Consultant – Bridging the Gap: A Rapid Learning Review on Multilateral Development Bank (MDB) – linked Resource Mobilization for Health Program in Indonesia

CHAI Overview

The Clinton Health Access Initiative, Inc. (CHAI) is a global health organization committed to our mission of saving lives and improve health outcomes in low- and middle-income countries by enabling the government and private sector to strengthen and sustain 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 that 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/

Background

Indonesia has made considerable progress in expanding immunization coverage over the past decade, yet the COVID-19 pandemic exposed deep vulnerabilities in the country’s routine immunization system. The proportion of zero-dose (ZD) children surged in the last couple years, reversing years of hard-won gains and placing millions of children at risk of vaccine-preventable diseases. Addressing this challenge requires not only programmatic interventions at the community level but also sustained financial commitment and coherent resource mobilization across multiple financing actors and government systems.

In response, the Government of Indonesia, with support from the World Bank, Gavi, and the Global Financing Facility (GFF), launched the second phase of the Investing in Nutrition and Early Years (INEY) program (2023–2028), backed by over US$630 million in external financing. This Multilateral Development Bank (MDB) financing scheme is not a grant in the traditional sense. It primarily takes the form of concessional loans channelled directly to the national government through Ministry of Finance. The government is then responsible for incorporating these funds into national budget (APBN) and disbursing them to implanting agencies such as Ministry of Health. One of MDB financing instruments is Program-for-Results (PforR), a result-based financing instrument where disbursements are linked to the achievement of pre-agreed results, known as Disbursement Linked Indicators (DLIs). For example, under INEY Phase 2, the World Bank releases funds to the Government of Indonesia only when specific targets, such as Number of Districts that attain at least 8 percentage point increase in coverage of the first dose of Pentavalent (DPT – HB – Hib) vaccine, are met and independently verified. This approach is designed to incentivize government ownership, performance and accountability.

INEY Phase 2 introduced a dedicated focus on identifying, tracking, and reaching zero-dose children through a combination of community-based outreach, Posyandu strengthening, digital health integration via the ASIK application and SatuSehat platform, and performance-based financing incentives at the subnational level. The program operates through a Program-for-Results (PforR) instrument, linking disbursement to the achievement of of Disbursement-Linked Indicators (DLIs) – including immunization coverage targets – with the aim of incentivizing domestic government commitment and resource allocation for priority health interventions.

Indonesia’s INEY Phase 2 represents a significant investment in strengthening zero-dose immunization reach through MDB-linked financing mechanisms. As implementation reaches its midpoint, there is a timely opportunity to generate practical, implementation-oriented learning to inform the remaining program period (2025–2028). This rapid learning review will support government stakeholders in examining how zero-dose priorities intersect with planning, budgeting, and financing processes at national and subnational levels, and how INEY’s structure interacts with domestic resource mobilization and implementation dynamics. The objective is to identify opportunities to strengthen alignment between program priorities and financing mechanisms and to inform adaptive implementation during the remainder of INEY Phase 2. This exercise is designed as a forward-looking learning support activity and is not intended as a formal evaluation of program or financing instrument performance.

Objectives

This assessment aims to generate actionable evidence and lessons on how INEY Phase 2 has contributed to reaching zero-dose children in Indonesia, with a specific focus on program implementation and country-level resource mobilization, financial decision-making, and Multilateral Development Bank (MDB)-linked financing mechanisms.

Specific Objectives

• Document and evaluate the key strategies, interventions, and activities implemented under INEY Phase 2 that specifically target zero-dose children at national and subnational levels, including outreach, identification, and social mobilization approaches.
• Examine implementation experiences and emerging trends in zero-dose reach under INEY Phase 2 to identify enabling factors and implementation bottlenecks and where government efforts should be prioritized. Map and analyze the financing architecture for immunization in Indonesia, including the roles and contributions of MDB-linked financing (World Bank PforR), Gavi, GFF, APBN, APBD, Dana Desa, and BPJS Kesehatan capitation funding, and assess the degree to which these streams are coordinated and aligned toward zero-dose reach objectives.
• Examine the impact of INEY Phase 2 program implementation on country-level financial planning instruments, including the RPJMN, RKA-K/L, and DIPA, to determine whether zero-dose prioritization is adequately reflected in government budgeting and resource allocation processes.
• Assess how MDB financing instruments have influenced domestic resource mobilization (Disbursement-Linked Indicators (DLIs) and identify how government agencies can better engage with and leverage these instruments.
• Identify structural barriers within government systems limiting the prioritization of zero-dose reach through MDB and external financing channels, including Ministry of Finance (MoF)-led governance structures, incentive misalignment between program and financial decision-makers, budget cycle mismatches, and fiduciary constraints that reduce financing flexibility at the subnational level, with a view to informing practical government-side solutions.
• Capture good practices and innovations from selected national and subnational experiences that demonstrate effective integration of program implementation with resource mobilization and financial planning for zero-dose reach, including examples of successful domestic budget leveraging and inter-sectoral financing coordination.
• Generate actionable recommendations for strengthening the remaining INEY Phase 2 implementation period (2025–2028), improving MDB financing alignment with ZD program priorities, and informing the design of future MDB-supported immunization financing mechanisms in Indonesia and comparable country contexts.

