Individual National Consultant for Systematic Reviews and Impact Assessment of Health Insurance Coverage of Acute Malnutrition Treatment for Children Under-Five, Viet Nam

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For every child, health and nutrition...

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Background:

In Viet Nam, the Integrated Management of Acute Malnutrition model has been implemented since 2009 and shown to be a successful package of prevention and treatment for acute malnutrition in children, which include community screening, outpatient treatment of uncomplicated cases using therapeutic products, inpatient care for complicated cases, nutrition counselling, growth monitoring, and follow-up after recovery. However, despite the inclusion of the package in the list of essential health services and in national target programs, the coverage of this high impact intervention is still limited due to the lack of a sustainable funding mechanism. It is estimated that more than 200,000 Vietnamese children under five experience severe acute malnutrition (SAM) each year, yet the majority of these cases do not receive treatment. Untreated SAM children are 12-20 times more likely to die from common childhood illnesses and often require expensive inpatient care.

Pursuant to Resolution No. 261/2025/QH15, the Government is developing policy options to increase health insurance benefits, expand the benefit package and adjust health insurance contribution rates.

Given the high health and economic costs of untreated SAM and the strong evidence that timely treatment can achieve high recovery rates, inclusion of acute malnutrition treatment in the health insurance benefit package represents a strategic investment in Viet Nam's future workforce and economic development. To support the inclusion of this intervention in health insurance, assessment of economic value and affordability for the Health Insurance Fund is necessary. In parallel, the draft policy includes a roadmap to increase health insurance contribution rates for five groups, initially to 5.1%, then to 5.4% after three years and to 6% after a further three years, with implementation dates varying by group. Evidence on cost-effectiveness, budget impact and expected changes in Fund revenue is therefore needed to support policy impact assessment and finalization.

Purpose of Activity/Assignment:

The national consultant will support UNICEF Viet Nam in generating economic evidence to inform assessment and refinement of national health insurance policy. The assignment will: (i) synthesize cost-effectiveness evidence for the treatment of acute malnutrition among children under five years of age; (ii) assess the budget impact on the Viet Nam Health Insurance Fund of covering this intervention; and (iii) assess the financial impact of the proposed roadmap for increasing health insurance contribution rates for five groups of insured persons.

Scope of Work:

- Conduct a systematic review on acute malnutrition treatment for children under five years of ages, with particular attention to evidence relevant to Vietnam and comparable settings.

- Clearly define the treatment package to be assessed, including eligible children, service-delivery settings, treatment components, commodities, follow-up requirements, and relevant health insurance reimbursement arrangements.

- Develop a budget impact model, from the perspective of the Viet Nam Health Insurance Fund, to estimate the financial impact of health insurance reimbursement for each nutrition intervention.

- Conduct a budget impact analysis of the health insurance contribution-rate roadmap for five groups, including the distribution of additional contributions across employers, employees/participants, the social insurance agency and the State budget, as applicable.

Summary of Key Functions/Accountabilities:

General objective: To provide evidence on the cost-effectiveness and budget impact of acute malnutrition treatment for children under-5 and on the financial impact of the health insurance contribution-rate roadmap, in support of policy impact assessment and completion of the health insurance policy options.

Specific objectives:

- Systematically review cost-effectiveness studies of nutritional treatment for children with acute malnutrition among children under five.

- Assess the budget impact on the Health Insurance Fund of reimbursing the treatment for acute malnutrition among children under five years of age.

- Assess the budget impact of the proposed health insurance contribution-rate roadmap for five insured groups.

Methodology:

For the systematic reviews, the consultant will apply standardized methods to conduct literature searches, screen relevant studies, extract data, and prepare reports on the study findings.

For the budget impact analysis of the nutrition intervention, the consultant will develop a model with a five-year time horizon from the perspective of the Health Insurance Fund. The consultant will then estimate and compare the current payment scenario with the future payment scenario to determine the budget impact.

For the contribution-rate analysis, the consultant will model changes in health insurance revenue over the full policy roadmap (planned baseline period 2027 to at least 2035), by insured group and responsible payer, taking account of participant numbers, contribution bases, applicable contribution rates, timing within the year and relevant macro-level parameters; one-way sensitivity analysis will be undertaken.

Location:

The consultant is expected to work primarily from home and attend technical meetings in Ha Noi as required.

Tasks:

- Finalize the detailed analytical plan and implementation workplan based on the approved research outline.

- Complete a systematic review of cost-effectiveness evidence for treatment of SAM among children under 5 years of age.

- Complete budget impact analysis of health insurance reimbursement for the for the treatment of SAM among children under 5 years of age.

- Complete the budget impact analysis of the health insurance contribution-rate roadmap for five insured groups.

Travel:

No field travel is expected within the scope of this consultancy unless subsequently agreed in writing.

Management:

The consultancy will be supervised by the UNICEF Nutrition Officer under the overall guidance of the Chief/Officer-in-Charge of the Child Survival and Development Section, with technical coordination as needed with relevant government and research counterparts.

If you would like to know more about this position, please review the complete TOR here: TOR_nutrition health insurance economic analysis.pdf

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

Minimum requirements:

Education: 

Master degree in health economics, public health, epidemiology, health policy, nutrition, health sciences, or a closely related discipline.

Work Experience:

- A minimum of 10 years of relevant professional experience in health economics, health financing, health policy research or closely related areas.

- Demonstrated experience conducting systematic reviews, preferably of economic evaluations and in line with PRISMA standards.

- Strong experience developing budget impact analyses and/or health economic models, preferably for health insurance benefit design or financing decisions in Viet Nam.

- Demonstrated understanding of national health insurance policy, contribution mechanisms, provider/payment and benefit-package analysis in Viet Nam.

- Experience with policy research and development for nutrition interventions for young children is an asset.

- Advanced analytical skills using MS Excel and related tools; strong report-writing and presentation skills.

Language Requirements:

- Fluency in written and spoken Vietnamese and English is required.

Submission of applications:

a. Updated CV/Resume;

b. 03 references including at least one from a past supervisor;

c. Financial proposal: All-inclusive lump-sum cost including consultancy fee and any other relevant costs for this assignment.  

For every Child, you demonstrate...

UNICEF’s Core Values of Care, Respect, Integrity, Trust and Accountability and Sustainability (CRITAS) underpin everything we do and how we do it. Get acquainted with Our Values Charter: UNICEF Values

The UNICEF competencies required for this post are…

(1) Builds and maintains partnerships

(2) Demonstrates self-awareness and ethical awareness

(3) Drive to achieve results for impact

(4) Innovates and embraces change

(5) Manages ambiguity and complexity

(6) Thinks and acts strategically

(7) Works collaboratively with others 

Familiarize yourself with our competency framework and its different levels.

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Remarks:  

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