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 skillsets and life experiences. CHAI is deeply grounded in the countries we work in, with 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. Low-income countries in Africa and Southeast Asia see over half of the global disease burden and are home to 40% of the global population, and yet account for only 3% of health spending. 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. COVID-19 and the ensuing global economic crisis have only exacerbated these pressures at a time when more health spending is needed. 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. This work builds on CHAI’s experience in SRMNCH, health financing, and health workforce, among other areas. 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 Sustainable Health Financing program in Malawi is to support the government to progressively move towards universal health coverage through sustainably bringing more resources into the health sector and to ensure they 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), and in particular with the Department of Planning and Policy Development and District Health Management Teams, to provide technical assistance, develop analytical tools, and strengthen capacity to manage spending in Malawi’s health sector. Some examples of ongoing projects are: supporting aid alignment towards the Health Sector Strategic Plan III for 2023-2030 as part of the “One Plan, One Budget One Report” approach; evidence-based modelling for health workforce recruitment and pre-service education; supporting District Health Offices in developing planning, budgeting, and management tools; scaling up direct facility financing across Malawi; strengthening strategic purchasing of health services to drive efficiencies; development of a costed and prioritized plan to coordinate health facility solar electrification investments in the country; and supporting long-term capacity-building of Malawi’s health financing ecosystem.

In particular, the recently launched 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 frontlines of service delivery, and ultimately to enable increased health facility autonomy and responsiveness to community health.

Moving forward, the Ministry of Health is in the process of establishing DFF guidelines which will govern DFF investments from both government and partners. The guidelines will outline key elements of the DFF model, including stakeholder roles/responsibilities, the types of eligible health facilities and the respective grant sizes, funding flows, eligible expenses, procurement, supervision/monitoring, liquidations, financial accounting and reporting, audits, etc. Critical to this will be complementary investments in strengthening the capacity of the District Council, as they are the ultimate cost center accountable for the DFF, and must ensure robust supervision, monitoring, and internal audits for the health facilities.

CHAI Malawi therefore seeks a Senior Associate, Sustainable Health Financing based in Lilongwe, Malawi to work with the Government of Malawi support the scale up of direct facility financing. The Senior Associate will report to the Project Manager, Health Systems Strengthening, within the office’s Health Systems Strengthening Cluster. The Senior Associate will be part of a team that works closely with senior leaders in the Ministry of Health as well as donors, NGOs, and civil society organizations.

This is a challenging but rewarding position which will directly impact the government’s capacity to deliver improved health services 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, providing strategic advice, and developing tools that will deliver a stronger health system for the people of Malawi.

This is a short-term opportunity funded through June 2024.

• Serve as a trusted technical advisor to the MOH on health financing and health systems issues, enabling MOH to mobilize more resources into the health sector, distribute them equitably, and use them effectively and efficiently
• Support the MOH to operationalize the recently developed Health Sector Strategic Plan III, with a particular focus on strengthening health provider autonomy through the institutionalization and scale-up of direct facility financing
• Support the implementation of direct facility financing in selected focal districts, including close collaboration and capacity-building of District Health Offices and health facilities on direct facility financing
• Facilitate the development and implementation of government planning, budgeting, and donor coordination processes and tools, with the aim of improving efficiency and joint accountability at the national and district levels
• Build strategic relationships and facilitate meetings with government, donors and external stakeholders to drive operational and policy changes
• Contribute to the development of program workplans, budgets, and reporting for internal and external audiences
• Lead preparation of activity budgets and ensure timely liquidation of all activities once completed, in line with CHAI and donor best practices and policies for sound financial management
• Lead activity logistics in collaboration with the CHAI Finance and Operations teams, including disbursing allowances to meeting participants and ensuring that services such as venue hire, conferencing, printing, etc. are available for activities as relevant
• Perform any other relevant duties and lead day-to-day implementation of activities as assigned by the Project Manager, Health Systems Strengthening

• Master’s degree in economics, health economics, health systems, public health, public policy, or similar subject preferred; bachelor’s degree with relevant experience will also be considered
• Minimum of three years of professional experience, preferably in health systems strengthening, health economics, health financing, health workforce, public health, public policy, public sector finance, consulting, or other relevant experience
• Knowledge and experience in health systems and health financing, particularly in low- and middle-income countries
• Strong analytical skills and 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 analyzing complex datasets to identify key trends and to translate them into actionable options for decision-makers
• 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 need for extensive structural or operational support
• Strong writer, facilitator and oral communicator, able to distill and explain complex concepts to varied audiences
• Self-motivated and able to lead workstreams with a high degree of independence and autonomy
• Team player with the desire and capacity to effectively coach others, based on the team’s professional development needs and as assigned by the supervisor

Advantages:

• Experience supporting governments and donors to make health policy and health financing decisions
• Experience in designing and implementing direct facility financing mechanisms, particularly in Sub-Saharan Africa
• Experience working with district health management teams at the subnational level
• Experience working in resource-limited settings and a multicultural office environment

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