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Grant 9057: Health Care Financing for the Poor

Ministry of Health
Health Sector Support Project
Consulting Services for Equity Funds Implementer
(for Non-Governmental Organizations, 18 months with possible extension)

The Royal Government of Cambodia has received a loan of US$ 20 million from the Asian Development Bank (ADB) and a credit from the International Development Association (IDA) in the amount of US$17.2 million, grants totaling US$9.8 million from the IDA, and US$ 22 million from the Department of International Development of United Kingdom (DFID).

This funding, along with counterpart funds of US$ 10 million equivalent, will finace the Health Sector Support Project (HSSP), which is currently being implemented under overall responsibility of the Ministry of Health (MOH) of the Royal Government of Cambodia.

The MOH would like to use portion of this Project's funds to engage a NGO to assist in implementing the equity funds (EFs) in 12 Operational Districts (ODs). Of these, 10 ODs will be funded by the Japan Fund for Poverty Reduction (JFPR) Assistance for Health Care Financing for the Poor (US$ 1.847 million).

These ODs include: ODs Ang Rokar, Kirivong, of Takeo Province, ODs Pearing and Preah Sdach of Prey Veng province, ODs Ponhea Krek and Memut of Kampong Cham province, OD Senmonorum of Mondulkiri province, OD Banlung of Rattankiri province, OD Sre Ambil and Smach Meanchey of Koh Kong province.

The other two ODs will be supported under the DFID Grant managed by the World Bank. These ODs are: OD Tbeng Meanchey of Prah Vihear province and OD, OD Kampong Thom of Kampong Thom province. The MOH may consider increasing the coverage of EFs (to be covered under this proposed assignment) to an additional 3-6 ODs at a late date subject to availability of budgetary resources.

Additional EF funds under DFID' s HSSP Maternal Mortality Reduction Component (£500,000, equivalent to about $800,000) will strengthen the focus on maternal mortality reduction.

Scope of Services:

The selected NGO(s) will be the Equity Fund Implementer (EFI) for a group of equity funds located in a cluster of ODs. The EFI will be responsible for overall EF management, operating policy, operating systems and plans, and will establish OD-level Beneficiary Systems and OD-level Fund Control Systems.

1. Define test and adopt a Beneficiary Identification System (BIS) in its cluster of ODs, using a poverty identification and monitoring tool. The BIS should draw upon other poverty identification tools already developed and in use in some districts, where possible entails a decision about the kind of credentials, or EF card, that will be distributed to the beneficiaries, the duration of the card validity (one or more years), and the operation of a definition of a beneficiary verification system, to avoid misuse of abuse of the system.
2. Define the set of health care services, including catastrophic and maternal health services, to be covered by EFs, including the medical and non-medical services to be covered.
3. Monitor the compliance by their EFs with BIS.
4. Operate a financial management system for EFs involving monitoring control and management information system reporting practices by EFs and paying EFs at least on a monthly basis.
5. Submit quarterly reports to HSSP with information about funds spent, benefits provided, overhead charges, and balance of funds.
6. Manage a system of monitoring beneficiary satisfaction with EF operations.
7. The lead NGO may apply in partnership with local NGO/s or local organizations already operating local EFs at the local OD level.
8. Enter into contracts with identified local NGOs for implementing EFs in each of the ODs in its cluster. When possible, contracts should be developed with NGOs or community structures that are already operating EFs in the area.
9. Manage Government counterpart funds contribution to the EFs in its cluster of ODs in compliance with the requirements of the RGC.
10. Conduct internal audit of the equity funds in its cluster.
11. Assess the training needs and oversee the appropriate training of EF staff recruited by local NGO/s to operate the local EFs.
12. Develop and implement a communications strategy including evidence-based awareness-raising campaigns to provide accessible information about the EFs to all potential beneficiaries, and staff of OD health facilities in its cluster of ODs. Outreach should give emphasis to public health priorities in the location and should utilize local community structures whenever possible.
13. Collaborate with a National Steering Committee, supported by an advisory subcommittee comprising members from the MOH, donor partners and financers supporting EFs, and other health sector partners.

Qualifications and Experience Required:

1. Experience with developing and managing equity funds, social health funds, health insurance funds for the po


2. Experience in design and implementation for schemes for identifying the poor for targeted services and in demand-creation intervention;
3. Experience with the financial management, control and internal audit of similar types of fund or service. NGOs may, if considered necessary, partner with specialized agencies to bring this type of experience to their expression of interest; and
4. Ability to provide evidence of satisfactory performance in both service delivery and fiduciary and financial aspects in managing contracts of similar size (e.g. through audit reports and evaluations of previous assignments similar to this).

The Equity Fund Implementer will be selected following an open competitive bidding process. The conflict of interest clauses applicable to ADB/WB assignments will apply.

Interested NGOs shall submit their Expression of Interest no later than 15 February 2006 to:

Health Sector Support Project
Ministry of Health
#151-153 Kampuchea Krom Blvd.
Phnom Penh, Cambodia
Attn: Dr. Char Meng Chuor, Project Coordinator