Background

Over the past years, the NaCC received several complaints in the private healthcare sector. These complaints raised concerns of anticompetitive practices which may impede competition and increase the cost of healthcare services. One such example is the twofold complaints regarding Namibia Association of Medical Aid Funds (NAMAF) in respect of its application of the benchmark tariff system. The functionining of the private healthcare market as well as the public healthcare market through the Public Service Medical Aid Scheme (PSEMAS) are dependent on the annual determination of benchmark tariffs by NAMAF given that all the medical aid funds including PSEMAS are linked to this system.

The Namibian Competition Commission requires services from an experienced local consultant to conduct  a study in order to understand the structure and provision of private healthcare in Namibian with a specific focus on analysing the cost trends over the years. A study into the provision of private healthcare would assess the state f competition as well as provide policy advice and competition guidelines that would promote fair competition amongst the different players in the sector.

 

Duties and Responsibilities

Objectives of the study

The objectives of the study are set out in the table below.

Table 1: Objectives of the study

Overall Objective 1: To understand the structure of the private health sector in Namibia

Specific Objectives

  1. understand the role and authority played by governing institutions in relation to the provision of private healthcare;
  2. understand the interaction between hospitals and healthcare providers;
  3. understand doctors’ referral process and its impact on competition in the private healthcare sector;
  4. assess possible barriers to entry or any anti-competitive practices in the private healthcare sector.

Overall Objective 2: To assess the impact of the NAMAF judgement on the jurisdiction of NaCC, the medical professions and on consumers.

Specific Objective

2.1 Identify recommendations to mitigate perceived negative impact of the judgement on medical aid service and on consumers.

Overall Objective 3: To analyse the cost trends over the years in the provision of private healthcare services.

Specific Objectives

3.1 Identify and analyse the various rules/laws that might impact price and competition;

3.2 Understand the push and pull factors behind price changes;

3.3 Assess the cost implications pre and post the NAMAF judgement. 

Gaining an understanding of the above objectives would aid the NaCC in carrying out its enforcement and or advocacy mandate as well as to provide an overview of the level of competition in the private healthcare and sound recommendations for key policy makers in order to enhance competition.

  1. Scope of the Services:

The provision of private healthcare is complex and diverse hence this study solely asses the cost of the below listed in order to fully understand, assess the state of competition as well as provide sound policy advice and competition guidelines that would promote fair competition amongst these market segments:

  • Consultations or visits: in and out of hospital
  • Radiology: Specialised Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans
  • Medicine and injections: acute medicine dispensed by doctors and pharmacies
  • Hospital services: accommodation and theatre
  • Optical services: eye tests

The sample population includes undertakings operating in the provision of private healthcare services in Namibia, with a focus on private health care financing. The key stakeholders for the study consist of the medical aid funds, its members and administrators; relevant government bodies; regulators; private healthcare providers; consumers of healthcare services and health professionals. The study covers the period between the years of 2000 and 2021. 

2.1 Research questions

The study aims to answer the following questions:

  1.  How is the structure of the private health sector in Namibia?
  2. What is the impact of the NAMAF judgement on the jurisdiction of the NaCC, medical professions and consumers?
  3. What is the cost trend in the provision of private healthcare?

The above stated research questions are intended to direct and guide all stages of the analysis and reporting.

1.2 Methodology

Literature will be reviewed in order to understand and explain the structure and operations of the sector. The study will also use instruments such as questionnaires in order to efficiently reach a wider sample in obtaining information. Furthermore, the research team will meet with relevant stakeholders in the health sector to collect data. Without limiting the market study methodology, the methods that will be used for gathering information in the quest to address the research objectives in section 1.4 include the following:

  • Information requests to particular market participants;
  • Targeted meeting with identified stakeholders;
  • Surveys and questionnaires;
  • Benchmarking selected countries by comparing and contrasting:
    • The administration of Healthcare cost
    • Role and application of Regulation
    • Countries healthcare model, shortcomings and benefits
    • Role of Competition and changes due to application of competition, cases, outcome and changes in competition in the market in these countries.

1.3 Expected Outcome

The expected outcome of the study is a research report that will inform the Commission on areas of recommendation to share with the relevant stakeholders either through formal consultations or informal workshops that will be undertaken for consolidation and action-oriented policy reform of the healthcare sector in Namibia.

