International Consultant: Costing and Financing of Community Health and Nutrition, UNICEF Regional Office for South Asia, Kathmandu, Nepal, November 2024 to September 2025 (82 Working Days) (Home-Based)

United Nations Children's Fund

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JOB DESCRIPTION

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. To save their lives. To defend their rights. To help them fulfill their potential.

Across 190 countries and territories, we work for every child, everywhere, every day, to build a better world for everyone.

And we never give up.

For every child, Health 

Over the last decades, South Asian countries have made notable progress in strengthening the health systems and in improving the health status of children. Despite these achievements, South Asia continues to face complex political, economic, social and health challenges. Repeated health emergencies including the COVID-19 pandemic, natural disasters, political conflicts and socio-economic crises have put the health systems in South Asian countries under stress, leading to disruptions in the provision of essential health care, insufficient service coverage for the most vulnerable populations, and high out of pocket health-related costs.

Despite a 60% reduction in child mortality in the past two decades, the region continues to experience high numbers of newborn deaths with over a million children dying each year before their 5th birthday. 53.8 million stunted children live in the region and more than 47,000 maternal deaths occur each year. These high numbers of maternal, under-five and infant mortality are mainly driven by inadequate and unequal access to antenatal and postnatal care.

Additionally, the burden of disease in the region has increasingly become complex, with non-communicable diseases (NCDs) on the rise due to urbanization and lifestyle changes. NCDs contribute to 65% of the overall disease burden in the region. Immunization coverage has recovered since the COVID-19 pandemic; however issues with access and equity remain, with 3.8 million zero-dose children living in South Asia, the region has the second-highest number of zero-dose children globally. These are children who tend to experience multiple deprivations such as poor nutrition, limited access to safe and clean water, in addition to challenges accessing basic primary health care services.

With access to basic primary health care and its quality having severely been affected by the COVID-19 pandemic, repeated natural disasters and ongoing conflicts in the region, the health and well-being of children and mothers are at risk, with the danger of countries experiencing reversing progress in child survival and development. Therefore, particular attention and investments need to be oriented in making health and nutrition systems more responsive and resilient, with a focus on building stronger health and nutrition service delivery systems, with particular emphasis on community-based primary health care and nutrition services.

It is based on this background that UNICEF Regional Office for South Asia and UNICEF Country Offices in the region are prioritizing strengthening primary health care and nutrition services at the community level and Community Health and nutrition as a critical agenda for reaching the Universal Health Coverage (UHC) but also for building resilient communities to ensure adequate response and preparedness again future health emergencies.

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The use of the term “Community Health and Nutrition” (CHN) aims to underscore a broader scope of Health and well-being, emphasizing the burden of nutrition issues on the health and well-being agenda, particularly in South Asia. CHN is defined as a framework that encompasses a comprehensive approach to promoting and protecting the health and well-being of children and community members. The inclusion of nutrition into the concept of community health acknowledges the intricate link between nutrition and health outcomes.

Investing in community health as the equity arm of Primary Health Care is essential in addressing the main drivers of maternal and child deaths, in responding to growing rates of chronic, noncommunicable diseases as well as in ensuring adequate preparedness against future epidemics and emergencies.

UNICEF works with Governments and key development partners to elevate community health and nutrition as a priority in national and global agendas. Working closely with governments and key development organizations, UNICEF prioritizes community health and nutrition on both national and global scales. This effort is guided by high-level commitments and advocacy actions, particularly for community-based primary health care (PHC) and is led by the Executive Director’s office.

In 2023, UNICEF ROSA undertook a rapid mapping of community health and nutrition programmes and polices initiative across all eight countries. Overall, the assessment revealed limited performance, scalability, and sustainability of CHN programmes in South Asia due to weak enabling environments around policies, financing, and multisectoral coordination.

A key pillar of the support that UNICEF offers is with evidence generation, both to support its advocacy efforts, and to support governments with the development of sustainable financing strategies that offer value-for-money.

This will include the development of Cost-Effectiveness Analysis (CEA) to identify areas where additional investment can lead to the highest levels of impact. This exercise will underpin multi-year investment cases which set out credible policy options to scale up financing, with a view to delivering well-funded and efficiently run community health and nutrition approaches are adequately supported across the region. This will be accompanied by financing (or fiscal space) strategies, which include clear and credible options for creating the fiscal space necessary to support the increased investments despite tight macro-fiscal conditions.

The primary purpose of this consultancy is to provide guidance and support to three Country Offices (COs) – Afghanistan, Bangladesh, and Pakistan – in UNICEF’s South Asia region which are undertaking costing exercises (including a financial gap analysis), cost-effectiveness, and fiscal space analyses for community health and nutrition. Each CO will employ the services of a national consultant, who will be primarily responsible for the additional data collection analysis required to develop these knowledge products. It is worth noting that COs are building on previous work that has already been conducted, with Community Health Worker strategies and nutrition plans already fully or partially costed, supported by Social and Behavior Change (SBC) strategies.

The role of the consultant will be to harmonize the approach taken across the COs, and to provide detailed guidance and hands-on support to COs with methodological guidance, guiding and reviewing data collection and analysis, and supporting the drafting of succinct knowledge products that are suitable for advocacy purposes. This will involve the development of guidance and template documents.

