DT Global, built on more than 50 years of experience from AECOM International Development, Development Transformations, and the Global Peace and Development (GPD) Charitable Trust, applies ingenuity, evidence, and passion to everything we do. Grounded in decades of technical expertise and leadership around the world, we incorporate rigorous learning and assessment in our program design process to ensure that we stay on the cutting edge of thought leadership. Our technical experts work in partnership with communities and institutions to deliver innovative, data-driven solutions that create sustainable change and improve people’s lives

Objective of this Assignment

The primary objective of this assignment is to disseminate experiential insights gained from the design, implementation, and expansion of a private sector mass-market health insurance product in East Africa. This knowledge-sharing initiative aims to benefit the current health insurance partners, with a particular focus on the two partners who have recently introduced mass-market health insurance products. Through mentorship and coaching, the assigned expert will provide tailored guidance to complement the ongoing support offered by the PSPH technical team. This collaborative approach aims to enhance the partners’ capacity to navigate the complexities of scaling and sustaining the health insurance initiative effectively.

Specific Objectives

This assignment aims to achieve the following specific objectives:

• Share expertise in marketing and sales strategies tailored for selling mass-market health insurance products to underserved populations with limited disposable income, utilizing targeted marketing strategies and innovative pricing models. This includes addressing the unique challenges of pioneering efforts in contexts where no precedent exists, while leveraging successful strategies identified in neighbouring countries with similar circumstances.
• Share insights on raising awareness of the product and increasing its uptake in the market.
• Extract valuable lessons learned from comparable initiatives implemented in neighbouring countries, providing actionable insights for the successful implementation and scaling of the health insurance program in Somalia and Somaliland.

The consultant is expected to offer virtual support as needed, contingent upon the demand from the partners and the availability of both the consultant and the partners, as well as the availability of PSPH health insurance experts and the technical team. In-person sessions will be arranged as necessary and subject to security clearance.
PSPH seeks an expert with a background in mass-market health insurance, possessing expertise in developing sustainable health insurance products for mass markets in contexts similar to Somalia. The selected expert will coordinate all activities with the PSPH team and work under the guidance of PSPH health insurance experts.

Scope of Work

Working closely with the PSPH technical staff and the health insurance partners, the expert will offer contextual insights from their experience in pricing, marketing strategy, target audience analysis, and other relevant areas, complementing information provided by the technical team and the partners. Additionally, the consultant will consult with PSPH technical staff and partners to determine appropriate support measures aimed at increasing product uptake and achieving commercial sustainability.

Specifically, the consultant will:

• Review and understand the current mass-market health insurance products, including an analysis of obstacles to sales and strategies employed to overcome them.
• Analyse how premium pricing was set and any changes made to the pricing structure over time based on experience. Provide insights into pricing strategies, adjustments, and the rationale behind them.
• Investigate the payment mechanism used, including types of technology-enabled solutions employed.
• Examine the renewal experience and frequency, including drop-out or non-renewal rates, and provide insights into improving renewal rates.
• Evaluate how family coverage plans were structured, considering the different numbers of individuals in various families.
• Identify and address any issues with healthcare providers in the insurance network, including challenges related to network management, quality of care, or reimbursement processes.
• Address any other relevant issues based on the consultant’s experience and expertise.

Deliverables

• Produce stakeholder meeting reports from each coaching/mentoring session with the partner in the standard PSPH format. Ensure these reports are circulated to the Technical Director, Team Leader, Project Manager, and health insurance experts within three working days of completion of the session. Additionally, file the reports on the shared Allteam drive in the appropriate folder for each partner.
• Participate in monthly in-depth intervention reviews for each health insurance partner.
• The consultant may be required to travel to the field if necessary. The decision to travel will be based on demand, cost-effectiveness, and budget availability. In the event of field work, stakeholder meeting reports as in (1) above will be required.
• Monthly timesheets itemizing hours spent and primary activities will be required, to be submitted within three working days of the end of each month.

About You

Required Expertise and Qualifications

• Working closely with the PSPH technical staff and the health insurance partners, the expert
• will offer contextual insights from their experience in pricing, marketing strategy, target audience analysis, and other relevant areas, complementing information provided by the technical team and the partners. Additionally, the consultant will consult with PSPH technical staff and partners to determine appropriate support measures aimed at increasing product uptake and achieving commercial sustainability.

Specifically, the consultant will:

• Review and understand the current mass-market health insurance products, including an analysis of obstacles to sales and strategies employed to overcome them.
• Analyse how premium pricing was set and any changes made to the pricing structure over time based on experience. Provide insights into pricing strategies, adjustments, and the rationale behind them.
• Investigate the payment mechanism used, including types of technology-enabled solutions employed.
• Examine the renewal experience and frequency, including drop-out or non-renewal rates, and provide insights into improving renewal rates.
• Evaluate how family coverage plans were structured, considering the different numbers of individuals in various families.
• Identify and address any issues with healthcare providers in the insurance network, including challenges related to network management, quality of care, or reimbursement processes.
• Address any other relevant issues based on the consultant’s experience and expertise.

Deliverables

• Produce stakeholder meeting reports from each coaching/mentoring session with the partner in the standard PSPH format. Ensure these reports are circulated to the Technical Director, Team Leader, Project Manager, and health insurance experts within three working days of completion of the session. Additionally, file the reports on the shared Allteam drive in the appropriate folder for each partner.
• Participate in monthly in-depth intervention reviews for each health insurance partner.
• The consultant may be required to travel to the field if necessary. The decision to travel will be based on demand, cost-effectiveness, and budget availability. In the event of field work, stakeholder meeting reports as in (1) above will be required.
• Monthly timesheets itemizing hours spent and primary activities will be required, to be submitted within three working days of the end of each month.

Qualifications And Requirements

• University degree in business, finance, healthcare management, insurance, risk management, or related field. A Masters or PhD would be advantageous.
• Minimum of 5 years of experience in commercial health insurance.
• Mandatory prior experience in developing mass-market health insurance products within underserved and limited-income contexts.
• Mandatory experience in or understanding of the private healthcare sector.
• Excellent verbal and written communication skills in English are required