REQUEST FOR EXPRESSION OF INTEREST (REoI) For the Public Expenditure Tracking Survey (PETS) of National Hospitals and Health Facilities Adhered to Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS) under Sehatmandi

Islamic Republic of Afghanistan         

Ministry of Public Health

Directorate of procurement

Grant and services contract management unit (GCMU)

) Sehatmandi Project(

(Project ID: 160615) / (Grant No.: XXX)

REQUEST FOR EXPRESSION OF INTEREST (REoI)

For the Public Expenditure Tracking Survey (PETS) of National Hospitals and Health Facilities Adhered to Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS) under Sehatmandi

Project

Reference Number: REoI/Sehatmandi/ 04                     Date: September 30, 2018

A. BACKGROUND

Afghanistan’s health sector funding comes from government’s core budget allocation, out of pocket payments (OOP), and external assistance. According to the Afghanistan’s National Health Accounts (NHA 2014) report, total health expenditure (THE) in 2014 was USD 1,992,000,402. This represents a significant 32 percent increase since the second round of NHA in 2011-2012. Private sources (mainly households) were the main financiers of the Afghan health system in 2014. This accounted for nearly three-quarters of all health spending (73.1%). The remaining 27% is financed publicly through the donors and government of Afghanistan resources – 21.8 and 5.1% respectively.

The Health Care Financing and Sustainability Strategy 2014-2018, outline low per-capita public health spending and limited cost data as challenges hindering informed health financing decisions. The strategy also prioritizes increasing the efficiency and equity of public spending using various mechanisms. It further emphasizes on promoting aid effectiveness, efficiency and equity of public health spending, and eliminating waste of resources.

A Public Expenditure Tracking Survey (PETS) tracks the flow of funds managed by the government (public funds and “on-budget” donors’ resources), through the administrative health hierarchy and implementer organizations out to frontline service providers. PETS is intended to provide information about the level of public resources allocated to different parts of the health sector and also how service providers sponsored by public funds are using the funds received by public budget or other resources. This is to determine: (a) how much of the originally allocated resources reach each level and how long they take to get there, and (b) how eventually “off-budget” resources and out-of-pocket payments have been captured and used by the health service providers. The survey therefore assesses the leakage of public funds, the eventual use of other funds and can help to assess the efficiency of public spending and the quality and quantity of services. The aim is to improve the quality of service delivery at the health facility level.

In the beginning of 2015, the second round of the PETS conducted among National Hospitals and Health Facilities Adhered to Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS) that tracked the flow of funds, and assessed delays and leakages of the flow of funds from the source (Ministry of Financing) and intermediary (Ministry of Public Health) to the service provider level.

Afghanistan’s third Public Expenditures Tracking Survey (PETS) will collect valuable data to track public expenditures for improved accountability and efficiency. Such data will also be used to monitor progress in the health system budgeting process. The third round of the PETS will comprise of four components: (i) a tracking component that seeks to assess delays and shortfalls in the execution of approved budgets for health services; (ii) identification of any leakage of financial resources from the origin through the intermediary administrative level in MoPH to the National Hospitals and  health facilities working in the frameworks of Basic Package of Health Services (BPHS) and Essential Package of Hospitals Services (EPHS); (iii) assessment of the impact of delays and leakages on health service delivery and; (iv) some evidence on how health services institutions are complementing public budget by receiving funds and delivering services financed by “off-budget” resources from donors and by out-of-pocket funds received from families.

B. The assignment objectives:

B1. General Objective: The general objective of the PETS 2019 is to track public expenditures in national hospitals and health facilities adhered to BPHS and EPHS frameworks, measuring (a) the extent to which the nationally allocated budget/resources reach the service provider level and (b) the extent to which the system is transparent and accountable. In addition to that, it will track the sources and uses of off-budget resources, detailing how these resources have been used by the health units, Non Governmental Organization (NGOs), private sector or other public or private stakeholder and service provider in the health sector.

