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.
NIGERIA HNP COUNTRY CONTEXT:
Despite some notable progress in Polio and malaria control, Nigeria is far behind in Human Capital and Especially Child Survival. Nigeria is ranked 152nd out of 157 on the Human Capital Index (HCI) (154th on child survival) and has the highest under-five mortality rate (U5MR) of any lower-middle income country (LMIC). Nigeria now accounts for about 13% of under-five deaths in the world and 25% of those in Africa.
U5MR in 2023 is going to be at least 17% higher than the AFR strategy goal. Almost 87% of U5MR in Nigeria, excluding neonatal mortality, is due to malaria, pneumonia, diarrhea and three other vaccine-preventable diseases.
Nigeria’s total fertility rate (TFR) of 5.8 children per woman in 2016 has changed little since 1990 when it was 6.0. The TFR appears to be increasing among the poor and the uneducated. Persistently high fertility rates have created a worker-to-dependent ratio of 1.1, less than half of the ratio in East Asian economies. Nigeria’s U5MR is stagnating at high levels (120 per 1,000 live births in 2016) although progress was made from 2003 to 2013. It is also inequitable. Immunization coverage (DPT3) was 33% in 2016, remaining the same since 1990. Skilled birth attendance, antenatal care, and contraceptive prevalence have followed the same trajectory. Recent Bank investments have achieved impressive results. Nigeria has not had a case of wild polio since August 2016 and is on the cusp of eradicating the disease. Use LLINs has increased by 71 percentage points and decreased severe anemia by 10 percentage points.
The Government of Nigeria’s spending on health is low. In 2016, government health spending was 0.6% as a share of GDP or just $US11 per capita resulting in limited resources available to pay for basic preventive and promotive health services that could have outsized impact; high levels of out-of-pocket payments at the point of delivery which reduce the use of services and act as a barrier to care, especially for the poor; and dependence on the largesse of development partners. External financing may decrease, as donors such as Gavi and GFATM reduce their commitments in line with Nigeria’s high per capita GNI. This will leave large gaps in key services unless there is greater domestic resource mobilization.
On the positive side, the Government of Nigeria has joined the Human Capital Project, and taken ownership of the Human Capital Agenda at the highest level through launching a call for action for strengthening the country’s human capital. The Government has further noted its strong focus on making dramatic improvements in child survival as one of the key pillars in addressing the human capital crisis in the country. Earlier in 2014, the national assembly passed the NHAct that provides for the establishment of the Basic Healthcare Provision Fund (BHCPF) funded from the Federal Government’s share of the consolidated revenue fund that will enable the Government to use its own resources to purchase services; buy services from both public and private providers; establishes a system of accreditation to improve quality of care; finance a rigorous system of verification toensure value for money; (v) creates robust electronic payment systems to providers to reduce the chance of corruption; and demonstrates long-term Government commitment to using public funds to subsidize the cost of services for the poor. Finally, In 2018, an investment case was developed to provide a country framework for alignment of sector stakeholders around a set of prioritized and phased RMNCAH + N interventions to accelerate progress towards better maternal and child health outcomes.
WORLD BANK GROUP CONTEXT:
The World Bank Group (WBG) is one of the world’s largest sources of funding and knowledge for development solutions – providing loans, grants, equity investments and guarantees to its members and private businesses. The vision of the World Bank Group (WBG) is the eradication of extreme poverty and the promotion of shared prosperity by fostering income growth of the bottom 40 percent in each country. To achieve its vision, the WBG leverages the combined strength of its institutions and their ability to partner with the public and private sectors to deliver customized development solutions backed by finance, world class knowledge and convening services.
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.
NIGERIA HNP COUNTRY CONTEXT:
Despite some notable progress in Polio and malaria control, Nigeria is far behind in Human Capital and Especially Child Survival. Nigeria is ranked 152nd out of 157 on the Human Capital Index (HCI) (154th on child survival) and has the highest under-five mortality rate (U5MR) of any lower-middle income country (LMIC). Nigeria now accounts for about 13% of under-five deaths in the world and 25% of those in Africa.
U5MR in 2023 is going to be at least 17% higher than the AFR strategy goal. Almost 87% of U5MR in Nigeria, excluding neonatal mortality, is due to malaria, pneumonia, diarrhea and three other vaccine-preventable diseases.
Nigeria’s total fertility rate (TFR) of 5.8 children per woman in 2016 has changed little since 1990 when it was 6.0. The TFR appears to be increasing among the poor and the uneducated. Persistently high fertility rates have created a worker-to-dependent ratio of 1.1, less than half of the ratio in East Asian economies. Nigeria’s U5MR is stagnating at high levels (120 per 1,000 live births in 2016) although progress was made from 2003 to 2013. It is also inequitable. Immunization coverage (DPT3) was 33% in 2016, remaining the same since 1990. Skilled birth attendance, antenatal care, and contraceptive prevalence have followed the same trajectory. Recent Bank investments have achieved impressive results. Nigeria has not had a case of wild polio since August 2016 and is on the cusp of eradicating the disease. Use LLINs has increased by 71 percentage points and decreased severe anemia by 10 percentage points.
The Government of Nigeria’s spending on health is low. In 2016, government health spending was 0.6% as a share of GDP or just $US11 per capita resulting in limited resources available to pay for basic preventive and promotive health services that could have outsized impact; high levels of out-of-pocket payments at the point of delivery which reduce the use of services and act as a barrier to care, especially for the poor; and dependence on the largesse of development partners. External financing may decrease, as donors such as Gavi and GFATM reduce their commitments in line with Nigeria’s high per capita GNI. This will leave large gaps in key services unless there is greater domestic resource mobilization.
