Consultancy - Advocacy Paper On Financing of
hace 5 días
**Job no**: 553787
**Contract type**: Consultant
**Duty Station**: Panama City
**Level**: Consultancy
**Location**: Panama
**Categories**: Health
UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. To save their lives. To defend their rights. To help them fulfill their potential.
Across 190 countries and territories, we work for every child, everywhere, every day, to build a better world for everyone.
And we never give up.
**For every child, **_health_**
**How can you make a difference?**
**Background**
UNICEF promotes the rights and welfare of all children and adolescents in everything we do. Together with our allies, we work in 190 countries and territories to transform this commitment into practical actions that benefit all children, especially focusing our efforts on reaching the most vulnerable and excluded, worldwide.
The UNICEF Latin America and Caribbean Regional Office is based in in Panama, operating in 36 territories, including 24 country offices.
UNICEF works to put the rights and well-being of the most disadvantaged children at the heart of the social, political, and economic agenda, in line with our equity focus, working across our organization and with our partners in government, civil society and the private sector to support shifts in public policy, fuel social engagement, and increase investment for children.
While the average regional and national under five and neonatal mortality rates in Latin America and the Caribbean have improved considerably over time (U5MR from 59.1 to 17.9 per 1,000 live births between 1990 and 2019 and NMR from 22.5 to 9.1 per 1,000 live births in the same time span[1]), disparities exist within countries, by wealth quintiles, geographic areas and maternal education levels.[2] Disparities in coverage of key health services are among the contributing factors for this.[3] Migrants and indigenous people face specific challenges in access to health services.
Health systems in the region are fragmented with parallel public, private and social security systems and underfinanced. This situation has created barriers to access. Public expenditures for health average 3.7% of GDP, much lower than the 6.0% target PAHO recommends.[4] Many countries, although with PHC strategies on paper, have reduced investments in PHC in recent times. Community engagement and multisectoral approaches are among the areas that require strengthening in many countries. In addition, the changing pattern of diseases (with the burden in many countries shifting from infectious to chronic non-communicable diseases) requires adaptations in the health system, including in PHC, that have not been fully incorporated.
Sustained, and in most settings increased investments in primary health care are crucial to ensure universal health coverage, maintain and improve the health of the population including the most vulnerable, and avoid catastrophic out-of-pocket expenditures. UNICEF is supporting costing exercises of primary health care in four countries, for advocacy for increased investments in primary health care in these countries, and aims to use the results of these studies as well as a broader review and analysis of health financing in the region, for advocacy at the regional level.
[2] EWEC-LAC Inequalities in maternal, child and adolescent health in LAC (forthcoming)
[4] ECLAC-PAHO: Health and the economy: a convergence needed to address COVID-19 and retake the path of sustainable development in Latin America and the Caribbean, 30 July 2020; see here.
**Purpose of the Assignment**
The purpose of the assignment is to develop an advocacy paper on primary health care financing in the LAC region, based on a literature review, and specific information from four countries that have undertaken a costing exercise (Colombia, Dominican Republic, Nicaragua, Peru).
**Specific Tasks**
Under the direct supervision of the Regional Adviser, Survive & Thrive and in coordination with the Regional Immunization Adviser and the Maternal and Child Health Specialist, the incumbent will:
1) Undertake a desk review of:
a. the epidemiological situation with emphasis on maternal, child and adolescent health, and key trends in the LAC region;
b. health systems in the LAC region and the positioning of primary health care (including examples of different country typologies); and
c. health financing in the LAC region, with emphasis on primary health care and maternal, child and adolescent health (including examples of different country typologies), and comparing investments n primary health care with investments in other levels of care;
2) Review and analyse the costing studies undertaken in four countries countries (Colombia, Dominican Republic, Nicaragua, Peru) and interview UNICEF staff in these countries;
3) Write a concise advocacy paper in support of increased investments in primary health care by national governments, and external donors where need
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