The Clinton Health Access Initiative, Inc. (CHAI) is a global health organization committed to our mission of saving lives and reducing the burden of disease in low-and middle-income countries. We work at the invitation of governments to support them and the private sector to create and sustain high-quality health systems.

CHAI was founded in 2002 in response to the HIV/AIDS epidemic, with the goal of dramatically reducing the price of life-saving drugs and increasing access to these medicines in the countries with the highest burden of the disease. Over the following two decades, CHAI has expanded its focus. Today, along with HIV, we work in conjunction with our partners to prevent and treat infectious diseases such as COVID-19, malaria, tuberculosis, and hepatitis. Our work has also expanded into cancer, diabetes, hypertension, and other non-communicable diseases, and we work to accelerate the rollout of lifesaving vaccines, reduce maternal and child mortality, combat chronic malnutrition, and increase access to assistive technology. We are investing in horizontal approaches to strengthen health systems through programs in human resources for health, digital health, and health financing. With each new and innovative program, our strategy is grounded in maximizing sustainable impact at scale, ensuring that governments lead the solutions, that programs are designed to scale nationally, and learnings are shared globally.

At CHAI, our people are our greatest asset, and none of this work would be possible without their talent, time, dedication, and passion for our mission and values. We are a highly diverse team of enthusiastic individuals across 40 countries with a broad range of skill sets and life experiences. CHAI is deeply grounded in the countries we work in, with the majority of our staff based in program countries. Learn more about our exciting work: http://www.clintonhealthaccess.org

CHAI is an Equal Opportunity Employer, and is committed to providing an environment of fairness, and mutual respect where all applicants have access to equal employment opportunities. CHAI values diversity and inclusion, and recognizes that our mission is best advanced by the leadership and contributions of people with diverse experience, backgrounds, and culture.

Program Overview

CHAI established its presence in Sierra Leone in 2015, evolving from initial Ebola response assistance to become a strategic partner for health systems strengthening, initially focusing on Human Resources for Health and Supply Chain. Building on strong government relationships, CHAI expanded its programs to include sexual and reproductive health, vaccines, assistive technology, geospatial data, medical oxygen, and malaria elimination. This strategy consistently prioritizes maximizing sustainable, government-led impact at national scale, with global learning dissemination.

Project Background

The global health landscape is undergoing a fundamental shift. Major reductions in foreign assistance, including abrupt cuts to U.S. government-funded programs are forcing countries to transition quickly toward greater self-reliance. These cuts are part of a broader trend of declining Official Development Assistance (ODA) from several donor countries, creating a prolonged funding instability that threatens decades of hard-won progress across HIV, malaria, maternal and child health, and other critical sectors​. Recognizing this challenge, CHAI has launched a global effort to support governments during this critical transition. Through the establishment of Technical Support Units (TSUs), CHAI aims to provide rapid, embedded technical assistance to Ministries of Health to identify financing gaps, reprogram existing resources, mobilize sustainable domestic financing, and drive systemic reforms​​.

Sierra Leone's significant health improvements over the past decade, largely driven by substantial USG funding in areas like RMNCAH-N, malaria, and HIV/AIDS, now face a critical threat due to recent external funding reductions. These cuts risk reversing hard-won gains, deepening health inequities, and disrupting essential services without immediate, strategic action and alternative financing. To counteract this, CHAI is supporting the Ministry of Health by conducting robust, data-driven analyses to quantify the impact of these reductions, identify at-risk programs, and inform critical resource reallocation and mitigation strategies. It is also catalysing domestic resource mobilization efforts to foster long-term sustainability and reduce donor dependency.

Position Overview

The Clinton Health Access Initiative Inc. (CHAI) Sierra Leone is seeking a highly motivated and experienced Health Financing Manager to lead and support the Ministry of Health (MOH) in strengthening its health financing systems. In a rapidly evolving global health landscape marked by funding cuts and shifting priorities, this role is critical to helping Sierra Leone optimize its fiscal space, mobilize domestic and external resources, and ensure sustainable, equitable progress towards Universal Health Coverage (UHC).

The Manager will provide strategic technical assistance, analytical leadership, and project management expertise across a range of health financing initiatives. This position requires a blend of advanced analytical capabilities, strong government and partner coordination skills, and a strategic mindset to drive evidence-based policy and implementation. They will serve as a key member of the CHAI Sierra Leone team, and will actively support CHAI Sierra Leone’s health systems strengthening initiatives, serving as a collaborative partner to government health officials. They will facilitate engagement with CHAI's global HSS and Technical Support Unit (TSU) ensuring the execution of impactful programs aligned with government priorities.