Furthermore, the consultant will be responsible for bringing these work streams together to produce regional overview documents for South Asia which synthesize the CO investment cases and costing exercises, producing a compelling regional narrative for investing in CHN.

How can you make a difference?

  • Conduct an initial desk review, supported by key informant interviews with relevant UNICEF staff, to provide a summary overview of the relevant data, evidence and background documentation that will support the three COs (Afghanistan, Bangladesh, Pakistan) with developing their investment cases.
  • Develop an inception report (work plan) that sets out the detailed timelines for the project. This should also set out the gaps in data and evidence, with guidance on how to address these gaps for each CO. This exercise will be coordinated and guided by the ROSA health economics and public finance specialists.
  • Develop methodological guidance and template approaches to ensure consistency in the methodological and presentational approaches for costing, financing and fiscal space analyses for their Community Health and Nutrition Roadmaps and/or strategies. Where relevant, the consultant can utilize established methodologies and examples of good practice. This will involve the development of product templates.
  • Provide hands-on support to the three COs. The consultant will be required to peer-review the data collection, inputs and analysis carried out by CO consultants. Furthermore, the consultant will be responsible for quality assuring the final products to ensure they are ready for publication. Support and feedback will be provided by UNICEF staff in reviewing these documents, though the consultant will be responsible for ensuring this feedback is adequately reflected in the finalized deliverables.
  • Conduct a brief review of the community health and nutrition costs and analysis in the remaining five South Asian countries (Bhutan, India, Maldives, Nepal, Sri Lanka).
  • Develop a brief regional synthesis publication that pulls together the evidence generated and published across the region. This will include a region-wide financial gap analysis, based upon the CO deliverables, and a synthesis of the investment cases that demonstrate the urgent need for investment in community health and nutrition in South Asia.

Key Deliverables:

Tasks/Milestone Deliverables/Outputs Delivery deadline
Develop inception report Complete inception report outlining project timeline, deliverables, gaps in data/evidence, and guidance on how to address the gaps. End November 2024
Provide support to Afghanistan, Bangladesh, and Pakistan COs (data collection/analysis, literature review, quality assurance) 1) Complete initial desk review (data for 3 COs) with relevant literature, evidence and background documentation and stakeholder consultations. 1) December 2024
2) Peer-review the data collection, inputs and analysis carried out by CO consultants. 2) Rolling support until Sept 2025
Methodological guidance Support methodology selection, application and data analysis for CHN countries/region.

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Develop methodological guidance and template approaches to ensure consistency in the methodological and presentational approaches for costing, financing and fiscal space analyses for their Community Health and Nutrition Roadmaps and/or strategies.

Rolling support until end of consultancy (Sept 2025)
Brief review of the community health and nutrition costs and analysis in all eight South Asian countries (incl Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka) Undertake a preliminary costing analysis of the available Community health and nutrition elements (of Roadmaps) and present an overall estimated envelope. Compile into a costed CHN “envelope” for the region. 1st week December 2024
Develop a brief regional synthesis publication/report (in Word) Prepare and draft regional report for publication (in Word), bringing together the evidence generated and published across the region on Community health and nutrition costs and budgets. This will include a region-wide financial gap analysis, based upon the CO deliverables, and a synthesis of the investment cases that demonstrate the urgent need for investment in community health and nutrition in South Asia. Sep-25
Final project report (and all data sets, data analysis and inputs generated during the consultancy period related to this project) Complete final project report. 1st October 2025
Travel To provide adequate supervision and support to the three country offices (Afghanistan, Bangladesh, Pakistan). The consultant will be expected to travel once to each of the three COs (Afghanistan, Bangladesh, Pakistan). The consultant will undertake additional data collection, provide hands-on guidance and supervision to the national consultants.

To qualify as an advocate for every child you will have…

  • Minimum 12 years of work experience at the international and/or national level in health economics research or analysis, primary health care and health systems financing, budget analysis, community health program costing with use of common community health costing tools.
  • Master’s degree in health economics, health finance, economics, finance, public health, epidemiology.
  • Experience in providing technical assistance and thought leadership surrounding the economic analysis, cost-effectiveness studies, design, and implementation of primary health care and/or community health and nutrition programs.
  • Knowledge and experience in community health/primary health care programmes.
  • Demonstrated knowledge and experience in using common costing methodologies (e.g., UNICEF/MSH community health costing and planning tool, EQUIST, LIST, etc.) is a must.
  • Excellent English writing skills.
  • Exposure to UNICEF, UN or other INGO programmatic areas, including (but not limited to) health, nutrition, child protection and/or education, and experience in analysis of primary health care systems to inform program review and decision-making.

For every Child, you demonstrate…

UNICEF’s values of Care, Respect, Integrity, Trust, Accountability, and Sustainability (CRITAS).

To view our competency framework, please visit  here.

UNICEF is here to serve the world’s most disadvantaged children and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, age, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, or any other personal characteristic.

UNICEF offers reasonable accommodation for consultants/individual contractors with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment.

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.

Remarks: 

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Only shortlisted candidates will be contacted and advance to the next stage of the selection process.

Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws.

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts.


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