National Consultant Assessment of National Health Insurance Programme (Remote), 1.5 months, Kathmandu

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For every child, the right to health.

How can you make a difference?

The Government of Nepal introduced the National Health Insurance Program (NHIP) under the Health Insurance Act, 2017 as a key mechanism for advancing Universal Health Coverage (UHC) and reducing financial barriers to accessing essential health services. Despite several years of implementation, coverage remains limited, Acharya, D., Sharma, S., & Bietsch, K. (2024) reported that only 10% of Nepal's population was enrolled in the National Health Insurance Program according to NDHS 2022. However, Asian Development Bank (ADB) study published in 2024 reported that about 23% of the population was covered under the Health insurance, highlighting challenges related to enrollment, renewal, and financial sustainability. The administrative data form HIB reveals that about 30% of Population is covered by Health Insurance. Coverage varies significantly among provinces with highest enrollment 21% in Koshi and just about 3.1% in Madhesh. Enrollment is disproportionately concentrated among subsidized and vulnerable populations, while sustaining voluntary enrollment and renewals continues to be a significant challenge.

In addition, concerns have emerged regarding the overall sustainability and effectiveness of the scheme, including overlapping financing arrangements across social protection and insurance mechanisms, inefficiencies in claims processing and reimbursement systems, provider payment delays, variable service quality, beneficiary dissatisfaction, and governance challenges affecting strategic stewardship of the Health Insurance Board (HIB).

Recognizing the importance of health insurance reform within Nepal's broader health financing agenda, the National Planning Commission (NPC), in collaboration with the Ministry of Health and Food Safety (MoHFS), seeks an evidence-based assessment of the NHIP. The study has two fold objectives first to conduct a concise literature review of the National Health Insurance Programme (NHIP), summarizing the key challenges to achieving financially sustainable Universal Health Coverage (UHC) and second is to develop a policy brief that outlines evidence-based reform options, identifies priority research gaps, and proposes a phased roadmap of practical reforms to strengthen governance, improve operational and financial performance, increase enrollment and retention, and accelerate progress towards UHC.

UNICEF Nepal will mobilize a consultant to support NPC on the preparation of the deliverable and support coordination with national stakeholders.

The purpose of this consultancy To review Nepal’s National Health Insurance Programme and identify evidence-based actions to strengthen its performance, financial sustainability, and contribution to Universal Health Coverage (UHC).

If you would like to know more about this consultancy, please review the complete Terms of Reference here: National Consultant Assessment of National Health Insurance Programme.pdf

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

Minimum requirements:

• Education: Master’s degree in public health. PhD preferred.
• Work Experience:
• Minimum 10 years of progressively responsible professional experience in health financing, social health insurance, health systems strengthening, public policy analysis, or related fields.
• Knowledge/Expertise/Skills:
• Demonstrated experience conducting policy reviews, health financing assessments, or insurance reform studies.
• Proven experience engaging with government institutions and high-level stakeholders.
• Experience in developing reform strategies, implementation of roadmaps, or investment cases.
• Previous work experience in Nepal or similar federal governance settings is highly desirable
• Language Requirements:
  • Good command in writing, excellent communication in English and Nepal language
• Desirables:
• Strong analytical and report-writing skills.
• Expertise in quantitative and qualitative policy analysis.
• Excellent stakeholder engagement and facilitation skills.
• Ability to synthesize complex evidence into actionable policy recommendations.
• Strong communication and presentation skills

For every Child, you demonstrate...

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UNICEF promotes and advocates for the protection of the rights of every child, everywhere, in everything it does and is mandated to support the realization of the rights of every child, including those most disadvantaged, and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, minority, or any other status.

UNICEF encourages applications from all qualified candidates, regardless of gender, nationality, religious or ethnic backgrounds, and from people with disabilities, including neurodivergence. We offer reasonable accommodation for persons with disabilities. throughout the recruitment process. If you require any accommodation, please submit your request through the accessibility email button on the UNICEF Careers webpage Accessibility | UNICEF. Should you be shortlisted, please get in touch with the recruiter directly to share further details, enabling us to make the necessary arrangements in advance.

UNICEF does not hire candidates who are married to children (persons under 18). 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 based on gender, nationality, age, race, sexual orientation, religious or ethnic background or disabilities. UNICEF is committed to promote the protection and safeguarding of all children. All selected candidates will, therefore, undergo rigorous reference and background checks, and will be expected to adhere to these standards and principles. 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, and selected candidates with disabilities may be requested to submit supporting documentation in relation to their disability confidentially.

Qualified candidates are invited to submit the following documents via the online recruitment portal, TMS (Talent Management System):

• An up-to-date TMS profile and curriculum vitae (CV)
• Cover letter
• A separate financial proposal (only acceptable in the format of the linked template) Financial proposal for National Consultant Assessment of National Health Insurance Programme.docx)
• A detailed technical proposal: Sample of previous self-written report should attached.