TERMS OF REFERENCE

Co-Principal Investigator (Consultant)

Project Title: Impact Evaluation of the Health Facilities Enhancement Program Using Propensity Score Matching Design

I.  BACKGROUND AND RATIONALE

HFEP is the third pillar of the Kalusugan Pangkalahatan (KP) or Universal Health Care (UHC), a flagship program of the Aquino Administration. Capital investments in health in the Philippines have been in a secular decline for decades, with the number of barangay health stations (BHS) and rural and city health units (RHUs, CHUs) unable to catch up with the ballooning population. The bed/10,000 population ratio has also declined from around 32 in the 1970s to 17 at present. The occupancy rates in most public hospitals exceed 100 percent, indicating severe shortage in infrastructure. HFEP is a major effort to arrest this decline in capital investments.

HFEP involves a large annual budget. It was not possible to locate a comprehensive summary of the total resources devoted to HFEP in the preparation of this proposal, but data downloaded from the DOH website indicate the following:

a.  As of September 20, 2012, the total amount of HFEP for that year was PHP9.8 billion (DOH, 2012).

b.  The proposed 2013 annual budget covered 67 DOH hospitals with a combined allocation of PHP6.6 billion (DOH, 2013). In addition, the proposed budget for the same year for Local Government Unit (LGU) health facilities covered 168 municipal and district hospitals with a combined budget of PHP1.3 billion (DOH, 2013). If the two figures are combined, the total would be PHP 7.9 billion.

c.  For 2014, the program has a total allocation of PHP 9.1 billion (DOH, 2014).

While the large capital infrastructure program in health is certainly warranted to arrest the stagnation of public health investments, they need to yield dramatic increase in health service utilization among households. This continues to be a “missing link” in health service financing and delivery in the Philippines. Most available health status and coverage indicators of the country show weak improvement, and especially so if compared with similar indicators in neighboring Southeast Asian countries (Picazo, et al., 2013).

By focusing on the effectiveness of capital investments, the impact evaluation will help shed light on the relative importance of this input vis-à-vis other inputs in health service delivery, including human resources, drugs and supplies, equipment, and management and supervision.

II.  OBJECTIVES

  1. To provide an overall picture of the current status of HFEP, including program description, major outputs so far, overall size of investment allocation and spending, project allocation and spending trends through time, geographic distribution of projects, and rates of completion of projects.
  1. To understand the processes involved in the program, including investment identification, approval, implementation, and monitoring.
  1. To conduct an impact evaluation of the program, using either a propensity score matching design or regression discontinuity design.
  1. To disseminate the study’s findings in relevant national and local government agencies and among stakeholders.

III.  QUALIFICATIONS OF THE CONSULTANT

Should have post-bachelor degree in medicine, health sciences, social sciences or economics

At least ten years’ experience managing research/operations in health financing and health insurance

Should be familiar with the key officials/stakeholders of DOH.

IV.  SCOPE OF WORK

Under the guidance and technical oversight of a PIDS Senior Research Fellow who acts as Project Director, the consultant will be the Co-Principal Investigator. S/he will provide technical assistance to PIDS in the conduct of data collection activities (including preparation of instruments and training of enumerators for primary data collection), examination of primary data collected, and other data compiled for the process and impact evaluation work pertaining to the study.

Specifically, the Consultant, as Co-Principal Investigator, will undertake the following:

·  Conduct desk research to come up with a review of literature;

·  Gather secondary data on LGU and facility profiles;

·  Prepare data collection instruments that will be used for the Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs) for the process evaluation, as well as KIIS, FGDs and surveys for the impact evaluation;

·  Together with the Project Director, assist in the conduct of training for the enumerators to prepare them for the conduct of the KIIs, FGDs and sample surveys;

·  Provide technical guidance and supervision for the primary data collection on the KIIs, FGDs and sample surveys in the study areas;

·  Support the Project Investigator in conducting fora as part of the study’s dissemination activity;

·  Participate in high-level and technical discussions with DOH, DBM, and NEDA, as necessary;

·  Help prepare, and provide inputs to, all Reports for the Project;

·  Submit at least one Policy Note from the study; and

·  In coordination with the Project Director, lead the supervision of one consultant in statistics and impact evaluation who will be engaged for the project.

V.  DELIVERABLES

The Consultant will prepare the following outputs based on agreed activities and timelines in the project.

Phase/Activity Expected Outputs Due Dates

1)  Project inception Concept note June 15, 2014

2)  Desk research Reviews of the literature August 15, 2014

3)  Secondary data gathering LGU and facility profiles October 15, 2014

4)  Field survey Instruments + profiles October 15, 2014

5)  Process evaluation Process Evaluation Report December 15, 2014

The entire assignment will be for 6 months, from 1 June 2014 to December 2014, for a total contract price of 479,700 PHP.

VI.  SCHEDULE OF PAYMENT RELEASES

15% / Upon submission of Concept Note on or before June 15, 2014, acceptance and approval of PIDS
25% / Upon submission of Reviews of literature on or before August 15, 2014, acceptance and approval of PIDS
30 % / Upon submission of LGU and facility profiles, and Instruments and profiles, on or before October 15, 2014, acceptance and approval of PIDS
30% / Upon submission of Process Evaluation Report, Policy Notes and Turn over of data on or before December 15, 2014, acceptance and approval of PIDS

VII.  PROPOSED PROJECT DURATION

The entire assignment will be for 6 months, from 1 June 2014 to December 2014.

VIII.  PROPOSED PROJECT COST: 479,700 PHP