CHAI places considerable emphasis on personal qualities such as resourcefulness, tenacity, independence, patience, humility, and a strong work ethic. Fluency in English is a requirement, with excellent communication and relationship-building skills, which are paramount for effective collaboration with diverse stakeholders. This role presents an exciting opportunity for a dedicated individual to make a meaningful impact in the realm of public health in Sierra Leone.

The Manager will provide technical expertise in health financing, resource optimization, health policy, and economic evaluation, and program fundraising. Reporting to the Associate Director, Programs, the Manager will:

• Assess and quantify the impact of funding cuts from USG and other major global health financing partners on key health programs, service delivery, and health outcomes in Sierra Leone. This will involve a consolidated analysis combining economic and health impact evaluations, alongside detailed mapping of donor investments, particularly in high-priority areas such as malaria, HIV/AIDS, tuberculosis, reproductive, maternal, newborn, child, adolescent health and nutrition (RMNCAH- N), and broader health systems strengthening. The insights generated will be critical for identifying gaps, informing mitigation strategies, and guiding the reallocation of resources to sustain essential health services.
• Strengthen the functionality and data quality of existing Resource Mapping and Expenditure Tracking (RMET) process to enhance coordination, data use, and evidence-based decision-making. This includes diagnosing bottlenecks to identify technical, institutional, and coordination gaps, and supporting the MOH to improve data collection, completeness, and timeliness.
• Build MOH’s capacity to manage and sustain the RMET process, while enhancing the utility of RMET outputs for health sector planning, resource allocation, and advocacy. This includes the development of real-time resource mapping and allocation dashboards to support timely, evidence-based policy and investment decisions.
• Develop evidence-based policy recommendations including scenario modeling, proposals, and business cases as well as actionable strategies for mobilizing, allocating, and managing domestic resources to sustain priority health services and reduce reliance on external aid.
• Evaluate the MOH fiscal space to identify opportunities for increased domestic resource mobilization, including options within government budgets, innovative financing mechanisms, and potential efficiency gains within the health sector.
• Engage with senior government officials of the MOH, MOF, and Integrated Health Projects Administration Unit (IHPAU) to advise on strategic financing reforms and resource mobilization strategies.
• Collaborate with CHAI’s HSS team to generate evidence to support the Global Fund Grant Cycle 7 (GC7) reprioritization and provide technical assistance for the Grant Cycle 8 (GC8) funding request for HIV, tuberculosis, and malaria (HTM) and Resilient and Sustainable Systems for Health (RSSH), with the aim of ensuring that program resources are directed toward high-impact areas, including strengthening and sustaining the national supply chain system, to help address gaps resulting from global health funding reductions
• Define and monitor key indicators related to efficiency, resource mobilization, and financial sustainability to guide ongoing decision-making and track progress
• Strengthen the capacity of national stakeholders, particularly the MOH and MOF to lead and implement sustainable health financing reforms aligned with the forthcoming Healthcare Financing Strategy (2026–2030).
• Manage and lead emerging health financing projects, the National Health Financing Strategy Development & Implementation process, National Health Accounts (NHA) & Data Utilization process Improve Budget Absorption & Allocative Efficiency, while ensuring timely delivery of high-quality outputs and effective coordination with government and development partners.
• Document and share progress, accomplishments, successes and learnings internally and externally to support learning across countries and for donor reporting purposes.
• Articulate and measure progress against program goals to enhance internal accountability.
• Facilitate cross-sectoral stakeholder engagement and coordination in health financing planning, ensuring alignment with national development priorities and increased accountability for health investments.
• Perform any other functions as assigned by the Country Director.

• Master’s degree (or higher) in Health Financing, Public Health, Health Policy, Public Administration, or a related field.
• At least 7–10 years of work experience in health financing, health systems strengthening, health policy and reform, preferably in low- or middle-income countries.
• Strong understanding of health financing structures in sub-Saharan Africa; direct experience working with National Health Insurance Schemes is highly desirable.
• Proven track record of conducting economic evaluations, financial gap analyses, or resource optimization strategies.
• Experience working directly with ministries of health, ministries of finance, or national health insurance bodies.
• Excellent analytical, strategic thinking, and problem-solving skills.
• Exceptional communication skills, including the ability to translate complex financial concepts into clear, actionable recommendations.
• Ability to work independently in a fast-paced, multicultural environment.
• Prior experience working with donor-funded projects (e.g., Global Fund, Gavi, USAID, World Bank) is an asset.

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