The Health Systems Trust (HST) was established in 1992 to supports the development of comprehensive, effective, efficient and equitable national and district health systems. Since 1992, HST has focused its work primarily in building the national health system in South Africa. More recently we have begun to work more widely within the SADC region.
Our Vision is: Health systems supporting health for all in southern Africa.
Our Mission is that: The Health Systems Trust actively supports the development of comprehensive, effective, efficient and equitable national and district health systems.
Our Principle Objective is to promote scientific research into health systems in South Africa with the principle objective of designing and planning programmes and evaluations thereof towards restructuring of the health system and the development of a comprehensive National Health System based on equity.
Our core activities are health systems research, health systems development, advocacy, capacity development and information dissemination. These activities are implemented through core clusters of Research, the Initiative for Sub-District Support (ISDS), Community Development and HealthLink.
The underlying principles that guide HST are support for the Primary Health Care philosophy and a commitment to equity and efficiency. HSTs uniqueness lies in the ability to integrate knowledge generation, policy development and practice in health systems development.
Our projects and programmes are geared to support and monitor transformation towards a more equitable provision of health services, especially to meet the needs of the most disadvantaged.
The role and practice of HST in district health system development, health systems research, electronic communication for health workers and reporting of progress particularly on health equity and health services delivery is widely acknowledged.
2. Rationale for Consultancy
From our inception, and for a number of subsequent years HST had access to core funding. This funding facilitated the development of the organisation itself, as well as providing the space for HST to be in charge of our own destiny. During this period HST had clear objectives and was able to plan and implement a range of activities designed to meet these objectives.
Over the past five years core funding has gradually been withdrawn and a substantial component of our current work derives from tenders that we have to successfully bid for. Although the focus of work of these tenders is broadly in line with our overall objectives and mission, it is in the nature of tenders that we are responding to the agendas of the funder rather than pursuing organic processes arising from our own work.
We are keen to get away from our current situation of having to respond to tenders, or at least to shrink the proportion of our work that is tender driven. To help us do this, HST wishes to crystallise our focus for the next five years and develop a clear programme of work around which we can fundraise.
To ensure that this programme is both cutting edge, and fully responsive to current trends and pressures, it should be informed by a clear understanding of global, regional and national developments and processes that collectively create the context in which HST operates. We wish to appoint a consultant to assist us in mapping this external environment, to assist HST in clarifying its focus/priorities to guide resource
The consultancy will result in the production of a report that will be used to:
facilitate an internal HST process to clarify our focus
assist HST in identifying appropriate funding opportunities
contribute to assisting HST in identifying the range of competencies required by management (and staff) of HST
3. TORs for the Consultancy
At the Global level:
Scan the environment and review factors that are impacting on health systems development in Southern Africa and in South Africa in particular. This would include developments in the global political economy and the current focus and priorities of relevant global bodies and processes, in particular WHO, the MDGs and the Commission on the Social Determinants of Health.
At the Regional level:
Scan the environment and review factors that are impacting on health systems development at a Regional level. This should be supplemented by a review of key events and players contributing to health systems development across the Region, which outlines their mission, primary focus and main interventions/ activities.
At the National level:
Document key players engaged in health systems development and outline their mission and primary focus. The analysis should also highlight the current challenges in regard to macro health systems issues in South Africa such as commercialisation, social health insurance, regulation of the private sector, decentralisation and community participation.
The consultant will be required to produce a report and present this report to HST. The report should, in addition to outlining the environment internationally/nationally, make specific recommendations as to how HST fits into this environment, and how HST can maximize its position and fund raising potential.
We anticipate this work would require part time involvement over a three month period. The report should be ready early in 2006.
Expressions of interest (three pages maximum) should be sent for the attention of Dr. Lilian Dudley, CEO, to Mercia at email@example.com by 30 September 2005.