Consultant to Development the Secondary Care Model

SPECIFIC PROCURMENT NOTICE

REQUEST FOR EXPRESSION OF INTEREST

Republic of Lebanon

Ministry of Public Health

Lebanon Health Resilience Project (P163476)

Consultancy Services for

Development of the Secondary Care Model

(Loan No. 87710-LB)

The Lebanon Health Resilience Project (LHRP) is a five-year project funded by the World Bank. The project is designed to support the Ministry of Public Health (MoPH) strategy to establish a pro-poor Universal Health Coverage program. The project aims to increase access to quality healthcare services to poor Lebanese identified by the Ministry of Social Affairs (MoSA) through the National Poverty Targeting Program (NPTP), based on a proxy-means testing targeting mechanism. All identified individuals will benefit from comprehensive packages of defined health services delivered at 204 Primary Health Care Centers (PHCCs) selected from the MoPH PHCCs network.

The Ministry of Public Health is seeking to recruit a Consultant to Development the Secondary Care Model.

The MoPH hereby invites eligible Consultants to indicate their interest in providing the Services. Interested Consultants should provide information indicating that they are qualified to perform the Services.

The consultant will be selected in accordance with the procedures set out in the World Bank's Procurement in Investment Project Financing Goods, Works, Non-Consulting, and Consulting Services (dated July 2016 and revised in November 2017, August 2018 and November 2020)

Interested Consultants are requested to provide the following information:

• A CV showing relevant similar experience, and previous academic and professional achievement.

Expression of Interest must be delivered electronically to the address below not later than June 23, 2025. The subject of the e-mail should be: “Lebanon Health Resilience Project – Secondary Care Model Consultant”.

Ministry of Public Health

Attention: Lebanon Health Resilience Project (LHRP)

Title: Project Management Unit (PMU)

E-mail: lhr.covid19@gmail.com

Lebanon Health Resilience Project

TERMS OF REFERENCE

Consultancy for the Development of the Secondary Care Model

1. BACKGROUND AND OBJECTIVES

The Government of Lebanon (GoL) has received financing from the World Bank toward the cost of the Lebanon Health Resilience Project (LHRP). The LHRP is a seven-year project that aims to increase access to quality healthcare services to vulnerable Lebanese people and to strengthen the Government’s capacity to respond to COVID-19. This project aims to: (i) provide subsidized packages of essential healthcare services to 210,000 vulnerable Lebanese living under poverty line identified by the Emergency Social Safety Net (ESSN) Project; (ii) strengthen the technical and organizational capacities of the Ministry of Public Health (MoPH), Primary Health Care Centers (PHCCs), and public hospitals; (iii) cover the hospitalization bills for COVID-19 and non-COVID-19 claims at private and public hospitals for uninsured Lebanese; and (iv) strengthen the Government of Lebanon’s capacity to respond to COVID-19 pandemic.  

Situational Analysis:

Lebanon, marked by long-standing political instability, has faced recent overlapping crises, such as the financial collapse, political paralysis, the COVID-19 pandemic, the Beirut Port explosion, and lately the Israeli attacks, which worsened inflation, poverty, and institutional disruptions, reversing progress in health outcomes and Sustainable Development Goals (SDGs).

The ongoing crisis continues to threaten the health and well-being of Lebanon's population and communities. For the past few years, Lebanon’s health system has been severely affected across its six foundational pillars: governance, health services, human resources, information systems, medical products, and health financing. Consequently, healthcare availability, affordability, accessibility, and quality have declined, with many delaying treatments or seeking alternatives, often resulting in preventable complications.

Rationale of the Consultancy:

While primary health is secured through MoPH’s network of PHC centers and tertiary care is provided by various public and private guarantors, secondary care services remain largely under-covered, particularly for beneficiaries who rely on the MoPH for health service delivery and coverage.  This gap in coverage further limits access to essential healthcare for vulnerable populations and exacerbates the financial burden on households already struggling with poverty and economic instability. Recognizing these challenges, the MoPH is exploring secondary care coverage as part of its broader efforts to achieve Universal Health Coverage.

A secondary care model is essential to address these systemic gaps in coverage, optimize resource allocation, and ensure efficient and smooth progression of patients across healthcare continuum. By developing referral and disease management protocols, integrating multidisciplinary health facilities and teams, enhancing interoperability of electronic medical records and digital infrastructure, this model would bridge the gap between service levels, aligning with the National Health Strategy's objectives of enhanced access to services and continuity of care.

Key Responsibilities:

The MoPH is seeking to recruit a consultant to develop the secondary care model.

