Hospital Service Management Advisor
Government of Timor-Leste
Government Organisation
Closing date: 16 Nov 2009
Location: Timor-Leste
Dili with travel to districts
Position Title: Hospital Service Management Advisor
Unit: Hospital Directorate
Reporting to: Dr. Ana Pereira Magno, National Director of Hospital Services and Referral
Version: 1
Position Start: December 2009
Position End: December 2011
Probation period: 3 months
Background of the Project
The Ministry of Health of Timor-Leste has received International Development Agency (World Bank – IDA) grant together with AusAID Trust Fund Grant for the Health Sector Strategic Plan – Support Project (HSSP-SP). The overall objective of the project is to improve the quality and coverage of preventive and curative health services, particularly for women and children, in order to accelerate progress toward the health Millennium Development Goals (MDGs). Specifically, the project aims to improve accessibility to, and demand for, quality health services, strengthen management, human resource development, and support systems, and improve overall coordination, planning and monitoring working within the Ministry of Health system.
Background to Position
When Timor-Leste emerged from conflict, it faced the challenge of rebuilding its health system from the ground up. Over 75 percent of health infrastructure was damaged or destroyed, and many senior-level staff, including some 85 percent of doctors, left the country. Preventive services such as immunization were effectively brought to a halt, despite attempts on the part of non-government organizations (NGO) to provide health services during the transition.
Since that time, rapid progress has been made in rehabilitating the health system, due in large part to an early focus on developing a realistic, pro-poor policy framework. The Ministry of Health (MOH) has responsibility for the provision of health services. A Health Policy Framework, Health Strategic Plan and Medium Term Expenditure Framework have been developed and approved, and the rehabilitation of facilities is nearing completion for the most part in accordance with the service delivery system defined in the policy framework. Systems for managing the human and financial resources needed to deliver the planned level of services to the community are being refined, and access to primary health care services has increased considerably. Many challenges remain, however. Prioritization of spending in the health has been essential to maintain the Government’s desired emphasis on cost-effective and pro-poor health care services that improve the health status of its citizens.
Objective of the Assignment
The purpose of this assignment is to support the Ministry of Health National Directorate of Hospital Services and Referral:
(i) To implement a system of policies and procedures to define appropriate standards of patient care, and delivery of services in the Hospital Services Package;
(ii) to define and implement an accountability system for patient outcomes, financial management and supply functions
(iii) to analyse staff and management professional development needs and develop a feasible plan for implementing strategies to meet those needs;
(iv) if appropriate, to assist the Ministry and/or hospitals to develop twinning relationships with appropriate institutions in neighbouring countries by identifying potential candidate institutions, supporting the Ministry in making initial enquiries, and in the development of appropriate contracts or memoranda of understanding to sustain the relationship;
(v) to advise on a framework for monitoring and evaluating progress in the implementation of the plan.
Scope of services:
The advisor, under the direction of the Director, National Directorate of Hospitals Division of the Ministry of Health will:
1. Work with the Directorate, to further develop Hospital based policy/procedures to improve professional standards and patient safety. These should be applicable to the whole hospital system but be tested in the 5 referral hospitals.
2. Advise on building and implementing accountability systems starting with clear accountabilities for patient care and outcomes, financial management and supply functions.
3. Support management in developing skills
4. Advise on strategies for staff professional development ( on the job)
5. With the Directorate, propose a practical system for monitoring and evaluating progress in implementation of these systems and management and staff development activities;
6. Support twinning arrangement activities between hospitals in Timor–Leste and Overseas.
The Advisor
The advisor will have comprehensive practical experience in the implementation Basic Package of health Services- essential services for hospitals, service delivery at the hospital level, strong management and clinical management and a demonstrated capacity to work effectively in cross-cultural settings. The consultant will have appropriate qualifications in hospital services management and a demonstrated record of achievement in management improvement, ideally in countries that have similar structural and capacity issues.
Activities
A 2 year contract is envisaged, with the initial analysis phase to take three months, following which a workshop of Ministry and Hospital managers, and World Bank technical and hospital advisors will agree detailed priorities, timelines and deliverables for the remainder of the assignment.
List of Reports, Schedule of Deliverables, Period of Performance
Reports and Deliverables
Inception Report: 14 days from commencement
Training and Capacity Building Program: 12 weeks from commencement
Progress Reports against work plan noting variation in from approved work plan. Every 3 months
Final Report: 14 days prior to completion
Project Quarterly Financial Reports Every 3 months and sent to donors and project implementers within the required timeframe quarter
Policy Matters
The exit strategy of the Hospital Service Package Commission should be incorporated in the elaboration of policies and procedures.
Working with the Directorate to provide advice with future Hospital based policy/procedures to improve professional standards and patient safety.
Technical and Management
By developing an operational document for HSP implementation using structures, organs and functions at the National Directorate and Hospitals, provides an enabling environment to the improvement of management of hospitals so they function effectively and efficiently as part of the health system.
The annual planning process of all hospitals should be done with the inclusion of the Directorate. The methodology and processes in the development of a common plan with the Directorate is essential.
The technical areas addressed by the Hospital Service Package Commission should be taken up as a guide and initial tool in selection of technical strategies.
Supervision/Coordination
The Advisor will facilitate the establishment of the links between the Hospital and the PHC service delivery system. A communications strategy to enhance supervision and coordination is a priority for the adviser to develop with the Director and the three departments at the Directorate.
Transfer of Knowledge
One of the core responsibilities of the Hospital Advisor is to establish an effective strategy to improve the capacity of the Hospital Management team in order to implement and maintain effective and quality service delivery. The Advisor is expected to develop an appropriate skill transfer program whereby through on-the-job training, distribution of tasks between the advisor and hospital management team.
Probation Period:
3 months from time of engagement. Prior to the completion of this period, the Ministry will decide if to continue the services of the consultant or not. If services are to be terminated, then 30 days notice will be provided, during this time the consultant is to handover all information, material, data and equipment relating to the service and in his/her position, to a person nominated by the Ministry.
Performance Assessment:
At the end of the contract period or annual basis, whichever is the lesser; the Ministry will provide an assessment of the Consultant’s performance and provide a written summary.
Data, Local Services, Personnel and Facilities to be Provided by the Borrower
The Ministry of Health will provide the following items for use by the consultant:
a. Office space within the National Directorate of Hospital Service Referral, office furniture and access to office equipment, phone and email.
b. Vehicle for travel outside of Dili only (not private use)
c. Rooms, as required, for training and meetings.
d. Consumables related to normal performance of services, including training.
Essential
1. A Masters in Hospital Management or Masters in Health Management.
2. At least 10 years of experience in a hospital management in a resource poor or fragile states environment.
3. Comprehensive practical experience in the implementation Basic Package of Health Services
4. Experience in service delivery at hospital level
5. Management skills and clinical knowledge and achievements in management improvement
6. Excellent communications skills and an ability to work with people from a diversity of backgrounds;
7. Fluency in English.
Desirable
1. Language ability in Portuguese, Tetum, Spanish or Bahasa Indonesian
Duration of the Assignment:
The assignment will be initially for a period of 24 months, subject to review of satisfactory performance at the end of the first 3-month probationary period; subject to a full performance review, the availability of funding and the circumstances of the Ministry prevailing at that time, an extension to the contract may be considered.
Reporting:
On a day-to-day basis the advisor will report to Dr. Ana Magno, the National Director of the Hospital Services and Referral, with frequent contact with Director Heads of
Duty Station: Position will be based at the Ministry of Health in Dili. However, there may be occasional travel to the districts.
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