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Supporting Egypt’s Universal Health Insurance System

Overview

NOTICE AT-A-GLANCE

  • P172426

  • Supporting Egypt’s Universal Health Insurance System

  • Egypt, Arab Republic of

  • OP00332944

  • Request for Expression of Interest

  • Published

  • EG-MOF-447338-CS-CQS

  • Individual Consultant Selection

  • English

  • Jan 31, 2025 12:00

  • Jan 11, 2025

CONTACT INFORMATION

  • Ministry of Health and Population

  • Yara Gamal

  • Floor 6 ministry of finance - New Capital - Cairo.

  • Egypt, Arab Republic of

  • Egypt, Arab Republic of

  • 01141221444

Details

Request for Expression of Interest

(CONSULTING SERVICES – INDIVIDUAL SELECTION)

Egypt

Supporting Egypt’s Universal Health Insurance System Project

Loan No.: IBRD-91320

Assignment Title: Senior Consultant for the development of the UHIS roadmap at Universal Health Insurance Agency (UHIA) in Egypt

Reference No. EG-MOF-447338-CS-CQS

Supporting Egypt’s Universal Health Insurance System Project (P172426)

The Ministry of Finance has received a loan of $400M from the World Bank toward the cost of the Supporting Egypt’s Universal Health Insurance System Project, and intends to apply part of the proceeds for consulting services.

The consulting services (“the Services”) include consultancy aimed for development of the UHIS roadmap at Universal Health Insurance Agency (UHIA) in Egypt

The detailed Terms of Reference (TOR) for the assignment are attached to this request for expressions of interest.

The “Supporting Egypt’s Universal Health Insurance System Project” now invites eligible consulting firms (“Consultants”) to indicate their interest in providing the Services.

Interested Consultants should provide information demonstrating that they have the required qualifications and relevant experience to perform the Services ( profile, brochures, experience in similar assignments, availability of appropriate skills and resources, ... etc.).

The shortlisting criteria are:  

  • A Master’s degree in management, economics, or health economics
  • At least 10 years of professional experience having worked at top-management level in health organization, preferably health insurance
  • Professional global experience with health system reforms and with change management in middle-income economies
  • Proven experience in conducting system evaluations
  • Previous experience and understanding of working in different cultural and political contexts
  • Professional experience in Middle East is an advantage
  • Previous experience or studies in the Egyptian health system is a plus
  • Proficiency in English and Arabic is a must

The attention of interested Consultants is drawn to Section III, paragraphs, 3.14, 3.16, and 3.17 of the World Bank’s “Procurement Regulations for IPF Borrowers” November 2020 (“Procurement Regulations”), setting forth the World Bank’s policy on conflict of interest. 

A Consultant will be selected in accordance with the CQS method set out in the Procurement Regulations.

Further information can be obtained at the address below during office hours 10.00 am to 4.00 pm – Sunday to Thursday.

Expressions of interest must be delivered in a written form to the address below by e-mail by 31st January, 2025.

Supporting Egypt’s Universal Health Insurance System Project.

Attn: Yara Gamal – Procurement Specialist.

Ministry of Finance.

Cairo – Egypt.

Tel: +201141221444

E-mail: procurement.uhis.eg@outlook.com

 

Terms of Reference for a Senior Consultant for the development of the UHIS roadmap

at Universal Health Insurance Agency (UHIA) in Egypt

Background

Egypt launched the Universal Health Insurance System (UHIS) to achieve universal health coverage (UHC) and improve health outcomes for its citizens. The Universal Health Insurance Law (UHIL) was passed in January 2018 to guide the implementation of the UHIS. The UHIS is being rolled out in six phases over a 15-year period. Phase 1 commenced implementation in 2019 with a pilot in Port Said governorate, then expanded into another three governorates:  Luxor in 2021, Ismailia in 2022, and South Sinai in 2024. Three new main public agencies have been established to implement the UHIS: (i) the Universal Health Insurance Agency (UHIA) which is in charge of the management and finance of the system (the purchaser); (ii) the Egypt Healthcare Authority (EHA) (the main public service provider); (iii) the General Authority for Healthcare Accreditation and Regulation (GAHAR) (Accreditor of all the healthcare service providers).

The UHIS aims to extend mandatory health insurance coverage to all citizens, including vulnerable groups who would be subsidized by the Government. By March 2024, the UHIS had enrolled 3.2 million individuals in the abovementioned four governorates, representing about 83 percent of the population in these Governorates.

The Government’s UHIS reform is supported by a World Bank (WB) health project entitled “Supporting Egypt’s Universal Health Insurance System” Project. The project aims to: (i) increase the coverage of Egypt’s Universal Health Insurance System (“UHIS”) in Phase I Governorates; (ii) strengthen UHIS-related governance and institutions; and (iii) provide temporary financial protection against high out of pocket health expenditures for vulnerable populations outside Phase I Governorates. The UHIS project components support the enrollment of the population into UHIS and strengthening UHIS governance, systems, and facilitating environment.