Given the previous PETS and the implementation (fully or partially) of its recommendations, the 2019 survey will provide elements to analyze if the previous identified problems remain, contributing to the design of new policies to strength financial management and efficiency of central hospitals and (NGOs), as well as contributing to increase local autonomy of the national hospitals and health systems at regional/local level.

B2. Specific Objectives: The specific objectives of the PETS 2019 are:

1. to assess the processes and procedures involved in overall National Hospitals, BPHS and EPHS budget planning, allocation, disbursement, and execution financed through Sehatmandi project;
2. to determine the reasons behind any possible delays in budget execution at each step;
3.  to identify in case there is any leakage or diversion in funds flow along different stages;
4.  to determine how much of the allocated fund is spent on the intended service delivery units;
5. to assess impact of budget execution delay and possible leakages in the adequacy of resources, resources efficiency and, quantity and quality of services delivery at each public health facility level, and;
6.  to track the sources and uses off-budget resources, detailing how these resources have been used by the health units, NGOs, private sector or other public or private stakeholder and service provider in the health sector
7. to provide specific recommendations for improvement of transparency and accountability in utilization of public resources.
8. In terms of Total Health Expenditures (THE), the PETS will need to estimate:
   1. How much is being funded from on-budget (domestic revenue + grants)
   2. How much is being funded through off budget sources, and
   3. How much is eventually financed directly by citizens and how much it should represent of the total out of pocket resources in the country;

The MoPH now invites national and international eligible firms to indicate their interest in providing the above services. Interested firms should provide information demonstrating that, they have the required qualifications and relevant experience to perform the Services.

The implementation period will be around 6 months starting from February till July 2019.

C. Criteria for Short listing: The short listing and eligibility criteria are:

1. General Qualification of the Consultant/Firms along with date of establishment and official registration document of the firm (in Afghanistan, or other countries);
2. Experience in providing the same or similar services (provision/management and conducting  of survey with brief information on date, duration, location, fund amount and donor) in Afghanistan or in countries at a similar level of socio-economic development;
3. Governance, organizational structure and availability of Human Resources;
4. Recent annual financial audit report for organization (to cover all the projects supported  by different donors)

D. Procedure/Method of selection: The consultant will be selected in accordance to Quality & Cost Based Selection (QCBS), and with the procedures set out in the World Bank Procurement Regulations for IPF Borrowers, July 2016-revised November 2017.

EOIs will be evaluated on the quality of responses to the items listed above. After evaluation of the EOIs, only shortlisted applicants will be qualified to receive the Request for Proposals (RFP).

The attention of interested Consultants is drawn to paragraph 3.16 and 3.17 of the World Bank Procurement Regulations for IPF Borrowers, July 2016-revised November 2017,  setting forth the World Bank’s policy on conflict of interest. 

The EOI must be presented in English and must be delivered with a covering letter (signed and stamped) by the following means:

• Those applicants who can submit the EOI in person (Hand –Delivery by their staff) are required to submit a total of six (6) copies (One original and five copies) in a sealed envelope, along with soft copy in a labeled CD-ROM. Each page of the original version should be signed and stamped.
• Those applicants who cannot submit the EOI in person (Hand –Delivery by their staff) are required to submit their EOI, along with scanned copy of the receipt of the courier by email, and send the six hard copies (One original and five copies) in a sealed envelope by international courier.

If a firm wishes to apply, it is kindly requested to submit the EOI in sealed and stamped envelope which must clearly indicate the following information on the outside of the envelope:

The deadline for submission of the EOI is Oct  20, 2018. (corresponding to Mizan 27, 1397) at 2:00 pm Kabul time. The EOI must be submitted before the submission deadline to the aforementioned address.

Interested Consultants may obtain further information from the contact provided below from 09:00 am to 02:00 pm Kabul time before Oct  20, 2018. (corresponding to Mizan 27, 1397)

Grant and Services Contract Management Unit (GCMU)

Ministry of Public Health

Kabul, Afghanistan

E-mail:             info@gcmu-moph.gov.af