Technical Consultant at Living Goods

About the job

Living Goods is seeking a technical consultant in epidemiology and health economics to estimate the lives saved, cost-effectiveness, and ROI of its programs using 2021 program monitoring data and recent evaluation results. The consultant(s) will also support the organization with additional analytical and strategic requests related to understanding, operationalizing, and advocating the use of ROI and cost-effectiveness in its programs and with its government partners and other stakeholders.

Context: Impact, cost-effectiveness, and ROI analyses are central to improving and driving durable investments in high-quality, large-scale community health programs and systems. Living Goods has developed a composite impact metric called “HIHTs” or “high impact health touches”, to monitor the impact of its programs and strengthen the performance of community health programs. HIHTs include the evidence-based interventions and services delivered by community health workers that contribute most directly to saving and improving lives, currently focusing on a priority ‘basket’ of ~10 top interventions currently delivered by LG CHWs in LG-supported programs. (For example, one of the HIHTs is the count of artemisinin combination therapy treatments recorded for positive malaria cases identified by rapid diagnostic tests).

Location: Remote with a strong preference for consultants with large overlap with East Africa time zone

Timeline: January – June 2022, with the majority of work frontloaded Jan – March 2022

Estimated LOE: 30-60 FTE Days

Objectives:

• Develop updated estimates of lives saved and cost-effectiveness measures (cost per life saved, cost per HIHT) for LG programs in Uganda and Kenya using 2021 program monitoring data, forthcoming external evaluation (randomized controlled trial) results, and an external data source such as DHIS2 electronic health records.
• Review and build on previous methodology and estimates from deterministic models using data from 2019 – June 2020, and the results of our first RCT with IPA on 2010-2013 data from our program in Uganda
• Update existing analytical decision support tools and potentially structural upgrades of this. These are currently in Excel with extensive documentation and reporting of outputs in PowerPoint slides. While it is preferable for management continuity and legibility to continue in MS Office software, it may be possible with discussion to use/port into other tools such as R if this is a strong preference of the consultant.
• Must provide simplified visualization/reporting to summarize and communicate key findings to various audiences (e.g. continued summary in slides and written documentation, more interactive/automated tools could be explored such as RShiny website, Tableau if the consultant is already skilled and prefers to provide data visualization in these)
• Refine HIHT and current lives saved methodology as needed, applying critical appraisal and updating source scientific literature as appropriate and feasible, for example:
• Pragmatically review the epidemiology literature (e.g. successors of the Child Health Epidemiology Reference Group) and associated key meta-analyses/systematic reviews to update parametric estimates on disease burden and clinical effectiveness, or to include data from further interventions where available, such as family planning (cf. IHME Global Burden of Disease, Cochrane reviews)
• Assess the LG in-house method vis-à-vis other child health decision support tools such as LiST/the Lives Saved Tool, to make ongoing recommendations on refinement and/or adoption of other methods based on functionality and scientific robustness
• Explore/consider methodological extensions that may result from the above, e.g. probabilistic sensitivity analysis extending beyond current deterministic sensitivity/scenario analysis in order to more precisely quantify joint parametric uncertainty
• Update High Impact Health Touches (HIHT) Methodology including a) key interventions/indicators included; b) recommendations on possible weighting, considering the tradeoffs between rigor and useability; c) recommended targets linked to mortality reduction goals and lives saved estimates by program, and d) methodology to link HIHTs to estimated lives saved. Priorities are likely to include several of the below:
• Incorporation of updated data linking HIHTs to lives saved from forthcoming RCT of our scaled-up program, as well as internal performance management and accounting data
• Epidemiological (health benefit) weighting based on relative life-saving impact of each intervention vis-à-vis national and/or subnational burden of disease, case fatality ratio, and real-world effectiveness of the intervention
• Cost weighting based on level-of-effort from community health workers as well as relative epidemiological/life-saving impact of interventions, e.g. via brief time-and-motion study or similar methods, and/or use of mobile app data
• More holistic costing including government partner costs, subject to feasibility of data collection/sharing
• Build strategic framework, methods, roadmap, and recommendations for collecting and using HIHTs, ROI, and cost-effectiveness data with government partners, including an approach for collecting government costing data in 2022 and/or input into evaluation (s) that will be taking place in government-supported areas which could collect this data.
• Solicit and incorporate external input on concepts and methods such that results are robust, externally validated and methods can be replicated by other partners and practitioners in community health. -
• Provide ad hoc strategic and technical support on lives saved, cost-effectiveness and ROI related to requests from LG leadership, government partners, prospective and existing funders, or other stakeholders.

Deliverables:

• Lives Saved and Cost-effectiveness Estimates: Brief (3-5 pages for External Dissemination) & PPT (5-10 slides for external sharing) & decision support tools (version for both external sharing and internal performance management, in MS Excel or other widely accessible software to be agreed) with lives saved and cost-effectiveness modeling and estimates across LG programs in UG and KE. Includes estimates, analysis, methods used, rationale, data sources, key assumptions, and recommendations.
• HIHTs Methodology: Brief (3-5 pages for External) on High Impact Health Touches (HIHTs) 2.0 definition, methods, targets, and weighting
• Strategic framework, roadmap, methods, and recommendations for building and using HIHTs, ROI, and cost-effectiveness data with government partners, including collecting government costing data: Internal brief (5-7 pages) and PPT (10-15 slides).
• All back up excel, word, and PPT, interview notes for reference
• Additional deliverables to be agreed as a part of the ad hoc support

Estimated Level of Effort and Timing: We estimate approximately 30-40 FTE days in Q1 2022, with the work weighted earlier in that timeframe and up to an additional 20 FTE days in Q2 for this assignment, with the opportunity to extend beyond that timeframe.

Experience and Qualifications

• Masters (Ph.D. preferred) in Epidemiology, Health Economics, Public Health, Bio/Medical Statistics, Actuarial Science, Quantitative Social Science/Policy or other relevant fields
• Demonstrated technical experience in conducting epidemiological and/or cost-effectiveness modeling in public health programs, and in critical appraisal of the literature to synthesize heterogeneous evidence/data sources for such models.
• Strong understanding of Monitoring, Evaluation, Research, and Learning, including past experience in program evaluation to drive strategic planning, particularly quantitative methods for health outcomes (e.g. interpretation of meta-analyses, ideally across both experimental and observational methods)
• (preferred) Experience with RMNCH and/or community health workers, especially complex decision support tools in maternal and child health, such as LiST and GBD.
• Record of peer-reviewed publication in this specialty is a plus, and maybe explored for this further work.
• Excellent quantitative analytical skills, and proven proficiency to rapidly develop decision support tools in MS-Excel/comparable software.
• Excellent written, verbal, and interpersonal communication skills
• Experience working with multiple stakeholders with diverse backgrounds and skills
• Ability to translate analysis and findings to non-technical audiences through writing and presentations
• Demonstrated ability to work independently, be highly organized, use judgement, and meet deadlines
• Fluency in reading and writing in English is required. French is a plus.
• (preferred) Previous experience in non-technical strategy or operational management of public health programs, particularly in resource-limited settings in Sub-Saharan Africa