New Consultancy on strengthening medical insurance for children, Beijing, China
UNICEF China is looking for a consultant, conducting a scoping exercise to identify gaps, barriers and opportunities for strengthening medical insurance for children in China
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For every child, care
Social protection is increasingly a crucial policy agenda in China. The government currently spends about a third of its expenditures on the provision of major basic public services (e.g., education, healthcare, social security and employment). Basic medical insurance (基本医疗保险) constitutes a critical pillar of social health protection in China, in addition to supplementary medical insurance (补充医疗保险), and medical assistance (医疗救助). The basic medical insurance (BMI) targets all citizens, through two separate schemes – one for employees and the other for all other residents. By the end of 2020, over 95% of the population are enrolled in BMI. The supplementary medical insurance is voluntary and targets those who are enrolled in the BMI with additional needs, e.g., the critical illness insurance program. Medical assistance targets groups with special needs, e.g., the impoverished, and those living with critical impairments etc. The three pillars are not exclusive to one another, with basic medical insurance as the foundation.
How can you make a difference?
This consultancy assignment is looking for an individual consultant to help UNICEF China identify existing gaps and barriers, as well as relevant stakeholders, based on which to provide recommendations on advocacy priorities and opportunities stemming from the ongoing medical insurance reforms to better serve children and families with children. Specifically, the exercise will look into issues at systematic, (e.g., the strategy, the policies, coordination and financing), the program (e.g., eligibility, benefit level, reimbursement packages, threshold, ceiling, OOP), and operational levels (e.g., billing and payment, portability of benefits). For the best use of limited resources, recommendations and insights from the scoping exercise shall focus on priority gaps that are of significant criticality to children and most likely to be prioritized in the government’s reform directions in the next five years.
Major Tasks, Deliverables & Timeframe:
The consultant is expected to perform a scoping exercise to: identify key gaps and barriers for children and families with children in the current medical insurance (including maternity insurance) schemes; identify key stakeholders and policy influencers; and produce recommendations for relevant policy windows UNICEF should pursue and key stakeholder engagement.
Key questions to be answered by the scoping exercise shall include but are not limited to the following:
- To what extend children (of different age groups) are covered by the current BMI scheme in terms of enrollment/coverage, benefit package (e.g., preventive and/or curative interventions covered and not covered), benefit level and out-of-pocket expenditure, and other costs;
- What gaps and barriers exist in the design and implementation of the current scheme and relevant policies (e.g., division/alignment of different schemes, financing) that lead to the inadequate and insufficient coverage for children;
- What are the key barriers that remain in the operation of BMI schemes which affect children’s access to healthcare (e.g., upfront payment requirements, portability of benefits);
- What are the main debates and latest trends of policy reforms which may present opportunities to address issues identified above.
Under this consultancy assignment, the following specific tasks will be performed by the consultant to achieve the overall objective and purpose:
- Review relevant policies and literature
The consultant will conduct a desktop review of key policy documents and latest administrative data and/or academic literature related to medical insurance and relevant reforms. The review shall aim to provide a clear picture of current status, as well as gaps and barriers for children and families with children in the current schemes, including but not limited to eligibility/criteria, coverage, benefit packages, benefit level and delivery of benefits etc. The desktop review shall also account for emerging and innovative policy solutions that have been proposed lately or may have been piloted by subnational governments to better serve children’s interest. When necessary, the consultant may carry out and document consultation with key informants. To enrich and vet analysis based on desktop review, the consultant is strongly encouraged to consult with key informants in the relevant sectors through individual interviews and/or focus group discussions.
- Map key stakeholders for relevant policy advocacy and engagement
The scoping exercise will also aim to identify key stakeholders involved in relevant policy design, management and implementation, especially those which play a key role in relevant policy making and reform. Such stakeholders may include government stakeholders, research institutes, key academia, think tanks and international organizations/development agencies which have substantial cooperation with the Government of China on medical insurance reforms.
- Develop a scoping report
Based on the above-mentioned reviews and analysis, the consultant is expected to produce a scoping report which shall at least present findings on current status, gaps and barriers in the medical insurance schemes for children and families with children, outline recommendations on key entry points, windows of opportunities, and stakeholders for UNICEF’s relevant policy engagement in the next five years.
Once the scoping report is ready, UNICEF may convene a close-door debriefing session at UNICEF China to disseminate the findings and facilitate brainstorming with its internal teams (e.g., Social Policy, Child Health Development) and external counterparts (e.g., the National Health Security Administration)on a wholistic strategy to engage in the sector of medical insurance. The consultant is also expected to participate in the debriefing session.
for more details, please refer to TOR_Scoping Exercise on Child-friendly Medical Insurance.docx
To qualify as an advocate for every child you will have…
- Minimum Academic Qualifications required and disciplines:
- Advanced education in the field of health-related social policy, social security and other related fields.
- Knowledge/Experience/Expertise/Skills required:
- At least ten years of professional experience in the field of health-related social security and social assistance research and policy analysis;
- Excellent knowledge of the medical insurance schemes and relevant reform agenda and processes in China; good knowledge of social assistance schemes in China;
- Familiarity with key stakeholders in the field of health-related social security and social assistance in China a strong asset;
- Excellent presentation and writing skills in Chinese; ability to speak/write in English an asset.
For every Child, you demonstrate…
UNICEF's values of Care, Respect, Integrity, Trust, and Accountability (CRITA) and core competencies in Communication, Working with People and Drive for Results.
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UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization.
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.
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.