Two National Experts

1. Background

Stewardship/governance is a core function of health systems that requires specific attention. Increased transparency and accountability are driving forces behind better health system performance, which health system “stewards” strive to achieve by carrying out a number of subsidiary functions, including:

• Formulating evidence-informed strategies and policies to ensure the attainment of health system goals;
• Supervising and supporting the implementation of policies and programmes;
• Ensuring the collection of the necessary data and information to develop strategic and operational intelligence;
• Monitoring and evaluating progress on priority health outcomes and Universal Health Coverage (UHC) and effective governance and accountability mechanisms to take corrective action, when necessary;
• Regulation to protect the population health and safety (pharmacovigilance, food safety, behavior of health care workers, patient safety, etc.);
• Ensure that the laws, decrees, and interpretation of legal frameworks support the continually improving health system performance;
• Ensuring equity in health care financing and progressively improving financial protection, including a benefit package that includes the evidence-based “best buys” appropriate to North Macedonia’s level of economic development;
• Ensuring that purchasing mechanisms support strategic purchasing and provider payment methods that encourage access, quality and efficiency;
• Ensuring an adequate generation of resources (infrastructure, equipment and devices, medicines, and, in particular, and an adequate number and distribution of well-trained health workers);
• Serving as the country’s leading advocate for achieving the health-related Sustainable Development Goals (SGDs) and UHC.
• Ensuring that whole-of-government and whole-of-society approaches support the achievement of the health-related SDGs.

The World Health Organization (WHO) in North Macedonia, at the request of the North Macedonia MOH and with the support of the Regional Director of the WHO Regional Office for Europe, in January 2023 initiated activities towards strengthening/building institutional capacity in the MOH, more specifically:  

i) to reverse the weakening of the MOH’s capacity observed during the past several years due at least in part to the rapid turn-over of Ministers (four in the last five years), and

ii) to lay the foundation for developing the MOH’s stewardship functions to a point where it has the capacity to ensure continual improvements in the performance of the (entire) health system better—more equitable access to health care, improved health outcomes, and better financial protection—as a means to implement the Sustainable Development Goals and universal health coverage.

In order to implement the above mentioned activities WHO will support the establishment of a dedicated team within the MOH to serve as a secretariat for the working groups currently engaged in ongoing reform efforts and to support overall the process of building institutional capacity in the MOH.  

2. Objectives, Tasks and Deliverables

Objective:

To support the Ministry of Health to strengthen the functioning of the major MOH technical working groups currently engaged in ongoing reform efforts and to support overall the process of building institutional capacity in the MOH.  

Tasks:

1. To serve as members of the secretariat for key MOH working groups currently engaged in ongoing reform efforts

• Develop a list of the major working group within the Ministry of Health (e.g., primary health care (PHC), maternal and child health (MCH), human resources for health (HRH), mental health (MH), clinical guidelines (CGs), and note where updates are needed (for groups with retired or inappropriate members, non-functioning groups, etc);
• Develop terms of reference (ToRs) and provide secretariate support to the key working groups within the MOH (e.g., PHC, MCH, HRH, MH, CGs, etc).
• Support the process for development of an annual Action Plan for each of the major working groups within the Ministry of Health (e.g., PHC, MCH, HRH, MH, CGs, etc);
• Organize and participate in the regular meetings of the working groups, take minutes and prepare reports with necessary follow up actions, and ensure that those are distributed to relevant national focal points;
• Propose the establishment of new working groups, and as needed, in coordination with the WHO;

2. To support the process of development of the policy development, coordination and implementation unit or team in the MOH

• Draft TORs for a policy development, coordination and implementation unit or team (hereinafter “policy unit”);
• In cooperation with the MoH Heads of Departments, MoH Cabinet and the WHO CO Skopje, draft the action plan for the new policy unit;
• Support capacity-building efforts in the area of policy analysis, evidence-based policy design, project management and other activities related to the performance of staff in the policy unit.

3. To support efforts to improve the integration and coordination of ongoing reform efforts to ensure policy coherence

• Initiate and take part of periodic (monthly) meetings, to be chaired by the Minister of Health or their delegate, with the heads of the relevant departments/units and senior management of MOH and relevant MOH working groups and institutions to present findings and implications from assessments and studies and to demonstrate their political usefulness, to understand the challenges they are facing in implementation of the health reform related activities, notify the challenges and prepare monthly reports from those meetings.
• In coordination with the communications team at the MOH and WHO, support communication efforts targeted to the general public concerning the health system reforms and initiatives, aiming to increase the transparency of the work of the MOH priorities and dissemination of results and achievements.
• Support conceptualization, planning and capacity building of the introduction of monitoring and evaluation of the health system performance in order to ensure accountability and transparency of the health system and MOH and involve and ensure contributions from the relevant stakeholders and MOH staff.

4. Assist the MOH in developing a report that outlines the strategic directions for addressing key health system challenges currently contributing to poor health outcomes, inadequate financial protection, and dissatisfaction with the health system on part of both the public and the health workforce.

• Assist in the development of a report that outlines the strategic directions for addressing the key health system challenges (in collaboration with WHO), including a workshop to support the development of the strategy directions for addressing the key health system challenges them and analysing their root causes.
• Provide support for organisation of a High-level workshop(s) with the Minister of Health and his team to agree the strategic “concept” for how to address the identified challenges, starting immediately and continuing in the mid- to long term.
• Prepare notes and follow up actions from the workshops.

5. Assist the implementation of activities for building a critical mass of government officials in the MOH and related agencies and key stakeholders who have a shared understanding of the principles of health systems strengthening

• Assist preparation and implementation of a series of workshops and Senior policy seminars (SPSes) targeted at the Minister of Health, his team and a small number of senior managers/high-level policymakers
• Document the workshops as needed

6. Assist other activities related to building MOH institutional capacities as requested by WHO CO
7. Prepare monthly reports for each of the Tasks as part of this ToR to be submitted to WHO CO

3.Contract duration

15 February – 31 December 2023

4.Qualifications, experience, skills and languages

Education:

Essential: Bachelor's degree in medical sciences / social sciences / or related field.

Desirable: University degree (Master's level) in public health / health management / or elated field

Experience: At least 3 years of professional experience in planning, developing and/or implementing programmes / projects in the area of health and/or health systems.  

Skills:

• Demonstrable knowledge of the national health system;
• Strong analytical skills and ability to review and synthesize information from multiple sources;
• Excellent communication, facilitation and report-writing skills;
• Strong interpersonal skills, able to work across cultures and with the capacity to build strong working relationships;
• Expert-level knowledge of English language;
• Proficiency in Office software applications.

5.Supervision

Direct supervision by the RD Special Representative and Head of Office a.i. in North Macedonia, Dr Anne Johansen

6.Location (including in-country missions, if any)

- Ministry of Health of North Macedonia

- Participating to meetings within the WHO CO as requested (at least once per week)

7.Remuneration and budget

The payment of remuneration will be done at the end of each calendar month, upon submission of monthly report for implemented activities, based on the UN local rates of payment.