International Consultant - Health Financing Data, National Health Accounts and Financial Protection, WHO Country Office, Phnom Penh, Cambodia

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Qualifications

Purpose of the Consultancy

The purpose of the consultancy is to strengthen Cambodia’s methods and national capacity for NHA production and financial protection monitoring (SDG 3.8.2), while providing technical inputs to the development of more integrated and digitalized health financing data systems.

Background

Cambodia has set ambitious goals to advance universal health coverage (UHC), as reflected in the UHC Roadmap 2024–2035 and the Fourth Health Strategic Plan (HSP4), including reducing out-of-pocket (OOP) spending to below 35% of current health expenditure by 2035. Achieving these goals requires reliable and timely health financing data to guide policy, resource allocation and monitoring.

National Health Accounts (NHA) and financial protection analysis provide complementary perspectives on health financing and progress towards UHC. NHA, based on the internationally agreed System of Health Accounts 2011 (SHA 2011), tracks the flow and use of resources across the health system, including the overall level and share of OOP spending. Financial protection analysis, guided by the global UHC monitoring framework developed by WHO and the World Bank and reflected in SDG indicator 3.8.2, examines the extent to which OOP spending exposes households to financial hardship, including catastrophic and impoverishing health expenditure.

The Cambodia Socio-Economic Survey (CSES), implemented by the National Institute of Statistics (NIS), Ministry of Planning, is the principal national household survey used to measure household consumption and expenditure, including spending on health. CSES data support both financial protection analysis and estimation of household OOP spending for NHA, but the two uses require different analytical approaches because they answer different questions. Financial protection analysis focuses on household-level impacts while NHA uses CSES information to support estimation of aggregate OOP spending within the national accounts framework. Cambodia has a long series of CSES surveys from 2009 onwards, currently conducted biennially; the 2025 questionnaire includes adjustments compared with recent rounds, with the dataset expected to become available in late 2026.

Cambodia has an established track record of NHA production and SDG 3.8.2 analysis with WHO support, and the resulting evidence has informed health financing policy dialogue and UHC monitoring. Recent reviews have identified opportunities to strengthen the completeness, granularity and consistency of expenditure data, improve OOP estimation and analytical methods, and further institutionalize the routine production and use of both NHA and financial protection evidence.

This assignment will take place alongside renewed efforts, beginning in 2026, to institutionalize routine NHA production, revisiting the methodologies of OOP estimation for NHA and SDG 3.8.2, and strengthen health financing data systems in Cambodia. Together, these efforts aim to strengthen the reliability and coherence of Cambodia’s measurement of national health expenditure and household OOP spending, providing a stronger evidence base for UHC monitoring and health financing policy.

Deliverables

Activity 1: CSES and OOP methodology review and mapping

Review available CSES questionnaires, survey reports, data dictionaries, datasets, health expenditure and consumption aggregates and analytical documentation from 2009 through 2023, including existing notes, do-files and WHO’s cross-year variable mapping, and complete and validate the mapping of OOP health expenditure, total household expenditure or consumption, household characteristics and other variables required for financial protection and NHA analysis;

Review and compare the 2023 and 2025 CSES survey (once the English version of the 2025 questionnaire, data dictionary and/or dataset become available), identifying material changes in questionnaire wording, item coverage, reference periods, survey design, sampling or weights, imputation, construction of household consumption aggregates and analytical treatment, etc.

Deliverable 1.1:
Technical review note on CSES and OOP measurement from 2009-2025, with a completed variable and methodology mapping and summary on methodologies and approaches used to produce SDG 3.8.2 and OOP aggregates and health spending categories for NHA.

Activity 2: Prepare and produce the 2025 financial protection (SDG 3.8.2) estimates
Under guidance from WHO, prepare or update reproducible, clearly annotated Stata do-files for the 2025 CSES
Once the 2025 CSES data becomes available, produce SDG 3.8.2 estimates in accordance with WHO guidance and in collaboration with the national government counterparts.

Facilitate technical exchanges and/or consultations to the government counterparts on financial protection estimation, quality assurance and interpretation, as requested.

Deliverable 2.1:
2025 CSES SDG 3.8.2 analysis package prepared and produced based on data availability.

Activity 3: Review and update NHA OOP methodology and historical data series
Review the current method used to estimate household OOP expenditure in Cambodia's NHA, including consultation with NIS and relevant national accounts staff, the methods and expenditure boundaries used to derive HFCE in Cambodia's national accounts and assess their alignment with CSES household consumption or expenditure aggregates.

