Senior Associate, Direct Facility Financing (Secondee)

The Clinton Health Access Initiative, Inc. (CHAI) is a global health organization committed to our mission of saving lives and reducing the burden of disease in low-and middle-income countries. We work at the invitation of governments to support them and the private sector to create and sustain high-quality health systems.

CHAI was founded in 2002 in response to the HIV/AIDS epidemic, with the goal of dramatically reducing the price of life-saving drugs and increasing access to these medicines in the countries with the highest burden of the disease. Over the following two decades, CHAI has expanded its focus. Today, along with HIV, we work in conjunction with our partners to prevent and treat infectious diseases such as COVID-19, malaria, tuberculosis, and hepatitis. Our work has also expanded into cancer, diabetes, hypertension, and other non-communicable diseases, and we work to accelerate the rollout of lifesaving vaccines, reduce maternal and child mortality, combat chronic malnutrition, and increase access to assistive technology. We are investing in horizontal approaches to strengthen health systems through programs in human resources for health, digital health, and health financing. With each new and innovative program, our strategy is grounded in maximizing sustainable impact at scale, ensuring that governments lead the solutions, that programs are designed to scale nationally, and learnings are shared globally.

At CHAI, our people are our greatest asset, and none of this work would be possible without their talent, time, dedication and passion for our mission and values. We are a highly diverse team of enthusiastic individuals across 40 countries with a broad range of skill sets and life experiences. CHAI is deeply grounded in the countries we work in, with the majority of our staff based in program countries. Learn more about our exciting work: http://www.clintonhealthaccess.org

CHAI is an Equal Opportunity Employer, and is committed to providing an environment of fairness, and mutual respect where all applicants have access to equal employment opportunities. CHAI values diversity and inclusion and recognizes that our mission is best advanced by the leadership and contributions of people with diverse experience, backgrounds, and culture.

Program Overview

CHAI’s health financing program supports Ministries of Health, Finance, and government insurers to substantially and sustainably improve population access to essential health services, towards the goal of universal health coverage. Financing for health is often insufficient and overly reliant on donors and individuals paying out of pocket at facilities. Donor contributions for health have plateaued, and in many countries are likely to decline in the coming years. While domestic resources for health are increasing, the rate of growth in government spending fluctuates, is often insufficient to meet population needs, and may not be spent efficiently. Countries supported by the global health finance team include Benin, Burkina Faso, Democratic Republic of Congo, Ethiopia, Kenya, Malawi, Mali, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zimbabwe.

CHAI’s health financing strategy supports governments to address these challenges through priority-setting and benefits package design; investment in upgrading health systems to deliver an optimized package of services; and strengthening or improving domestic financing through public financial management and strategic purchasing. At the request of governments, our strategy for health financing is expanding to include work in health systems and management, with a focus on building primary health care systems as the foundation of equitable UHC. At CHAI, staff work closely with government partners to support evidence-based decision-making and to design systems to ensure resources go as far as possible so that providers can deliver quality care that patients can afford and access.

Position Overview

The goal of the CHAI Malawi Sustainable Health Financing program is to support the Government of Malawi to progressively move towards universal health coverage by ensuring that scarce resources are distributed and utilized equitably, efficiently and effectively for the delivery of high-quality health services. The CHAI Malawi Sustainable Health Financing team works closely with departments across the Ministry of Health (MoH) to provide technical assistance, develop analytical tools, and strengthen capacity to manage spending in Malawi’s health sector.

Malawi’s Health Sector Strategic Plan III for 2023–2030 outlines eleven “game-changer” reforms that represent the Government of Malawi’s “priorities among priorities.” These aim to improve access to essential health services. One critical reform is enabling greater health provider autonomy through direct facility financing (DFF). Following a successful pilot of Health Center Improvement Grants that was supported by CHAI, the Government of Malawi has indicated that they plan to institutionalize DFF and scale it up nationwide through both government and partner funding. This represents a critical opportunity to ensure that government and partner funding are channeled closer to the front line of service delivery, and ultimately to enable increased health facility autonomy and responsiveness to community health. Moving forward, the Ministry of Health has recently approved DFF guidelines which will govern DFF investments from both government and partners and seeks to scale up DFF nationally.

CHAI in collaboration with MoH, seeks to recruit a Senior Associate, Direct Facility Financing, who will be seconded to the Ministry of Health and based in Lilongwe, Malawi. The Senior Associate will support the national scale-up and implementation of DFF, with a particular focus on six districts that are expected to receive funding through the Health Services Joint Fund (HSJF), a pooled donor fund. The Senior Associate will report to the MoH DFF Coordinator, Chief Economist, Health Financing within the MoH Department of Planning and Policy Development. For administrative and contracting issues, the Senior Associate will report to the Project Manager, of Health Systems Strengthening at CHAI.

This is a challenging but rewarding position which will directly impact the government’s capacity to deliver improved health outcomes for the population of Malawi. It presents an opportunity to work closely with a government that is committed to finding opportunities for sustainable financing of the health sector and delivering a stronger health system for the people of Malawi.

• Provide technical support to the MoH Department of Planning and Policy Development to coordinate the national scale-up and implementation of Direct Facility Financing (DFF), with a particular focus on the six HSJF-supported districts of Balaka, Chikwawa, Dedza, Kasungu, Lilongwe, and Salima
• Support the MoH to convene the national DFF taskforce, including government and donor representation, to ensure alignment and coordination across stakeholders throughout the national scale-up of DFF
• Provide close support and supervision to the District Councils of the six focal districts as they scale up DFF, including through targeted training, skills development, and mentorship on DFF implementation and reporting requirements
• Support roll-out of the intra-district resource allocation formula across districts implementing DFF
• Backstop the HSJF Fiscal Agent by reviewing financial requests/reporting from the District Councils for alignment with the DFF guidelines, compliance, and technical accuracy
• Ensure coordination and linkages of DFF with other health sector reforms such as service delivery integration, district and facility planning, quality improvement and accreditation, etc.
• Proactively identify areas for improvement in DFF implementation and work with the DFF taskforce to revise the DFF guidelines accordingly
• Perform any other relevant duties and lead day-to-day implementation of activities as assigned

• Bachelor’s degree in economics, health economics, public policy, finance or similar subject preferred; master’s degree is an added advantage
• Minimum of three years of professional experience, preferably in health financing, governance, public sector finance, public policy, consulting, or other relevant experience
• Knowledge and experience in health financing, particularly in low- and middle-income countries
• Outstanding analytical skills and advanced proficiency with Microsoft Excel and PowerPoint
• Strategically minded and able to think creatively about long-term program goals and objectives, and the detailed steps necessary to achieve these goals
• Structured thinker with experience in strategic planning and operational implementation
• Strong diplomatic and interpersonal skills and ability to build strategic relationships with government partners, donors and other stakeholders
• Demonstrated ability to deliver excellence in high-pressure situations, set priorities, and adapt to rapidly changing environments
• Excellent organizational and problem-solving skills without the need for extensive structural or operational support
• Strong writer, facilitator, and oral communicator, able to distil and explain complex concepts to varied audiences
• Self-motivated and able to lead workstreams with a high degree of independence and autonomy

Advantages

• Experience supporting governments and donors to make health policy and health financing decisions, particularly at the subnational level
• Experience in designing and implementing direct facility financing mechanisms, particularly in Sub-Saharan Africa

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