Background

Zambia has demonstrated leadership in Primary Health Care (PHC) delivery. However, persistent fiscal constraints—exacerbated by recent economic challenges—have weakened the stability and predictability of financing for immunisation services. These constraints have resulted in delayed and insufficient disbursements for both Gavi-supported and routine vaccines, leading to service disruptions and vaccine stockouts that undermine immunisation programme performance.

Immunisation financing in Zambia is increasingly under pressure from rising programme costs due to an expanded vaccine portfolio, inflationary trends, and competing public health priorities. Government contributions—excluding health worker salaries—covered only 37% of immunisation costs between 2020 and 2022. While Zambia has maintained its Gavi co-financing commitments, delays in actual remittances have posed operational risks.

The current financing model involves centralised procurement of vaccines and capital equipment, alongside decentralised disbursement of operational grants to provinces and districts. However, inefficiencies, bottlenecks, and underfunding at the subnational level remain unresolved. These challenges are compounded by fragmented donor support, limited private sector engagement, and weak expenditure tracking mechanisms.

Amid broader reforms—such as decentralisation and the rollout of the National Health Insurance Scheme—there is a critical need to re-evaluate how immunisation financing is structured, tracked, and sustained. Strengthening budget planning, resource mobilisation, and public financial management (PFM) at all levels will be essential to safeguard gains in immunisation coverage and equity.

To this end, the National Health Research Authority (NHRA), in collaboration with UNICEF and the Ministry of Health, is undertaking a comprehensive Immunisation Financing Assessment (IFA). The goal is to generate robust evidence and practical recommendations to improve the efficiency, equity, and sustainability of Zambia’s immunisation financing landscape within the broader PHC framework.

Position: Team Lead/Health Economist & Assessment Team

Project: Immunisation Financing Assessment

Duration of Contract: Up to 60 working days in 4 months

Start Date: 15 July 2025

Location: Lusaka (with field travel to targeted provinces and districts)

Purpose of Activity/Assignment

UNICEF’s Zambia Country office, in collaboration with the Zambian Ministry of Health (MOH) and partners, is supporting efforts to strengthen health systems for better immunisation within Primary Health Care (PHC).

The main goal of this immunisation financing analysis is to identify and address funding issues affecting PHC and immunisation at the sub-national level, and to build capacity to overcome these challenges in Zambia.

Scope of Work

1. Mapping and Tracking Funding Flows

• Engage stakeholders from Ministry of Health, Ministry of Finance and National Planning, UNICEF, and partners.

• Analyse funding allocations, disbursements, and spending at national and subnational levels.

• Identify bottlenecks and inefficiencies.

• Produce a funding flow map and summary report with recommendations.

2. Capacity Building in Budgeting and Planning

• Design and deliver training for district and facility-level staff on immunisation budgeting within PHC systems.

• Develop/adapt budgeting tools for subnational use.

• Support inclusion of immunisation in district operational plans.

• Document key lessons.

3. Assessment of Innovative Financing Models

• Review global and local models (e.g., performance-based financing, direct facility funding).

• Conduct fieldwork and stakeholder interviews.

• Assess feasibility in the Zambian context and provide recommendations.

4. Health Spending Analysis

• Analyse PHC and immunisation budgets and expenditures.

• Identify trends, inefficiencies, and priority gaps.

• Consult stakeholders to define domestic financing options.

• Produce a technical report and policy brief.

5. Validation and Implementation Planning

• Organize a stakeholder validation workshop.

• Present findings, gather feedback.

• Finalize the full assessment report and implementation roadmap.

Minimum Requirements/Qualifications

• Must have an advanced degree in Health Economics Knowledge/Expertise/Skills required

• Minimum 7 years of proven experience conducting research in health and Immunisation Financing (IF) or implementation research.

• Documented knowledge of Immunisation Financing (IF), PFM, and health systems.

• Direct work experience with Zambia’s Ministry of Health and/or Ministry of Finance and National Planning.

• Familiarity with Zambia’s ethical review process and ability to lead ethical approval submissions.

• Strong quantitative and qualitative research capabilities.

• Proven ability to produce policy-oriented outputs for decision-makers.

• Excellent report writing and verbal communication skills in English.

• Experience with UN or UNICEF-supported projects is an added advantage.

Additional Team Members (Minimum 2 Required)

• Advanced degrees in economics, public health, social sciences, statistics, demography, or related fields.

• At least 5 years of professional experience including research on PHC, immunisation, or community health in Zambia.

• Skills in data collection, analysis, synthesis, and stakeholder engagement.

• Strong quantitative and qualitative analysis.

• Ability to translate findings into clear, actionable reports for policy and planning audiences.

• Knowledge of research uptake strategies and local health systems.

Optional but encouraged: Field Coordinator and/or Research Assistants with demonstrated experience in field logistics, data collection, and stakeholder engagement.

How to apply

• Cover letter from Team Lead

• Detailed CVs of the Team Lead and all team members with traceable referees

• Description of at least two similar projects completed in the last 5 years

• A sample report authored or co-authored by the Team Lead

• Daily rates and availability of each team member between July and November 2025

Interested candidates who meet the above requirements are encouraged to submit their applications to jobs@nhra.org.zm

Closing date is Wednesday 9th July, 2025. Note that only the short-listed candidates will be contacted to attend panel interviews.