HEALTH, NUTRITION AND POPULATION GLOBAL PRACTICE CONTEXT:
The central contribution of the HNP Global Practice to the World Bank’s twin goals is to enable the achievement of Universal Health Coverage (UHC), in which all people are effectively covered by essential health services, and nobody suffers undue financial hardship because of illnesses. The HNP Global Practice includes staff members in Washington, DC and many country offices. The HNP Global Practice works with and across multiple sectors, in recognition of the fact that HNP outcomes often depend on actions that lie outside the HNP sector. The HNP Global Practice supports country and regional efforts to: (i) improve health outcomes, especially for the poor and most vulnerable; (ii) expand access to high-quality HNP services, interventions and technologies that give the most value for money; (iii) strengthen health systems for results; (iv) establish and improve health financing mechanisms that promote efficiency, equity and sustainability of investments; (v) strengthen heath-relevant institutions within and outside the health sector; (vi) harness multisectoral policies and investments for better health outcomes; and (vii) develop and learn from rigorous impact evaluations.
AFRICA REGION CONTEXT:
Africa has registered strong economic growth in recent years that has helped to reduce poverty levels in the continent. Yet, as Africa’s population expands, the region faces a critical challenge of creating the foundations for long-term inclusive growth. Many countries still contend with high levels of child and maternal mortality, malnutrition is far too common, and most health systems are not able to deal effectively with epidemics and the growing burden of chronic diseases. These challenges call for renewed commitments and accelerated progress toward Universal Health Coverage (UHC)—the principle that everyone receives needed health services without financial hardship.
Most African countries have integrated UHC as a goal in their national health strategies. Yet, progress in translating commitments to UHC into expanded domestic resources for health, effective development assistance, and ultimately, equitable and quality health services, and increased financial protection has been slow. To accelerate progress toward UHC in Africa, the countries will require political leadership and a clear strategic vision to achieve their UHC targets and to be able to eliminate preventable maternal and child deaths, strengthen resilience to public health emergencies, reduce financial hardship linked to illness, and strengthen the foundations for long-term economic growth.
HNP COUNTRY CONTEXTS and PROGRAMs:
CHAD HNP COUNTRY CONTEXT
Chad has one of the highest population growth rates in the world, estimated at 3.6% every year with a total fertility rate of 6.4 per woman with projections that the total population is likely to double by 2035. Chad’s maternal mortality ratio, estimated at 856 per 100,000 live births, is the highest among Central African countries. Prenatal care rate is 64%, deliveries assisted by skilled providers is at 24 percent and deliveries taking place in health facilities at 22 percent in 2014. Infant mortality rate is 72% while neonatal mortality rate is 34% and about one in eight children does not reach their fifth birthday. Immunization coverage with Penta 3 was estimated at 37% in 2017, and that of children aged 12-23 months stood at only 22%; 40% of children are stunted. As for HIV/AIDS, adult HIV prevalence stands at 1.6%. The prevalence of physical violence based on gender is 18%, the prevalence of sexual violence is 12%, and the prevalence of genital mutilation is 44% .
The availability of public health services is limited nationwide. Chad has less than 5 hospital beds per 10,000 while hundreds of public facilities are dysfunctional due to lack of human resources and weak management. Geographical access to health care services is limited: 30 percent of households require more than a two hour walk to access a health facility, and only 10 percent of poor people live within a 15-minute walk of a health facility. Overall, the quality of healthcare services is considered poor. The health system’s ability to respond to the needs of the population has been constrained by inadequate performance of its essential functions: lack of adequate data and tools for developing a health financing strategy; human resources and drugs are not sufficiently regulated leading to poor distribution, inefficient use, and inevitable leakages of drugs; and health management information does not provide an evidentiary basis for decision-making. The proportion of the national budget allocated to health care is generally very low (2014: 3.6% of GDP and 19.4% of external aid in 2014) to health in Chad. Household spending accounted for 71 percent of overall expenditures in the health sector. These have resulted in a very low use of existing health care services, especially at primary level and among women and children (0.18 contacts per year and per child).
Chad has recently been selected to benefit from a full GFF Grant once a program is successfully prepared. Chad has a very active policy dialogue at both the Government and the development partners levels.
CHAD WORLD BANK HNP PROGRAM
The existing HNP portfolio in Chad comprises two projects: one country level and one regional project. The country level project is the Mother and Child Health Services Strengthening Project-MCHSSP: (IDA: US$15.79 million and US$5 million HRITF) aiming to increase the utilization and improve the quality of maternal and child health services in targeted areas. The regional project is the Sahel Women’s Empowerment and Demographic Dividend (SWEDD) Project(IDA: US$26.7 million for Chad) aiming to improve women and adolescent girls’ empowerment and their access to quality reproductive, child and maternal health services in selected areas of the participating countries. A second regional project, the Regional Disease Surveillance Systems Enhancement-4, is under preparation (IDA: US$30 million for Chad) aiming to strengthen the weak human health, animal health, and disaster response systems and promote cross-border collaboration to prevent, detect and respond to disease outbreaks.
