of wages and salaries, goods and services, operations and maintenance, transfers and subsidies and capital expenditure, including external financing;
III. Assessment of processes for financial accounting, control and audit practices;
a. Examine budget transparency i.e. accessibility of fiscal and budget information to the public;
b. Maintenance of records and accounts, and production of information and its dissemination to meet decision making control, management and reporting purpose;
c. Audit system and oversight of budgets and accounts;
Scope of Work
The review will be conducted at the Ministry of Health in Puntland. Achieved results and on-going work on the reform of the public financial management system led by the Ministries of Finance and Planning are to be reflected and alignment needs to be ensured to Government processes.
Expected deliverables
1) An inception report five days after the start of the assignment;
2) A financial management assessment for Puntland Ministry of Health; this assessment should also include regional, and if applicable, district levels;
3) Recommendations on how to improve the current FM system;
Duration and Timing
The consultancy is planned to be conducted within 15 days but can include more consultancy days as required. Initial work will take place in Nairobi to review background documents and budget data and to meet with relevant partners. The consultant will visit Puntland’s Ministry of Finance and Health to consult and work with the Ministry team and, if relevant, other stakeholders. A debriefing workshop is supposed to be organized at the end of the assignment. Its location is to be determined.
Competencies
The candidate should have:
Hands on experience of assessing costing and budgeting processes, especially in fragile states;
Experience and understanding of implementation of public sector budgeting and budgetary reform processes; ;
Strong facilitation skills with particular attention to transfer of knowledge and skills to MoH public health managers;
Ability to work under pressure;
Excellent communication and facilitation skills;
Strong report writing and analytical skills.
Qualifications and experience
· Degree in Public Finance, Accounting, Public Administration / Management or equivalent;
· Full membership of an internationally recognized professional body of management accountants;
· Experience of working with Ministry of Finance and Ministry of Health;
· Experience in similar programmes related to health sector reform and analysis in post-conflict countries;
Ability to provide practical methodological and technical advice and guidance to Ministry staff;
How to apply:
Additional information
· Qualified female candidates are encouraged to apply.
· Interested candidates are kindly requested and strongly encouraged to apply in writing sending their CVs and motivational letters to:
Administrative Officer
WHO Somalia
recruitment@nbo.emro.who.int
Deadline for applications: 26 September 2014
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