August 2017
Background
The Department of Global Health and Population (GHP) at the Harvard T.H. Chan School of Public Health improves global health through education, research, and service from a population-based perspective. Over the past half-century, our faculty members, students, and researchers have helped shape the field, and have launched some of the major ideas in global public health and population sciences. The Health Systems cluster within GHP focuses on the governance, financing, and delivery of health care at national and sub-national levels and within health institutions.
We are pleased to have a multi-year collaborative research project with the Government of Malaysia to address how health care is financed and delivered. By joining our team September 2017 to June 2018, you would contribute to helping Malaysia undertake significant steps to transform its health system as the country transitions to high income status, as well as advancing the field of health systems reform. Specifically, we seek an enthusiastic and motivated candidate, the “Organization Transformation Researcher,” to conduct research on the organizational implications and strategies for the Malaysia MOH of the possible system-level reforms to health care financing and delivery reforms being considered. The scope of possible organizational transformation would include key structures and functions of the MOH as well as developing new strategic purchasing capacities. More information about the Malaysia Health Systems Reform Project is available here.
Objective
The Researcher will bring a theoretical and practical knowledge of organizational change within public institutions to help address questions about the impact of the potential reforms on the institutional organization of the Malaysian Ministry of Health (MOH). For example, the introduction of a “purchaser-provider split,” strategic purchasing, and/or new financing models such as health insurance would have implications for the traditional roles and functions of the MOH, and would also require organizational change to reflect new roles and responsibilities. The purpose of this work is to inform early planning within the MOH and GOM about organizational changes that may be needed in the medium and long term to support a health system transformation in the context of changes in health care financing and delivery, strategic purchasing, and new forms of government engagement in a pluralistic healthcare delivery market. Drawing from international experience, the analysis will examine the options Malaysia may want to consider about how the function and organization of the MOH may change and about the capacities within the MOH and beyond that will be needed to support the new structures and functions.
Examples of the structures and functions that may evolve include the following:
- MOH might gain functional responsibility in new areas such as regulation, quality assurance, and accreditation related to the increasingly robust private sector of health providers in Malaysia.
- If significant funding shifts to a purchasing body, what would the impact be on the existing structure for financial and policy management?
- What would happen if local health facilities had more financial independence and were no longer directly funded and managed from the central ministry as budgetary units?
The establishment of an effective strategic purchasing function is a critical component to the reforms underway, because it will help use new incentive mechanisms to optimize resources for Malaysia’s health system in the medium to long term. Effective purchasing requires organizational change and the development of appropriate capacity, for example, instituting a governance structure for holding the purchaser accountable, and developing technical and human resource capacity in conducting its functions.
Duties & Responsibilities
Specific duties and responsibilities include contributing to the following deliverables:
- Set of organization transformation (OT) case studies and webinars about the experiences of ministries of health in other countries who have undergone significant organizational transformation, to highlight their trajectories of reform and related experiences with organizational change. Participating in the planning and successful delivery of webinars
- A final set of presentation(s) and/or paper(s) synthesizing organizational change pathways and options for MOH. Components will include: exploration of the current structure and its strengths and weaknesses; assessment of the fitness-for-purpose of the current structure in relation to the planned health system reforms; key lessons from the experience of other countries that have transformed their health systems and health ministries to move to more effective models; assessment of a case for change for Malaysia; generation of options for change; identification of the pros and cons for each option; assessment of the sequencing of actions for change; and elaboration of risks with the major transition that the change will involve.
- Set of strategic purchasing (SP) case studies highlighting reform experiences in a targeted number of other countries that have adopted distinct institutional arrangements for strategic purchasing.
- A final set of presentation(s) and/or papers(s) recommending the design of a strategic purchasing function and the associated organizational arrangements for its establishment, with a comparative analysis drawing from international experience. The comparative analysis would inform a discussion of options for Malaysia describing various strategic purchasing models that Malaysia could pursue, with an analysis of benefits and drawbacks and key considerations related to each option.
- Developing academic publications on organizational structure and function in MOH’s in middle and upper income countries and their experiences with organizational transformation, in collaboration with other project scientists and faculty.
Working Relationships
- The overall assignment is from September 2017 to June 15, 2018.
- The Researcher will be expected to spend two to three months in Malaysia, flexible within the October 2017 to March 2018 timeframe.
- The Researcher will report primarily to Peter Berman, Professor of the Practice of Global Health Systems and Economics, and leader of the Organizational Transformation work. The Researcher will also report to Chi-Man (Winnie) Yip, Professor of the Practice of International Health Policy and Economics, for the Strategic Purchasing work; and have a strong working relationship with Elizabeth Osborn, Researcher for Organizational Transformation and overall Project Director.
- The Researcher may have opportunities to publish paper(s) in relevant journals.
Type of Appointment
- There is flexibility for the type of appointment, based on the qualifications and experience of the successful applicant. This position could be filled as research staff position, post-doc fellow, research associate, or visiting scientist position.
Desired Qualifications
- The ideal candidate will be committed to advancing public sector reform and ideally will be skilled in the area of organizational change as it relates to public health institutions at the national or sub-national level. S/he will possess both practical and theoretical knowledge in the areas of organizational change and/or public administration. Practical knowledge should be demonstrated by past experience having contributed to or having conducted some form of organizational analysis related to a major reform of public administration.
- The successful applicant will have at least a master’s degree in a field related to public administration or public health, with 3 years relevant work experience such as working on organizational issues and reforms in large public-sector bodies in middle or upper income countries.
- Familiarity with health financing reforms such as strategic purchasing is desired though not required.
To apply for this position, please email CV and coverletter to Elizabeth Osborn, Project Director (eosborn@hsph.harvard.edu).