MALI HNP COUNTRY CONTEXT
Health status indicators are very low in Mali with stagnant progress on reducing infant and child mortality between 2012 and 2018. Maternal mortality is at 540 per 100,000 live births and under five mortality at 101 per 1,000. Overall coverage remains low with only 67 percent of births in facility. Population growth is a critical issue in Mali. With an average of 6.3 births per woman, the total fertility rate is the second highest in Sub-Saharan Africa and the World. This growth is expected to continue, given the country’s young age structure, high fertility rates, and low levels of contraceptive use (8 percent). Stunting is down back at pre-crisis (2012) level, but still high (27% in 2018).
The already delicate health care situation in Mali further worsened with the 2012 crisis. The Ebola outbreak in October 2014 unveiled the country’s inadequate health. Key challenges in the sector include: weak institutional capacity; problematic demography-related interventions due to divergent opinions within the government; challenging sector-wide coordination; information gaps; weak monitoring and evaluation and fiduciary systems; and low accessibility and high cost of operating in the Northern areas with high security risks, difficulties in mobilizing qualified international expertise, as well as high cost of doing business. A new reform platform has recently been announced.
MALI WORLD BANK HNP PROGRAM
The WBG’s HNP GP has put in place a strategic, operational and analytical engagement in health care delivery, population and nutrition in Mali articulated around a regional and national agenda. Mali is part of three regional operations for a total of US$107 million (Sahel Women’s Empowerment and Demographic Dividend Project, Sahel Malaria and Neglected Tropical Diseases Project and Regional Disease Surveillance Systems Enhancement Project in West Africa – Phase 3) and a recently approved Accelerating Progress Towards Universal Health Coverage Project (US$60 million IDA+ US$30 million co-financing from the Netherlands). The Global Financing Facility (GFF) multi-donor trust fund provides US$10 million co-financing for the project.
The recently completed analytical portfolio includes:Service Delivery in an FCV Context, Impact of the Crisis on Social Sectors Study; Public Expenditure Review in Education and Health; Service Delivery Indicator (SDI) in Health, and Health in Africa (HiA) program through which IFC supported several studies and workshops on public private partnership in Health.
NIGER HNP COUNTRY CONTEXT
In Niger, fertility, health and nutrition outcomes are among the worst in the world. The rapid population growth is hampering the country’s development. Low coverage of the population and low use of health and nutrition services leads to many of these poor outcomes. Skilled birth attendance is dismally low (40 percent), putting women and their newborns at risk for mortality and morbidity. Niger has a total fertility rate of 7.3 births per woman – the highest in the world. The population is very young and predominantly rural. Early and frequent pregnancies increase the exposure to and risk of maternal death. Maternal mortality remains very high with 520 maternal deaths per 100,000 live births. Under-five mortality declined steadily to 84.5 per 1,000 live births but remains above the regional sub-Saharan Africa average. Similarly, infant mortality has dropped to 50 per 1000 live births. Anemia continues to be a problem for both women (46% of pregnant women) and children (73 percent of children under 5). Poor protective health behaviors and utilization of services – e.g. low rates of immunization (52 percent fully vaccinated), exclusive breastfeeding (23 percent), and bed net use (20 percent) – lead to poor child health and nutrition. Children suffer widely from both chronic and acute malnutrition with 44 percent of children under 5 being stunted and 36 percent being wasted.
Health financing (less than 5 percent of the public budget) is a substantial challenge which restraint the sector capacity to meet the health and nutrition needs of the population. Furthermore, out-of-pocket (OOP) health expenditures are very high (34.3 percent of all health expenditures are OOP), putting the burden of health expenditures, especially catastrophic health expenditures, directly on households. Despite the abolishment of the user fees for care of child under five, pregnant woman, the treatment for specific diseases, access to care remains very challenging for the poor and vulnerable households.
NIGER WORLD BANK HNP PROGRAM
The health sector portfolio consists of three regional IDA projects (US$130.5 million), the Sahel Women’s Empowerment and Demographic Dividend Project, the Sahel Malaria and Neglected Tropical Diseases Project and the Regional Disease Surveillance Systems Enhancement Phase III; and one national IDA operation (US$103 million), the Population and Health Support Project, focused on increasing the utilization of reproductive, maternal, newborn, child health and nutrition services in targeted areas of Niger. The project includes Disbursement Liked Indicators (DLIs). The newly proposed multi-sector Nutrition and Community Health project, a response to the Human Capital Project, is expected to improve the delivery of nutrition and health services in communities using community health workers and reinforcing the decentralized platform of services for young children and women. It is expected to be delivered by Q3 FY20. Niger also benefits from an exploratory grant from the Global Finance Facility (GFF) to help develop a community-level service platform and has recently been selected to benefit from a full GFF Grant once a program is successfully prepared.
To strengthen the World Bank’s health teams for Chad, Mali, and Niger, the World Bank is recruiting a Senior Health Specialist/Senior Health Economist to be based in the Ndjamena, Bamako, and Niamey Country Offices respectively, to complement health team members based at HQ in Washington DC and elsewhere.
