Health Economist – Cost and Efficiency Analysis

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    "description": "<p><span style=\"color: rgb(27, 94, 123); font-size: 12pt; font-weight: bold\">1. Background</span></p>\n<p><span style=\"font-size: 10pt\">As part of the pediatric pneumonia continuum of care intervention in Zanzibar, D-tree seeks to demonstrate that strengthening the care pathway between community and facility levels can reduce costs to the health system while improving outcomes. A health economist is needed to provide cost-related expertise during the intervention design phase, ensuring D-tree has the economic evidence and methodological guidance needed to design an intervention that is positioned to demonstrate cost-effectiveness and efficiency gains.</span></p>\n<p><span style=\"color: rgb(27, 94, 123); font-size: 12pt; font-weight: bold\">2. Objective</span></p>\n<p><span style=\"font-size: 10pt\">To provide health economics expertise that equips D-tree with the evidence, benchmarks, and methodological guidance needed to design an intervention that incorporates cost-reduction strategies and is positioned to demonstrate measurable health system cost savings, cost-effectiveness, and efficiency improvements. D-tree will lead the translation of these economic inputs into intervention design decisions.</span></p>\n<p><span style=\"color: rgb(27, 94, 123); font-size: 12pt; font-weight: bold\">3. What We Need From the Health Economist</span></p>\n<p><span style=\"font-size: 10pt; font-style: italic\">The health economist provides specialized economic knowledge and methodology guidance. </span></p>\n<p><br></p>\n<p><span style=\"font-size: 10pt; font-weight: bold\">A. Understanding Current Cost Drivers</span></p>\n<ul>\n<li><span style=\"font-size: 10pt\">What are the primary cost drivers in the current pediatric pneumonia care pathway in Zanzibar (e.g., late presentation leading to hospitalization, inefficient referral systems, drug stockouts, unnecessary facility visits)?</span></li>\n<li><span style=\"font-size: 10pt\">Where are the greatest inefficiencies or cost leakages in the current system that an intervention of this type could realistically address?</span></li>\n</ul>\n<p><br></p>\n<p><span style=\"font-size: 10pt; font-weight: bold\">B. Economic Evidence for Intervention Design</span></p>\n<p><span style=\"font-size: 10pt; font-style: italic\">The economist provides the cost evidence and analysis that will inform design decisions.</span></p>\n<ul>\n<li><span style=\"font-size: 10pt\">What intervention design features are most likely to reduce costs to the health system, based on evidence from comparable settings? For example:</span>\n<ul>\n<li><span style=\"font-size: 10pt\">Earlier identification and treatment at community level (reducing severe cases)</span></li>\n<li><span style=\"font-size: 10pt\">Improved referral completion (reducing repeat visits or delayed care)</span></li>\n<li><span style=\"font-size: 10pt\">Digital tools that reduce time spent gathering redundant information or context</span></li>\n</ul>\n</li>\n<li><span style=\"font-size: 10pt\">What evidence exists from comparable settings about cost savings from strengthening community-to-facility pneumonia care pathways?</span></li>\n<li><span style=\"font-size: 10pt\">What are realistic expectations for cost reduction within a 1-year timeframe, and what assumptions underpin those estimates?</span></li>\n<li><span style=\"font-size: 10pt\">How should we think about the investment costs of the intervention itself (training, tools, supervision) relative to the expected savings?</span></li>\n</ul>\n<p><br></p>\n<p><span style=\"font-size: 10pt; font-weight: bold\">C. Anticipating Cost-Effectiveness Measurement and Designing for Evaluability</span></p>\n<p><span style=\"font-size: 10pt; font-style: italic\">The health economist is not expected to design the evaluation methodology. A separate evaluation partner will be engaged to lead that work. The purpose of this section is to ensure the intervention is designed with likely cost-effectiveness measures in mind, so that the program is positioned to demonstrate impact when evaluated. The health economist should also be available to advise and align with the evaluation team as the evaluation framework is developed.</span></p>\n<ul>\n<li><span style=\"font-size: 10pt\">What cost-effectiveness measures are most likely to be used in an evaluation of this type of intervention (e.g., cost per DALY averted, cost per life saved, cost per case appropriately managed)? Given that these are the likely measures, what does the intervention need to demonstrate—and what should D-tree be paying attention to in its design choices?</span></li>\n<li><span style=\"font-size: 10pt\">What averted-cost metrics are evaluators likely to focus on (e.g., hospitalizations prevented, reduced length of stay, cases managed at community vs. facility level)? For each, what intervention design features would most directly drive those savings?