Health Insurance Costing Expert

at Palladium

Location:    Travels to Afghanistan

Company Overview

Palladium is a global leader in the design, development and delivery of Positive Impact - the intentional creation of enduring social and economic value. We work with foundations, investors, governments, corporations, communities and civil society to formulate strategies and implement solutions that generate lasting social, environmental and financial benefits.

For the past 50 years, we have been making Positive Impact possible. With a team of more than 2,500 employees operating in 90 plus countries and a global network of more than 35,000 technical experts, Palladium has improved - and is committed to continuing to improve - economies, societies and most importantly, people's lives.

Palladium is a child-safe organisation, and screens applicants for suitability to work with children. We also provide equal employment to all participants and employees without regard to race, colour, religion, gender, age, disability, sexual orientation, veteran or marital status.


Project Details

The Health Sector Resiliency (HSR) project is a USAID funded programme that supports the Government of the Islamic Republic of Afghanistan (GIRoA) to foster a strengthened, reformed, and increasingly self-reliant Afghan health system prepared for the decreased donor support anticipated over the coming decade. The Project acts as a resource and a catalyst to the Ministry of Public Health (MoPH) and other GIRoA entities as it considers and implements critical sector-wide reforms that are required to make the system more resilient and sustainable. The five- year project primarily focuses on governance, health finance and human resources for health and engages both the public and private components of the health sector.

Background and scope of work

Afghanistan, like most developing countries, is challenged by limited resources. Income levels are generally very low with widespread poverty. Afghanistan’s GDP[1] per capita in 2016 was US$562 compared to the average of US$964 among the least developed countries (LDCs). Unemployment rate is high at 23.9%. Eighty (80) percent of all the jobs are classified vulnerable employment. Moreover, 54.5% of the population live below the national poverty line while 44.6% of the entire population are affected by food insecurity (CSO 2018). Additionally, despite the income levels, due to insufficient access to quality health services in government health facilities, the population is exposed to catastrophic health expenditure.For example, in 2014, household out-of-pocket (OOP) health expenditure alone accounts for 71.8% of total health expenditure (THE), constituting about US$51 per capita (MoPH 2016).

Recently, there has been increased interest especially from the government of Afghanistan, to explore the possibility of implementing a national health insurance programme in Afghanistan as an alternative risk pooling mechanism towards improved healthcare delivery as well as a means towards reducing out-of-pocket expenditures. For instance, in March 2016, the President’s office issued a directive to the Ministry of Public Health (MoPH) to prioritize investigating how to implement health insurance for government employees in Afghanistan. In light of this, a new health insurance law has been drafted and currently being reviewed by the Ministry of Justice. Also, a Phase I health insurance feasibility study has been conducted which primarily assessed stakeholders’ opinions about health insurance and the enabling environment. Assessment of the demand-side of the health insurance market was not covered in this study. Therefore, the Phase II feasibility study is conducted to provide further information on feasibility of health insurance in Afghanistan and outline a roadmap for implementation of the same. The Phase II feasibility study contains the following key activities:


  • Carry out a further situational analysis of the country context to examine the enabling environment for the introduction of health insurance in Afghanistan;

  • Define a Health Insurance (HI) benefit package;

  • Recommend a strategic purchasing mechanism for health insurance;

  • Conduct a willingness and ability to pay study for health insurance;

  • Train and provide relevant health insurance implementation tools to the Health Economics and Finance Directorate (HEFD) of the Ministry of Public Health (MoPH); and

  • On-an-ongoing basis, engage and mobilize stakeholders’ commitment towards the introduction of a health insurance programme in Afghanistan.


The Health Insurance Costing Expert is therefore expected to contribute to these efforts including:


  • Develop a methodology for costing of health services including primary, secondary and tertiary services;

  • Lead a review of the costing studies in Afghanistan and synthesize a report. There are a few costing studies conducted in Afghanistan including: 2012 The First Round Cost Analysis of Kabul’s National Hospitals; 2016 Cost Analysis of Afghanistan’s Basic Package of Health Services 2010: An Assessment of The Costs; 2013 Cost Analysis of Afghanistan’s Essential Package of Hospital Services (EPHS); 2013 A Benefit Incidence Analysis of the Afghanistan health system; 2015 The Second Round Cost Analysis of Kabul’s National Hospitals; 2014 Afghanistan National Health Accounts with Disease Accounts; 2016 Assessment of the Referral System and Costing of the Basic Package of Health Services (BPHS) in Afghanistan; and 2017 standard cost of BPHS at various Health Facility levels. Currently, the HSR and the Health Economics and Finance Directorate (HEFD) of the Ministry of Public Health are conducting a services fees and price list review of a selected private healthcare providers in Kabul. The review report will be available by mid of August 2018;

  • Contribute to the definition of the 3 benefit packages;

  • Lead the costing of the three (3) Health Insurance benefit packages;

  • Support the project Actuary to develop financial models for the 3 benefit packages; and

  • Conduct a health costing training for the staff and partners of HSR




Outputs, deliverables and timelines

Below are the expected outputs and deliverables of the costing expert:























































A total of 22 consulting days are allocated for these activities and deliverables.



The costing expert must have at least these qualifications and expertise:

  • Master's Degree or higher in economics, health economics, public health or related fields.

  • A minimum of 5 years of experience working in similar roles

  • Proven track record of conducting health insurance costing analysis

  • Good understanding of health insurance processes and costing

  • Excellent at facilitating high-level meetings and trainings

  • Experience in working for international organizations such as USAID, UKaid etc.

  • Excellent report writing skills

  • Excellent English communication skills, both verbal and written is strongly desired

  • Prior work in Afghanistan and or other developing countries will be a plus.

TO APPLY: Submit your cover letter and resume to with the subject line “Palladium – HI Costing Expert"




LinkedIn: BroderickHaight Consulting


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