Hardship Level (not applicable for home-based)A (least hardship)
Family Type (not applicable for home-based)
Family
Staff Member / Affiliate TypeCONS Local
Target Start Date2024-08-01
Job Posting End DateAugust 7, 2024
Terms of ReferenceBackground:
As of December 2023, over 12,500 refugees and asylum seekers are residing in Indonesia, with 5,800 in Jakarta and the surrounding area. While some refugees are living under assistance, many are living independently and are in vulnerable situations, due to limited support to cover basic needs and access to health service. The United Nations High Commissioner for Refugees (UNHCR) Indonesia advocates for ensuring refugees’ access to human rights, including access to healthcare and inclusion in the national health insurance program, in collaboration with our health partner, Church World Service (CWS).
Refugees have access to primary healthcare facilities such as PUSKESMAS to be diagnosed and treated for basic health issues. Refugees are required to pay for the services at PUSKESMAS at the same rate as the Indonesian host community. Access to secondary and tertiary healthcare for independent living refugees remains very limited and UNHCR, in partnership with CWS, is only able to financially cover the most urgent and emergency care. Limited resources are one of the biggest challenges in fulfilling refugees’ rights to access health services. From January to December 2023, there were 3092 refugees who requested health assistance, and only 1723 were granted referrals for assistance due to funding limitations.
Building on the challenges refugees face in accessing general healthcare, obtaining HIV treatment presents an additional hurdle. While the Indonesian database now includes an option to register refugees, clear regulations regarding their access to antiretroviral medication (ARVs) are still lacking. This lack of clarity creates a barrier for independently living refugees seeking HIV treatment and care, which is currently primarily funded by UNHCR.
In order to improve refugee access to Universal Health Care (UHC), including care and treatment for HIV and SRHR, it is crucial to first understand the access barriers. This knowledge will help guide UNHCR and partners to act to remove barriers in order to improve access and greater inclusion in the national health system as well as the national health insurance system for Universal Health Care, including access to HIV and TB diagnosis care and treatment.
An accurate research and situation analysis regarding the current health condition of refugees in Jakarta and Greater Area is needed to understand the current gaps and barriers in accessing healthcare including HIV and TB care and treatment, the consequences of refugees are not able to access the required health services, and the recommendations to improve access to healthcare. The research will also explore the importance of refugees’ inclusion in the national insurance scheme looking at the overarching SDG goals and the Global AIDS strategy, which will be presented to the relevant government institutions. A careful analysis of spending on health care may also help determine the cost of insurance versus the current health assistance modality for refugees, as well as what services the schemes would be most suitable for. In response to this need, situation analysis on the refugee’s access to health is required for UNHCR to strategize its advocacy to the government, together with partners and other stakeholders.
Methodology:
- The research can use a mixed method of qualitative and quantitative approach by analysing the available data from UNHCR and its Partner Church World Service, and various legal formal aspects.
- Primary data collection will be conducted through field study: observation, interviews, and FGDs involving several main stakeholders, including but not limited to:
1. Refugees and asylum seekers in Jakarta and Surrounding Area
2. Church World Service (CWS)
3. Ministry of Health
4. WHO Indonesia
5. United Nations High Commissioner for Refugees
6. International Organization for Migration
7. PUSKESMAS in Jakarta and Surrounding Area
8. Partner Hospitals
9. UNAIDS Indonesia
10. Other UNHCR Health Partners
11. UNHCR country and regional health focal points
12. BPJS Kesehatan
13. Jaminan Sosial Nasional
- Secondary data collection will be obtained from desk research from the available data resources, including but not limited to books, laws and regulations, journals, working papers, reports on study results, and so on.
Organizational context:
The consultant will work under direct supervision of the Protection Officer from Protection Unit overseeing AAP and in close coordination with the Community Based Protection (CBP) unit.
Objectives of the Situation Analysis Project:
- Understand the barriers to access to UHC, including HIV and TB care and treatment, among the refugees in Indonesia; identify the effective mechanisms to improve access, including greater inclusion into national health systems and social security systems; and assess the financial implications of inclusion in the national health insurance program.
Duties and Responsibilities:
1. Conduct an assessment of health needs and identify gaps in health access for refugees, including non-communicable diseases (NCDs), communicable diseases, vaccination, mental health, and psychosocial support (MHPSS), as well as prevention and health promotion initiatives.
2. Evaluate the access gaps in HIV, tuberculosis (TB), and sexual and reproductive health and rights (SRHR) services among refugees.
3. Examine the implications and inequalities arising from the gaps in general health, HIV, TB, SRHR access, and health insurance access among refugees, and their impact on refugee well-being and the achievement of Sustainable Development Goals (SDGs).
4. Conduct a comparative analysis between private insurance schemes accessible to refugees and national insurance schemes to identify the advantages, disadvantages, and suitability for meeting the healthcare needs of refugees.
5. Develop recommendations to assist UNHCR’s advocacy and efforts to include refugees and asylum seekers in the national health system, including the national health insurance program.
6. Conduct a workshop to raise awareness of challenges, present research comparing private and national insurance options, and develop recommendations to support UNHCR's advocacy for refugee inclusion in the national health system and insurance program improving refugee access to national health insurance.
Core Deliverables:
1. Prepare a comprehensive situation analysis report that encompasses the findings from points 1 to 4 of duties and responsibilities, accompanied by an executive summary highlighting the key findings and recommendations.
2. Consultation session with UNHCR with the draft report to capture comments and review.
3. Deliver a presentation of the research findings and recommendations to UNHCR Indonesia and relevant partners, including Indonesian health authorities, offering insights and actionable recommendations to enhance health services and access for refugees, especially in insurance scheme through workshop and publication.
Timeline:
The activities are expected to be completed in three months, with tentative timeline and details.
Qualifications and Professional Experience Required:
Education
Advance university level qualifications in a relevant area including but not limited to in health statistic, public health, health actuary or related field.
Job Experience
- Demonstrates at least 5 years of experience in data analysis related work, research assignment, and report writing. Previous work experience with relevant government institutions or in public health program and refugee context, will be a significant advantage.
- Demonstrated experience in undertaking projects similar in nature and level of complexity, knowledge and expertise in Indonesian health system and insurance scheme is desirable.
- Demonstrated experience assessing innovation programmes or pilots highly desirable.
- Experience working with UN agency or international organization, with a focus on human rights and/or refugee issues.
- Knowledge of the humanitarian landscape in Indonesia, and exposure to the work done with refugees and other forcibly displaced populations in the country is an advantage.
Language
- Fluency in English (required)
- Fluency in Bahasa Indonesia (required)
Nationality
Citizen of Indonesia; non-citizen with Indonesian permanent residence
Competencies:
- Highly organized and autonomous, able to multitask and prioritize workload when necessary.
- Excellent writing and documentation skills, demonstrating high levels of attention to detail in English.
- Strong time management skills, including the ability to work quickly and to meet deadlines.
- Ability to work as a team, including remotely.
- Strong interpersonal and communication skills, including across cultural contexts.
- Works well in a multicultural team and has a strong work ethic; strives to deliver high-quality, error-free deliverables potentially targeting different types of users e.g., senior management and Results managers.
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Other informationThis position doesn't require a functional clearance
Home-BasedNo