On the positive side, the Government of Nigeria has joined the Human Capital Project, and taken ownership of the Human Capital Agenda at the highest level through launching a call for action for strengthening the country’s human capital. The Government has further noted its strong focus on making dramatic improvements in child survival as one of the key pillars in addressing the human capital crisis in the country. Earlier in 2014, the national assembly passed the NHAct that provides for the establishment of the Basic Healthcare Provision Fund (BHCPF) funded from the Federal Government’s share of the consolidated revenue fund that will enable the Government to use its own resources to purchase services; buy services from both public and private providers; establishes a system of accreditation to improve quality of care; finance a rigorous system of verification to ensure value for money; (v) creates robust electronic payment systems to providers to reduce the chance of corruption; and demonstrates long-term Government commitment to using public funds to subsidize the cost of services for the poor. Finally, In 2018, an investment case was developed to provide a country framework for alignment of sector stakeholders around a set of prioritized and phased RMNCAH + N interventions to accelerate progress towards better maternal and child health outcomes.
NIGERIA WORLD BANK HNP PROGRAM:
The World Bank has been involved in the health sector since its reengagement in 2001 and the current program has taken into account the lessons from the first decade of lending. There is a greater focus on results, output financing and accountability –through a set of innovative and high-impact approaches. The current portfolio includes: (i) the Nigeria State Health Investment Project (NSHIP) (IDA, HRITF, and GFF Grants totaling $315M) aims to strengthen the health systems in eight states (including all 6 states in the North East) by introducing performance-based financing that provides funds directly to health facilities based on the quantity and quality of services they deliver; (ii) the Saving One Million Lives- Program for Results (SOML PforR) (IDA $500M). The Program for Results (PforR) supports the Government’s existing Saving One Million Lives (SOML) initiative and rewards federal and state governments based on their performance in increasing utilization of maternal and child health interventions; (iii) the Nigeria Polio Eradication and Routine Immunization Support Project (IDA $420M) supports Nigeria within the Global Polio Eradication Initiative with funds for implementation of polio campaigns, surveillance and data management, and also supports procurement of vaccines for routine immunization and strengthening of logistics systems; (iii) the Regional Disease Surveillance and Response Project (REDISSE) (IDA $90M): a regional project to strengthen cross-sectoral and regional capacity for integrated disease surveillance and response; the (iv) the Basic Health Care Provision Fund (BHCPF GFF Grant $20M), to support the roll-out phase of the BHCPF to provide primary health care facilities much needed operational budgets to improve their overall capacity to provide basic services and also provides fee-for-service payments to public and private providers while making care free for the patient; (v) the Accelerating Nutrition Results in Nigeria (ANRiN – IDA $225M; GFF – $7M) that will use non-state actors (NSAs) to deliver high impact services to 12 high-burden states. Under preparation is the Multi-Phased Approach (MPA) to Cut U5MR in Half in 10 Years program which will build human capital and help achieve a fertility reduction. Its first phase of operation, the Immunization & Malaria Progress by Accelerating Coverage and Transforming Services (IMPACT) Project will support high-impact priority programs in malaria and immunization with innovations in service delivery and health systems strengthening.
To strengthen the World Bank’s health team for Nigeria, the World Bank is recruiting a Senior Health Specialist based in Abuja, in addition to other staff based in Abuja and in the Washington DC HQ and elsewhere. The candidates’ work program will focus on supporting the Bank’s health engagement in Nigeria. In addition, within the Health, Nutrition and Population Global Practice, the successful candidates might contribute to selected regional/global health engagement and solutions areas based on his/her expertise and interest.
The Bank has been supporting several Advisory Services and Analytics in Nigeria. These include: (i) a health financing systems assessment (HFSA) that deepened the Government’s understanding of its health financing situation and options; (ii) a private sector engagement with IFC to conduct a rapid private sector diagnostic and to work with the federal government on a managed equipment scheme (MES) that builds on the experience in Kenya; and (iii) a demographic dividend study that included an in-depth analysis of the fertility situation in Nigeria and developed long-term policy options and to demonstrate that it will require supportive macro-economic policies that helps create many more jobs.
Duties and Accountabilities:
The Senior Health Specialist will have the following key responsibilities, inter alia:
•Lead / co-lead implementation support of the Bank’s HNP portfolio in Nigeria and preparation of selected national and/or regional operations involving Nigeria as appropriate;
•Lead/co-lead/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, background reports, portfolio performance reviews, etc.);
•Review and contribute to sector-specific policy and other documents; participate in missions of the health team; and respond to ad hoc information requests from internal and external parties.
The work will be substantive in nature, requiring frequent interactions with senior external and internal counterparts.
The Senior Health Specialist will report to the Practice Manager (Health Nutrition and Population) for GHN07. For day-to-day operational work, the Senior Health Specialist will serve as Task Team Leader on assigned tasks and also work closely with other Task Team Leaders 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.
•A proven track-record of leading policy dialogue, policy reforms, and/or service delivery innovations would be regarded as an asset.
•Prior experience in an international development institution (public, NGO or private) 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 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.
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 #: | req3203 |
Organization: | World Bank |
Sector: | Health/Nutrition/Population |
Grade: | GG |
Term Duration: | 3 years 0 months |
Recruitment Type: | Local Recruitment |
Location: | Abuja, Nigeria |
Required Language(s): | English |
Preferred Language(s): | |
Closing Date: | 6/5/2019 (MM/DD/YYYY) at 11:59pm UTC |
Tagged as: Health, Nigeria, World Bank
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