</span></li>\n<li><span style=\"font-size: 10pt\">What cost data will an evaluation likely need to capture at community, facility, and health system levels? Collaborate with D-tree to assess whether routine monitoring systems and digital tools are generating data in the right format and frequency, or if modifications are needed.</span></li>\n<li><span style=\"font-size: 10pt\">How should we think about government costs vs. program/donor costs from an intervention design perspective? Are there design choices that shift costs toward government-funded inputs, making the program more sustainable and the cost argument more compelling for RGoZ?</span></li>\n<li><span style=\"font-size: 10pt\">What are the most common methodological limitations in cost-effectiveness evaluations of community health programs in LMICs, and what should D-tree be aware of when designing the intervention and its data systems?</span></li>\n</ul>\n<p><br></p>\n<p><span style=\"font-size: 10pt; font-weight: bold\">D. Building the Investment Case</span></p>\n<ul>\n<li><span style=\"font-size: 10pt\">What economic evidence would be most compelling for the RGoZ and potential funders to justify continued investment and scale-up of this model?</span></li>\n<li><span style=\"font-size: 10pt\">How should we frame the return on investment for a government-integrated community health program versus the counterfactual (no intervention)?</span></li>\n<li><span style=\"font-size: 10pt\">What benchmarks from comparable programs or countries should we reference to contextualize our findings?</span></li>\n</ul>\n<p><br></p>\n<p><span style=\"color: rgb(27, 94, 123); font-size: 12pt; font-weight: bold\">4. Deliverables</span></p>\n<ol>\n<li><span style=\"font-size: 10pt\">Analysis of current cost drivers in the Zanzibar pediatric pneumonia care pathway, identifying where the greatest inefficiencies exist and which are most amenable to intervention</span></li>\n<li><span style=\"font-size: 10pt\">Summary of economic evidence on cost-reduction strategies from comparable settings, with guidance on which design features are most likely to generate savings</span></li>\n<li><span style=\"font-size: 10pt\">Joint memo with clinical expert linking priority health outcome indicators to their cost implications and quantifiable savings potential</span></li>\n<li><span style=\"font-size: 10pt\">Summary of likely cost-effectiveness measures and averted-cost metrics that an evaluation would use, with recommendations for how the intervention’s monitoring systems and digital tools could be configured to generate the data an evaluation will need</span></li>\n<li><span style=\"font-size: 10pt\">Brief investment case framing document outlining the economic argument for RGoZ and funders, including relevant benchmarks from comparable programs</span></li>\n</ol>\n<p><br></p>\n<p><span style=\"color: rgb(27, 94, 123); font-size: 12pt; font-weight: bold\">5. Expert Profile</span></p>\n<ul>\n<li><span style=\"font-size: 10pt\">Advanced degree in health economics, public health economics, or related field</span></li>\n<li><span style=\"font-size: 10pt\">Demonstrated experience conducting cost-effectiveness analyses of health interventions in low- and middle-income countries</span></li>\n<li><span style=\"font-size: 10pt\">Experience with costing studies in primary health care or community health systems</span></li>\n<li><span style=\"font-size: 10pt\">Familiarity with economic evaluation methods used in global health (e.g., CEA, cost-benefit analysis, budget impact analysis)</span></li>\n<li><span style=\"font-size: 10pt\">Experience in East Africa or similar LMIC contexts preferred</span></li>\n<li><span style=\"font-size: 10pt\">Track record of producing evidence used for policy advocacy or investment cases</span></li>\n</ul>\n<p><span style=\"color: rgb(27, 94, 123); font-size: 12pt; font-weight: bold\">6. Level of Effort and Timeline</span></p>\n<p><span style=\"font-size: 10pt\">Estimated 4-6 days from April-June 2026. Unless the consultant is based in Zanzibar, engagement will include remote consultations and document review. Potential for one-trip to Zanzibar if the consultant is based nearby and budgetarily feasible. </span></p>\n<p><br></p>\n<p><span style=\"color: rgb(27, 94, 123); font-size: 12pt; font-weight: bold\">7. Budget Requirements</span></p>\n<p><span style=\"font-size: 10pt\">The consultant will submit a proposed budget which will be reviewed and approved by D-tree. </span></p>\n<p><br></p>\n<p><span style=\"color: rgb(27, 94, 123); font-size: 12pt; font-weight: bold\">8. Application</span></p>\n<p><br><span style=\"font-size: 10pt\">To apply for this role, please click the link </span><span style=\"font-size: 10pt\">&lt;</span><a href=\"https://dtree.bamboohr.com/careers/44\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-size: 10pt; font-weight: bold\">Here</span></a><span style=\"font-size: 10pt\">&gt; </span><span style=\"font-size: 10pt; font-weight: bold\">and submit your resume and a cover letter</span><span style=\"font-size: 10pt\">. Please note that by applying to this position, you consent to your name being checked against a terrorist watch list prior to an consultancy engagement.  Deadline for submitting applications  is April 10, 2026</span></p>",
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