Consultant: Health Financing Activities in Tanzania

Dar Es Salaam, Tanzania.

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I.    Background

USAID’s Act to End Neglected Tropical Diseases | East (Act | East) program (2018-2023), led by RTI International, supports countries to reach their NTD control and elimination goals through proven, cost-effective public health interventions. The program provides critical support to countries in their journey to self-reliance by helping to create sustainable NTD programming within a robust and resilient health system. The project focuses on partnering with NTD-endemic countries to eliminate and control five of the most common NTDs, including lymphatic filariasis, trachoma, onchocerciasis, schistosomiasis, and soil-transmitted helminths (hookworm, ringworm, and whipworm), which affect more than one billion people worldwide.

Act to End NTDs | East also strengthens local capacity for planning, budgeting, and budget execution so that NTD programs can continue with high levels of effectiveness. In Tanzania the program helps Ministry of Health identify potential options for sustainable financing of NTDs, in line with broader health financing strategies for domestic resource mobilization (DRM), Primary Health Care (PHC) and/or Universal Health Coverage (UHC). As such, Act | East will support government institutions to assume greater programmatic and financial responsibility for their NTDs response.

In 2020, Act | East and the Tanzania Neglected Tropical Disease Control Program (TZNTDCP) conducted a sustainability planning consultation and identified that the major gap in financing was the low levels of funding to the NTD program, which is partly a result of inadequate data to inform planning, budget allocation, evidence-informed advocacy, and resource tracking. To address data gaps, in 2021, Act | East conducted a detailed analysis of financial and programmatic records of major donor funded NTD initiatives in six districts. Additionally, in 2021, Act | East completed a mapping exercise of critical actors and decision-making spaces for NTD budget allocation in the country at both national and regional levels.

In FY22, Act | East provided technical support to 15 prioritized councils to plan and budget for NTD activities using the existing PO-RALG planning system during the development of Comprehensive Council Health Plans. Act I East developed an evidence-based methodological guide and approach to council NTD coordinators on how NTDs can be prioritized based on available epidemiological and financial data in the planning and budgeting during the CCHP process. In addition, Act I East developed an operational manual for NTD coordinators in councils Planning and Budgeting for NTD interventions. Key staff of the MOH, NTDCP, PO-RALG, and councils validated the manual. The Act I East also provided capacity building activities to 15 councils to improve their capacity to allocate local council resources to NTD programs.

In FY23, Act | East will continue providing technical support to the same 15 councils to plan and budget for NTDs in CCHPs by building their capacity to use the PO-RALG PlanRep tool to track approval, allocation, and disbursement of funds; and to negotiate fund allocation at council budgeting meetings.A local consultant, through R4D, will support the CCHP activities in close coordination with Tanzania’s HSS Advisor, Chief of Party (COP), NTDCP Program Manager and PORALG.   

II. Objective of the consultancy

The objective of the consultancy is to provide technical assistance to the Ministry of Health (MoH) strengthen the Comprehensive Council Health Plan and budget development process and preparation of an NTD Domestic Resource Mobilization (DRM) Strategy.

The consultant will perform the following tasks: –

Activity #1: Track CCHP budget allocation and disbursement: The consultant will work with MoH and PO-RALG to hold a 3-day workshop to build the capacity of the 15 councils to use the Plan Rep system to track the funds planned, allocated, and disbursed for the NTD program. The workshop will also support councils in assessing the budget negotiation approaches, prospects, and challenges of mobilizing domestic public financing.

Activity #2: Develop and pilot a training module on NTD planning and budgeting: The consultant will use the WHO Program Managers NTD Course to review and adapt/tailor the existing PO-RALG planning and budgeting training materials on NTD. In the long term (post-FY23), the plan is to collaborate with learning institutions or use the MOH National e-Learning Platform for Healthand providethis course to all councils to guide NTD implementers to be up-to date with NTD information and best practices. The overall objective of this activity is to support NTD Coordinators and CHMTs in their role of adequately budgeting and allocating resources for NTDs from their council resources.

The specific objectives of these modules will be:

·       To orient NTD Coordinators and CHMTs teams on the CCHP Guideline and Health Financing Planning Guidelines for the successful planning and budgeting for NTDs at the council level.

·       To build skills on how to use web-based PlanRep systems based on the CCHP Guidelines, to plan and budget for NTDs.

·       To improve understanding of the NTD Coordinators and CHMTs teams’ roles in data production/ extraction from relevant sources of data.

·       To create a culture of data use through building skills on how to interpret and use data in planning, budgeting, and performance monitoring of NTDs.

The activity will be implemented in the following steps: – 

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