Develop and test methodological options for translating CSES-derived OOP shares or ratios into aggregate NHA OOP estimates aligned with HFCE; recommend a preferred approach and document the rationale.

Produce the 2024 and 2025 OOP aggregates for NHA if the 2025 CSES data becomes available.
Support technical consultations with relevant national counterparts to validate assumptions, results and proposed changes.

Deliverable 3.1:
NHA OOP methodology note, including review of CSES-HFCE alignment, tested options, preferred method, assumptions, limitations and recommendations for application to future NHA rounds.
2024 and 2025 OOP aggregates for NHA once 2025 CSES data becomes available

Activity 4: Review and revise Cambodia’s 2017-2019 NHA data for GHED
Review Cambodia's 2017-2019 NHA data and metadata in GHED, and prepare agreed revisions focusing on the completeness of current health expenditure and exchange rates.

Deliverable 4.1:
Revised 2017-2019 NHA and GHED data package as agreed
Technical notes of key methodological decisions for the 2017-2019 revision.

Activity 5: Provide technical inputs to health financing data-system digitalization
Review relevant findings from the mapping of health financing flows, routine reporting systems and data points undertaken under the NHA institutionalization and health financing data-system strengthening initiative by WHO and government counterparts.

Advise on minimum facility- and programme-level expenditure data requirements that can support NHA production and other policy and management uses, with attention to source of funds, financing scheme, provider, function or service, disease or programme where feasible, economic classification, geography and reporting period.

Assess how proposed data elements and coding structures could be mapped to SHA 2011 classifications and incorporated into routine or digital financial reporting without unnecessary parallel reporting.

Recommend data definitions, validation rules, metadata, aggregation procedures and interoperability requirements needed to improve completeness, granularity, consistency and reuse of health financing information.

Deliverable 5.1:
Technical note on health expenditure data requirements and recommendations for integration, classification, validation and interoperability within the health financing data-system digitalization work.
Final consultancy report and complete technical handover package

Qualifications, experience, skills and languages

Educational Qualifications

Essential: University degree in health economics, economics, statistics, econometrics, public health, demography or a closely related field.

Desirable: Master degree or above, additional specialized training in household survey analysis, health financing, national accounts or health accounts and data management.

Work Experience

Essential: 
At least seven years of relevant professional experience in health financing, household survey analysis, financial protection monitoring, health accounts or related quantitative work.

Desirable:

• Demonstrated experience analysing household income and expenditure or living standards surveys using Stata, including construction of health expenditure and household consumption aggregates and application of complex survey design and weights.
• Demonstrated experience producing financial protection indicators, including catastrophic and impoverishing health expenditure, in accordance with international standards.
• Demonstrated experience with SHA 2011 and estimation of household OOP spending for national health accounts.
• Experience reconciling household survey estimates with national accounts aggregates, particularly HFCE, is highly desirable.
• Experience supporting government institutions in low- or middle-income countries and transferring analytical capacity is desirable.
• Experience in health financing information systems, data architecture, routine financial reporting or digitalization is an asset.
• Prior experience in Cambodia or the Western Pacific Region is an asset.

Skills/Knowledge

• Strong knowledge of financial protection concepts and SDG 3.8.2 methods.
• Strong knowledge of NHA, SHA 2011, GHED reporting and household OOP estimation.
• Advanced proficiency in Stata and sound practices for reproducible analytical programming and quality assurance.
• Ability to interpret survey instruments, data dictionaries, national accounts concepts and institutional data flows.
• Strong analytical writing, facilitation and communication skills and the ability to explain technical issues to non-specialist audiences.
• Ability to work independently, manage interdependent tasks and collaborate effectively with multidisciplinary and government teams.

Languages and level required
Essential: Expert knowledge of English.

Place of assignment

Offsite

Travel

The consultant is expected to travel to Phnom Penh, Cambodia, once or twice during the contract period and spend a total of approximately 4 weeks in-country to undertake the main activities, including engagement with the WHO Country Office and national counterparts. For the remainder of the contract period, the consultant may work remotely but should be available and reachable during the majority of core working hours in the Cambodia time zone upon request.

Remuneration and budget (travel costs are excluded):

Remuneration: USD 450 per day (payband level B), up to maximum of 70 working days throughout the contract duration
Expected duration of contract: 4.5 months

Additional Information:

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