The report should:

  1. Provide an outline of the structure of the private health sector in Namibia.
  2. This section reviews the relevant players in the provision of private healthcare in Namibia as well as examines the theory of healthcare economics and relevant existing theories.
  3. The section further presents an understanding and combines literature on the nature of the relationship between players within the healthcare sector (between funders, practitioners, specialists, and the consumers) – from the point of departure of referrals as well as assess potential anti-competitive practises in the sector, regulatory frameworks, and any other issues of relevance.
  1. Provide an assessment on the impact of the judgement on medical aid service and on consumers.
  2. Provide an analysis of the cost trends over the years in the provision of private healthcare
  • This section examines the role of Government and its impact on prices as well as the role of competition and regulation with regards to price control and tariff setting.
  • The section further provides a cost analysis of the market segments listed under section 1.6 to fully understand, assess the state of competition as well as provide sound policy advice and competition guidelines that would promote fair competition in the provision of private healthcare.
  1. Provide sound recommendations to enhance competition and promote sector growth (either direct or indirect)

3. Timeframe:

  • The study will be completed over a period of no more than 3 months.
  • Interested candidates are required to submit bids outlining the Research Plan with clear deliverables and cost proposals.

Deliverables and Payment Milestones and Percentages

Deliverables/outputs

Target Due

Dates

Review and Approvals

Required

Payment Milestones /

Percentages

Deliverable 1:

  • Report addressing the Overall Objective 1, its specific objectives in Table 1 above as well as responding to the Expected outcome 2.3.1 (see ToRs)

30 days from the starting

date

The Team Leader will seek final approval from UNDP and the Namibian Competition Commission 

25%

Deliverable 2:

  • Report addressing the Overall Objective 2, its specific objectives in Table 1 above as well as responding to the Expected outcome 2.3.2 (see ToRs)

 

45 days from the starting date

 

 

The Team Leader will seek final approval from UNDP and the Namibian Competition Commission

20%

Deliverable 3:

  • Report addressing the Overall Objective 3, its specific objectives in Table 1 above as well as responding to the Expected outcome 2.3.3 (see ToRs)

 75 days from the starting

date

The Team Leader will seek final approval from UNDP and the Namibian Competition Commission

30%

Deliverable 4:

  • A complete research study in APA referencing with an abstract/ executive summary, respective chapters in responding to the research objectives, conclusion as well as a response to Expected outcome 2.3.4 (see ToRs)

90 days from the starting

date

The Team Leader will seek final approval from UNDP and the Namibian Competition Commission

25%

Competencies

  • Proven knowledge of data collection methods.
  • Proficiency in data analysis tools and statistical applications.
  •  Excellent written and compositional skills.
  • Excellent time management skills.Basic knowledge of Competition Law will be an advantage.

Required Skills and Experience

Education:

  • Master’s or doctorate degree in health sciences, economics, or related fields.

Experiences:

  • A consulting expert with 10 years or more experience in the health sector and/ or research.

Language:

  • Excellent written and oral communication skills in English required.
  • Fluency in one or several other UN working languages (s) would be an added advantage

Recommended Method of Application and Presentation of Offer;

  • Completed Letter of Confirmation of Interest and Availability using the Template provided by UNDP;
  • Personal CV or a P11 Personal History form, indicating all past experience from similar projects, as well as the contact details (email and telephone number) of the candidate and at least three (3) professional references;
  • Provide Brief description of Approach to Work / Technical Proposal of why the individual considers him/herself as the most suitable for the assignment, and a proposed methodology on how they will approach and complete the assignment (max 1 page).
  • To view the full Terms of Reference (TOR) and download letter of confirmation of interest and P11 form, please access the UNDP Procurement Notice site on the link:  https://procurement-notices.undp.org/view_notice.cfm?notice_id=91282

     

Financial proposal:

Financial Proposal that indicates the all-inclusive fixed total contract price, supported by a breakdown of costs, as per attached Letter Confirmation of Interest document. (based on the number of working days mentioned ToR.)

Note: Please group all your documents into one (1) single PDF document as the system only allows uploading maximum one document.

  • Qualified women and members of minorities are encouraged to apply;
  • Incomplete applications will not be considered. Please make sure you have provided all requested materials.