The consultant shall be responsible for the following:

1. Conduct Basic Assessment: Analyze existing structures, including mapping of key stakeholders, resources, and gaps at the levels of PHCCs, hospitals, other outpatient health facilities.
2. Develop Eligibility Criteria and Guidelines: Define the eligibility criteria for beneficiaries (based on vulnerability) who will be eligible for accessing secondary healthcare services and outline the criteria for selecting healthcare institutions to participate in the referral system.
3. Design the Referral Pathway and System: Design the referral pathway and the platform to facilitate the referral process, incorporating user-friendly and efficient features for all stakeholders. The system should facilitate efficient tracking, coordination, and communication among all stakeholders.
4. Develop Monitoring and Evaluation Framework: Create a monitoring and evaluation framework with measurable targets and indicators.
5. Training and Capacity Building: Develop and deliver tailored training materials for PHCC staff, hospital personnel, and other stakeholders to ensure they are proficient in using the referral system and understanding its processes.
6. Communication: Develop informational content to facilitate public communication on the new coverage area
7. Stakeholder Engagement: Participate in meetings with the MoPH, PHCCs, hospitals, and other partners to ensure a proper drafting of the referral mechanism.
8. Report and Document Progress: Produce detailed progress reports, highlighting project progress.

Deliverables-Add progress reports

Deliverable

Type of Deliverable

Number of Days

Expected Outcomes/Goals

Stakeholder Engagement

A. Inception Report:

• Analyze existing benchmarks and models of secondary care referral systems in similar-context countries and international organizations to identify best practices and adaptable models.
• Analyze existing structures, including mapping of key stakeholders, resources, and gaps at the levels of PHCCs, hospitals, other outpatient health facilities.

Report

10

A clear understanding of best practices and adaptable models from similar-context countries and organizations.

Desk research and review of global and regional referral systems.

B. Design of the Referral System which include:

• Design of the referral pathway.
• Define the eligibility criteria of beneficiaries.
• Define the criteria for selecting PHCCs, hospitals, and other health facilities that shall participate in delivering the secondary care package.
• Identify the requirements for an online platform outlining the referral pathway from PHCCs to secondary care service providers (and vice versa).
• Review the available resources related to secondary care service packages, including PHCCs, hospitals, outpatient facilities, and digital infrastructure.

Referral System Design Document

25

A well-structured referral system and online platform requirements for seamless patient referrals.

Comprehensive assessment of current resources, gaps, and opportunities related to secondary care service packages.

Validation meetings with stakeholders to review and refine the proposed design.

Conduct interviews with PHCC staff, hospital administrators, and IT teams to validate findings.

C. Development of a Monitoring and Evaluation Framework:

• Comprehensive framework with targets and indicators to monitor the effectiveness, efficiency, and equity of the referral mechanism.
• Mechanisms for continuous assessment and feedback.

M&E Framework

Document

15

A robust framework with measurable indicators to track referral system performance and equity.

Consultations with MOPH and field experts to finalize targets and feedback mechanisms.

D. Training

Guides for using referral system, training slides, etc.

5

Training platform users

E. Communication

Presentation/dissemination event, where the main findings are presented to key stakeholders

5

Presentation of findings to key stakeholders

F. Draft a TOR for the Implementing firm/organization

TOR Document

5

Scope of work of the implementing firm/organization including all deliverables and outcomes

NA

Duration of the Consultancy:

The duration of this consultancy is 65 days, between June and August 2025.

 Qualifications:

• Master’s or PhD in Public Health, Health Systems Management, Health Service Delivery, Health Administration, Health Policy, or a related field.
• Additional certifications in health financing, health information systems, or health leadership is an asset.
• Minimum of 7 years of practical professional experience in public health, health systems strengthening, health administration, including work on referral mechanisms or healthcare service delivery, with a minimum of 3 years in a senior managerial position.
• Demonstrated expertise in conducting needs assessments, health projects implementation, and engaging with multi-stakeholder groups, including government entities, international organizations, and local healthcare providers.
• Familiarity with the Lebanese healthcare system and context.

Competencies:

• Excellent analytical and problem-solving skills, with the ability to synthesize complex data into actionable insights.
• Strong project management skills, including planning, coordination, and reporting.
• Strong communication and facilitation skills, with experience in delivering training and capacity-building initiatives.
• Strong interpersonal skills with the ability to work collaboratively with diverse stakeholders.
• High level of accountability, professionalism, and attention to detail.

Payment Terms:

The payments shall be made in US Dollars, as follows:

• 10% (of the contract amount): Shall be paid after submission of the inception report along with an official invoice, reviewed and approved by the Ministry of Public Health and the World Bank.
• 30% (of the contract amount): Shall be paid after submission of the 1st report, covering the Design of the Referral System along with an official invoice, reviewed and approved by the Ministry of Public Health and the World Bank.
• 30% (of the contract amount): Shall be paid after submission of the 2nd progress report along with an official invoice, covering the Monitor & Evaluation Framework, reviewed and approved by the Ministry of Public Health and the World Bank.
• 30% (of the contract amount): Shall be paid after submission of final detailed progress report, covering all tasks completed along with an official invoice, Training and Capacity Building Plan, and Communication Plan. This will be reviewed and approved by the Ministry of Public Health and the World Bank to complete the final payment.