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Tender description :
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Tenders are invited for Individual Consultant to Develop a Framework for Evaluating the Voluntary Social Health Insurance Scheme of the NSSF
Description
The objective of this assignment is to prepare an evaluation framework needed for the policy, process, and actuarial evaluations of the voluntary healthcare scheme for self-employed workers and dependents of NSSF members. This evaluation framework will provide the basis for the comprehensive evaluation of the voluntary healthcare scheme which will be conducted as a follow-up intervention. The consultant is NOT expected to conduct the evaluation through this assignment. The evaluation of the scheme is intended to support both policy, parametric and process reforms to support the implementation of UHC in Cambodia.
Scope of work
The framework concerns the policy design, process, and the actuarial valuation of the scheme. The consultant is expected to map relevant evaluation questions and specify the data needs, including data sources, collection methods, and possible analysis techniques. The objective of the process evaluation framework is to understand how well the scheme is working, the extent to which the programme is being implemented as designed, and the factors (if any) which are moderating the delivery of the programme. The process evaluation framework is expected to define the indicators needed to provide insights on the implementation processes and how they can be improved, and if (any) scheme’s failures or slowdowns are the result of design flaws or delivery gaps. The objective of the policy design evaluation framework is to provide key questions on the adequacy of the parameters, eligibility conditions, benefit provisions, target group definition, and other relevant dimension to understand whether the policy meets the needs, capacity, and objectives of the target population and the NSSF, and the extent to which the programme is being implemented as designed.
Relevant dimensions that can be included in the design and process evaluations are:
- service accessibility
- eligibility
- complaints and grievances
- enrolment
- benefits
- case management
- contribution collection
- compliance
- beneficiary perceptions
- consumption
For the actuarial valuation framework, the consultant is expected to prepare a framework that defines the indicators needed to measure the sustainability of the scheme. Relevant dimensions that must be included are:
- Demographic and socioeconomic data of registered members.
- Enrolment, contribution, eligibility indicators.
- Healthcare utilization.
- Financial data on expenditures, revenues, reserves.
The scope of the work does not entail performing the design, process, and actuarial evaluations. The scope of the work does not entail a framework for an impact evaluation.
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