According to in the Ministerial Diploma 127/2002 of July 31st, the Ministry of Health (MOH) defines the organization of Health Care Services in four levels of care and 11 types of Health Facilities: (1) Primary Level: Rural Health Facilities – type I and II -, Health Facilities type A, B and C – with or without Maternity-; (2) Secondary Level: Rural, District and General Hospitals; (3) Tertiary Level: Provincial Hospitals; (4) Quaternary Level: Central and Specialized Hospitals.
MOH recognizes the need to review this legal instrument (Ministerial Diploma) due to the evolution of the services provided by the National Health Service, starting with the design of the Essential Package of Health Services at all levels of care, including the definition of the HRH framework and the revision of the Ministerial Diploma itself.
In April 2016, MOH held the first Primary Health Care National Meeting under the theme “Primary Health Care: The Foundation of Resilient Health Systems”. This meeting recognized the adequacy of the Health Services to the real health needs of the populations, considering the importance, benefits of high level interventions that allow the prevention and protection of the population against risks and health hazards, access to essential services for the entire Mozambican population, prioritizing the poorest and most vulnerable social groups, and reducing inequity in access to health care.
International experience has shown that Primary Health Care is cost – effective, comprehensive, integrated and constitutes an efficient approach to the organization of a Health System, resulting in better levels of health and user satisfaction, ensuring continued care and Universal Coverage.
The Government of Mozambique has committed to Universal Health Coverage, focusing on Primary Health Care (PHC), whose health services are provided by three sectors:
The response capacity of the National Health System (NHS) is a major challenge. The NHS network covers about 60% of the population and the reference system is poorly functional, resulting in health facilities –with greater capacity of response – often congested.
The Primary Health Care National Meeting (RMCSP) recommended to strengthen the primary care workforce, the health infrastructure, the community involvement and to support the public policy reforms to better foster its implementation.
The MOH represented by its National Directorates and technical working groups will coordinate the design of the EPHS for each level of care.
The EPHS’s design for each level of care requires prioritizing and choosing a set of interventions that will help the country achieving its health goals and targets.
The EPHS is a set of promotional, preventive, curative and rehabilitative health interventions that should be available for the entire population. These services can be provided by the NHS, the private sector and/or in combination with other actors. Overall, EPHS aims to improve equity and efficiency of the health system by expanding access to the entire population – including vulnerable and risk groups – and reduce the financial burden of those who pay for services. The EPHS should comprise a wide set of Health and diagnostic services, the HRH framework by level of care and the costing of the services provided by level of care, as well.
The proposed EPHS should be aligned with the Health Policy, the Health Sector Strategic Plan and the Health Financing Policy from the perspective of Universal Coverage.
It should be emphasized that the definition process must be carried out in an interactive way, involving all stakeholders at all levels, covering the areas of management and assistance. The outcome of this process should take into account the following aspects:
In the medium and long term, the EPHS may need to be adapted due to changes in the demographic and epidemiological profile. Therefore, both the Human Resources framework and the infrastructures and services framework may need to be adjusted to the real needs of the patients.
Provide technical assistance to the Ministry of Health in designing the Essential Package for Health Services (EPHS) for each level of care, takin into account the multisectoral and community approach to move towards Universal Health Coverage, as well as including the definition of the Personnel (HRH) framework per levels of care and with its respective legal framework, and the costing of the package.
The consultancy will provide the following products:
The international consultant will submit a technical proposal, including a timeline.
In general terms, the methodology will have 4 phases:
The Minister’s Consultative is the forum for the approval and/or endorsement of each of the stages. It is expected that the Consultancy will work closely with the MOH technicians in each of the stages of the exercise.
The work will be carried out by an expert that meets the following requirements:
Excellent analytical and writing skills, good interpersonal and networking skills, facilitation skills and team player, advanced computer literacy skills including proficiency in word processing packages (e.g. Word) and presentation packages (e.g. Power point).
The consultancy will consist in maximum sixty (60) days to be used during the months of November and December 2019.
A consultancy fee at P3-level and perdiem in line with the WHO travel rules for international consultants
The consultancy will be based in Maputo, MOH (Planning and Cooperation Directorate).
WHO will hire the consultancy and therefore the administrative issues will be managed by WHO. However, the technically related aspects of the consultancy will be discussed with the reference group (led by the DPC). The results of this consultancy will be submitted for approval to the Technical Council (Permanent Secretary) and to the Advisory Council of the Minister