In 2022/23 the World Bank conducted a process evaluation to assess whether the UHIS is being implemented as intended and on track to achieve the government’s reform objectives. The focus was on the transformation process of UHIS governance, benefits, claims, information management, and provider reimbursement. Recommendations proposed ways to adjust the implementation process, including to set up a transformation program for the UHIS with a steering committee, roadmap, and support office to coordinate the reform process across agencies and governorates over the next decade.

In this regard, Egypt is developing a transformation program with a newly established Coordinating Committee (CC) created in September 2023 by the Prime Minister decree No. 3475 of 2023. This CC is chaired by the Prime Minister with the Minister of Health and Population as the Rapporteur and replaces the chair in case of his absence. Among others, the CC is responsible for establishing the roadmap for the transitional phase of the health system and preparing it for the UHIS geographical phased implementation. This is also in accordance with the provisions of the executive bylaw of the UHIL. Such roadmap should be clear and agreed upon by all parties responsible for implementing the system in Egypt’s Governorates. Additionally, the CC is responsible for the coordination and supervision of the implementation of the health system transformation process; in line with the goals and plans set in the roadmap, ensuring coordination and integration of the agencies’ plans and any initiatives with the abovementioned roadmap while setting priorities at the health system level, and assessing the relevant risks and challenges. The CC has a Technical Secretariat, headed by the Chief Executive Officer (CEO) of UHIA, that is assisting the committee in carrying out its duties. Its members are representatives from UHIA, GAHAR, EHA, MoHP and Ministry of Finance (MoF).

Technical assistance is needed to support the Steering Committee in the development of the roadmap, which sets out the expected results of the transformation and the major tasks that UHIS agencies need to implement to complete transformation. UHIA leadership now seeks to hire, under the abovementioned WB project, a consultant to the UHIA CEO to support the Steering Committee in the development of the roadmap.

Approach

The senior consultant will be based in the UHIA office in Cairo and report to the UHIA CEO. The senior consultant will work closely with UHIA leadership, management and staff, and with representatives of other UHIS entities. The consultant will be supported with personnel from the UHIA to assist in working arrangements[FM1] .

Objectives

The expected output is a document for the transformation roadmap with milestones identified for the UHIS agencies to strengthen and expand the UHIS rollout.

Scope of Work

The senior consultant will produce the following:

The UHIS transformation roadmap.

The senior consultant will support the Steering Committee in the development of the roadmap, in accordance with the mandate of the committee as described above. This roadmap should constitute the “big picture” that sets the end-state of the convergence process and the broad work streams around a clear organizational principle, i.e., by organization, insurance function, etc…, that would lead to the end goal where all UHIS organizations would be working in congruence.

It should include the roles and responsibilities, KPIs and targets, procedures of monitoring, evaluation and reporting as well as the schedule of sequenced activities/tasks and their related financing, staffing, technology, and data requirements. Each activity/task must be assigned to an agency/organization, within its prerogative, to ensure ownership and accountability. The roadmap will have KPIs to enable the monitoring of the transformation progress, which will be reviewed by the CC at least once a quarter.

The roadmap is to be constructed based on three guiding principles. First, the roadmap requires starting at the destination and working backwards. There must be a sufficiently detailed image of the destination including how each agency will operate in the end-state. Second, the transformation roadmap has intermediate-level specificity. It offers enough signposts to guide actions and eliminate ambiguity, but it does not detail each turn and step. Those work-level details are for the agency owners to decide. Finally, the roadmap should be realistic and be treated as a living document subject to periodic finetuning/updates to remain relevant. The Steering Committee will use the roadmap to guide the agencies towards the final goal. This technical assistance will benefit and build on the analysis and relevant recommendations from the previously conducted studies such as the abovementioned process evaluation of the UHIS transformation, the National Health Accounts, the Public Expenditure Review, etc. Additionally, the consultant is expected to support in identifying the needed relevant assessments that should be conducted in the future.

Deliverables

The senior consultant will produce the following deliverable:

No.

Deliverable

Weight out of the total Payment

Estimated timeline

1.

Inception Report

20%

First month

3.

Progress report (including draft developments for the roadmap document)

20%

Third month

4.

Draft roadmap document submitted to UHIA CEO

20%

Fourth month

5.

2 Consensus building workshops with stakeholders

10%

Fifth month

6.

Final roadmap submitted to Steering Committee

30%

Sixth month

 

Total contract amount

100%

6 months concluded

 

Duration of the Assignment

The duration of this consultancy is expected to be implemented within 6 months.

 

Educational and professional experience required

  • A Master’s degree in management, economics, or health economics
  • At least 10 years of professional experience having worked at top-management level in health organization, preferably health insurance
  • Professional global experience with health system reforms and with change management in middle-income economies
  • Proven experience in conducting system evaluations
  • Previous experience and understanding of working in different cultural and political contexts
  • Professional experience in Middle East is an advantage
  • Previous experience or studies in the Egyptian health system is a plus
  • Proficiency in English and Arabic is a must

Renumeration:

The contract amount will include all fees related to carrying out the services in Cairo including, but not limited to, the accommodation, travel, field trips, telephone charges, etc. These activities are to be implemented according to the TOR and MOF regulations.