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Consultant

THE WORLD BANK

TERMS OF REFERENCE

DIGITAL HEALTH PROJECT LEAD IN LIBYA

A.PROJECT BACKGROUND AND OBJECTIVES Project Background:

Libya has made significant progress in achieving positive health outcomes in the last decade, but it still sees health conditions seen in lower income countries (LIC). The country’s epidemiological transition mimics that of other upper middle-income countries (UMIC) in moving from high mortality among infants and communicable diseases to life style related noncommunicable diseases (NCD). However, while its mortality rates have declined, it still faces significant fertility rates and is in the midst of a nutrition transition, where one sees undernutrition (such as in LIC) along with obesity (such as in UMIC). Additionally, due to the conflict, the socioeconomic and demographic situation is changing. Households are becoming vulnerable, as many have lost jobs and income, and price inflation of goods and services are rising faster than wage inflation. At least 20% of the population is displaced with limited access to basic health care: water, sanitation, health, education.

Access to many basic primary health care services are lacking in quantity and quality. Due to the conflict, only one-third are fully functional. Most services, including child immunization and normal delivery services, typically found in primary health care clinics, are available at less than 40% of facilities (WHO, 2017). Staff shortages, drug stock outs, and limited funding for recurrent budgets have made many of these facilities ineffective. There are serious concerns both in access and the quality of the care being provided.

Additionally, though the Libyan health delivery system is hospital centric there are major regional of “effective” hospital beds and lack of services being provided due to human resources for health (HRH) losses and operations budget constraints. For example, general medical curative and emergency services are available in at least 60% of hospitals, while only 50% of hospitals offer child delivery services.

For these reasons, the Libyan Ministry of Health (MoH) and the World Bank are working to improve the health services provided in Libya, especially during the COVID-19 pandemic. The MoH suggested six areas of potential work and telemedicine health services was selected as the first priority area. The objective of this work is to develop an implementation plan to improve the stewardship and delivery of telemedicine services in Libya, addressing the technical, financial, and legal aspects.

To this end there will be three major areas of work in this first phase:

1.Situational analysis, a rapid review of current COVID-19 oriented telemedicine systems to identify gaps, establish an operational business model, and recommend the way forward;

2.Analysis of the current legal framework for telemedicine in Libya to provide recommendations for updates to further enable telemedicine;

3.Learning from global experiences by interacting with governments and providers in other countries.

The primary objective of the TOR is to perform the in-country work and management for these areas of work. The person selected will be working directly with the Libya World Bank team and be supervised and supported by the Service Delivery team.

B. SCOPE OF WORK

Situational analysis

1.Identify all telemedicine and direct to consumer digital health interventions in Libya including services provided, cost, scale, other countries where intervention has been used, evaluations performed of the service, plans to scale the intervention further, and current problems they are facing.

o Review relevant peer-reviewed, grey literature, and published data related to these interventions.

o Conduct key informant interviews with country leaders, country partners, private sector organizations, and other relevant policy makers.

2.Identify the benefits of sharing information between these interventions grouped by the type of information to be shared.

3.Identify current gaps and bottlenecks in both physical and telemedicine services, potential barriers to further expansion of telemedicine services, and the priority of each of them from the MoH.

o Conduct key informant interviews with country leaders, country partners, private sector organizations, and other relevant policy makers.

4.Provide recommendations on how to strengthen the telemedicine services provided in Libya which includes:

o an analysis of the current gaps in care being provided by both the health system and the telemedicine/direct to consumer interventions.

o identifying telemedicine expansion opportunities to fill service coverage gaps.

Legal framework

1. Manage legal consultant to ensure deliverables are met

Global telemedicine experiences

1.Connect the Libyan government with multiple telemedicine providers and regulators in other countries to discuss and learn from their experiences.

2.Coordinate these meetings and their outputs

Other areas

1.Provide technical support and advise to the Libya World Bank country team, as needed

2.Provide coordination support to the Libya World Bank country team, as needed

C.DELIVERABLES

1.Inception report with finalized list of data items to be collected, list of interviewees and systems to be analysed, and list of international organizations to connect to Libyan government.

2.Draft report of recommendations.

3.Document with all interventions analysed.

4.Final report of recommendations

5.Report of all meetings coordinated with international organizations and the lessons learned from each meeting.

D.REQUIRED EXPERTISE

• The consultant will have at least a master’s degree in Community Health, Public Health, Global health, Medicine, or related field, or equivalent, with 5+ years of experience in health informatics or service delivery innovation within the health sector in LMICs.

• Preferred if consultant is based out of Libya

• Preferred if consultant has a working knowledge of Arabic

• This work is expected to be full-time for approximately 2 months, with a possible extension.

E.PAYMENT SCHEDULE

Every two weeks as deliverables are being met

Please submit your CV to : Moataz.shikhy@gmail.com
Email Subject MUST include Position title