The candidates’ work program will focus on supporting the Bank’s health engagement in the country where they will be based. In addition, the successful candidates might contribute to selected regional/global health engagement and solutions areas, based on his/her expertise and interest, within the Health, Nutrition and Population Global Practice.
Note:
Both Chad and Mali are non-family duty stations.
Duties and Accountabilities:
The Senior Health Specialists/Senior Health Economists will have the following key responsibilities, inter alia:
• Lead implementation support, as needed, to the Bank’s HNP portfolio in Chad, Mali, or Niger, depending on which country’s position they are selected into; they will also support selected Regional operations as appropriate;
• Contribute to the technical discussions and monitoring of the Bank portfolio on a day-to-day basis, in close collaboration with the relevant government agencies and development partners;
• Lead and/or assist the team in policy dialogue, communications and interactions with government counterparts, country stakeholders as well as development partners;
• Contribute to sector-specific inputs for various operational products/outputs (e.g. sector/country briefings, sector analyses and background reports, portfolio performance reviews, etc.);
• Review and contribute to sector-specific policy and other documents;
• Assume leadership of missions of the health team as needed; and
• Respond to ad hoc information requests from internal and external parties.
• The work will be substantive in nature, requiring frequent interactions with various external and internal counterparts.
The Senior Health Specialist/Senior Health Economist will report to the Practice Manager (Health Nutrition and Population) for GHN07 and coordinate with the HD Program Leader based in Bamako. For day-to-day operational work, the Senior Health Specialist will serve as Task Team Leader for assigned tasks and also work closely with relevant GP colleagues, country office fiduciary and operations support staff and national counterparts and the Human Development Program Leader. The Senior Health Specialist will be subject to all World Bank regulations and guidelines applicable to staff in the Country Office which is their duty station.
Selection Criteria
• Graduate degrees (Masters degree required, PhD or equivalent would be an asset) in public health, health economics, health financing, epidemiology, business administration or professional degree (medicine, nursing). Candidates without a core qualification in at least one of these domains need not apply. Candidates with combined degrees will have an added advantage.
• Minimum of 8 years as senior analyst, senior specialist or senior program management positions in one or more of the following areas: health systems, public health program management, service delivery, monitoring and evaluation, operations research in health, results-based financing. Experience in two or more of these areas is advantageous.
• Prior experience in an international development institution (public, NGO or private) as well as in FCV contexts is preferred. Ability to function effectively in multi-disciplinary teams within a matrix environment is essential.
• A drive for results, including a proven track record of high standards/accountability for work products, meeting deadlines, an ability to prioritize tasks within his/her work program and strategies for working collectively with others on the team to deliver products of the highest caliber.
• Strong interpersonal and diplomatic skills.
• Fluency in French and in English (excellent oral and written communication skills) is essential, with ability to prepare documents on complex subjects, speak and write persuasively, and present ideas clearly and concisely.
In addition to the above, the selected candidate is expected to demonstrate the following WBG core competencies:
Integrative Skills — Understands core issues and knows where to get additional expertise when needed.
Knowledge and Experience in Development Arena — Understands policy making process and role of the health sector in that process. Is able to find relevant information and examine similar policy questions in multiple regions and to distill operationally relevant recommendations and lessons from this analysis for clients.
Policy Dialogue Skills — Identifies and assesses policy issues and communicates findings/points of view verbally and through economic reports and papers. Plays an active role in the dialogue with the government and/or other stakeholders as part of Bank teams.
Client Orientation — Maintains client relationships in the face of conflicting demands or directions and provides evidence-based advice and solutions based on sound diagnosis and knowledge.
Drive for Results — Identifies the needed resources to accomplish results involving multiple stakeholders and finds solutions to obstacles affecting key deliverables.
Teamwork (Collaboration) and Inclusion — Shows leadership in ensuring the team stays organized and focused, and actively seeks and considers diverse ideas and approaches.
IMPORTANT: Please note that if the selected candidate’s skills do not fully meet the hiring selection criteria for an Internationally Recruited Staff (IRS) appointment, the vacancy may be adjusted, and the candidate will be assessed and may be hired as a Locally Recruited Staff (LRS) with Global Mobility Benefits, instead of those benefits accompanying an IRS staff appointment.
The World Bank Group values diversity and encourages all qualified candidates who are nationals of World Bank Group member countries to apply, regardless of gender, gender identity, religion, race, ethnicity, sexual orientation, or disability. Sub-Saharan African nationals, Caribbean nationals, and female candidates are strongly encouraged to apply.
Job #: | req3204 |
Organization: | World Bank |
Sector: | Health/Nutrition/Population |
Grade: | GG |
Term Duration: | 3 years 0 months |
Recruitment Type: | International Recruitment |
Location: | N’Djamena, Chad |
Required Language(s): | English, French |
Preferred Language(s): | |
Closing Date: | 6/5/2019 (MM/DD/YYYY) at 11:59pm UTC |
Tagged as: Chad, Health, World Bank
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