Assessment Questions

To guide the assessment, the following overarching questions will be addressed:

• What implementation patterns and financing dynamics appear to support or constrain progress toward reducing zero-dose children under INEY Phase 2?
• Where and how has INEY Phase 2 intersected with national and subnational financial decision-making for immunization?
• How well are MDB financing instruments designed and implemented to incentivize zero-dose prioritization, and what structural factors limit their effectiveness?
• What lessons from INEY Phase 2 can inform stronger alignment between MDB-supported programs and domestic resource mobilization for immunization in Indonesia?

Scope and Approach

Geographic Scope

The assessment will cover national-level stakeholders and include deep-dive field assessments in a minimum of 4 districts across 2 provinces, selected purposively to represent variation in geographic context where INEY 2 implemented, ZD prevalence, and implementation performance (including both high-performing and lagging districts).

Methodological Approach

The consultant is expected to employ a rapid mixed-methods assessment approach, including:

• Document and data review:Analysis of program documents, INEY Phase 2 progress reports, immunization coverage data (ASIK/SatuSehat), subnational budget data, MDB financing agreements, and national health budget documents (DIPA, RKA-K/L).
• Key Informant Interviews (KIIs):With national stakeholders including the Ministry of Health (Directorate of Immunization, Directorate of Primary Health Care Governance, Directorate of Nutrition and MCH, Bureau of Planning), BPJS Kesehatan, Secretariat of the Directorate General of Primary and Community Health, the Ministry of Finance (MoF) – particularly units responsible for MDB loan management and health budget allocation – Bappenas, and development partners (World Bank, Gavi, UNICEF, WHO).
• Focus Group Discussions (FGDs):With community health workers (kader), Puskesmas staff, and district health office personnel in selected sites.
• Field observation:Of Posyandu activities, immunization outreach, and data recording practices at selected sites.

Deliverables

1. Inception Report: outlining the refined methodology, data collection instruments, sampling framework, ethical considerations, and detailed workplan.
2. Draft Assessment/Learning Report: a comprehensive report (maximum 50 pages, excluding annexes) presenting findings, analysis, and preliminary recommendations across all assessment objectives.
3. Final Assessment/Learning Report: incorporating feedback from stakeholder validation; to include an executive summary, full findings, good practice case studies, and actionable recommendations.
4. Policy Brief: a concise (maximum 4 pages) evidence-based summary of key findings and recommendations, suitable for government and development partner audiences.
5. Presentation Deck: a professionally prepared slide deck for dissemination to key stakeholders including the Ministry of Health and INEY program partners.

All deliverables must be submitted in English and Bahasa Indonesia.

Timeline

The total duration of this assignment is 8 weeks from the date of contract signing.

Qualifications of the Consultant

The selected consultant (individual or team) should demonstrate the following qualifications:

• Advanced degree in public health, health policy, epidemiology, or a related field.
• Minimum 5 years of experience in health program evaluation, health systems research, or immunization program assessment in Indonesia or similar low- and middle-income country contexts.
• Demonstrated expertise in mixed-methods research design and rapid assessment methodologies.
• Strong familiarity with Indonesia’s immunization program, primary health care system, and subnational governance structures.
• Experience engaging with government counterparts at national and subnational levels, particularly the Ministry of Health.
• Proficiency in both English and Bahasa Indonesia (written and spoken).
• Prior experience with INEY, Gavi-supported programs, or zero-dose immunization initiatives is an advantage.

Proposal Requirements

Applicants are requested to submit the following documents:

1. Technical Proposal: including understanding of the assignment, proposed methodology, work plan, team composition, and relevant experience (maximum 20 pages).
2. Budget Proposal: a detailed budget with unit costs and justification for all activities.
3. CV(s)of proposed team members, highlighting relevant qualifications and experience.
4. Work Sample: at least one sample of a previous rapid assessment, program evaluation, or research report of similar scope.

Proposals will be evaluated based on the following criteria:

This Scope of Work is subject to revision based on stakeholder feedback during the inception phase.

Budget and Disbursement

The projection budget estimate for this project is totalling up to IDR 100,000,000. This amount includes both the consultant fee; all applicable income tax and expenses related to activities necessary to deliver the objectives during the study. Payment will be disbursed by deliverables. The costs of the dissemination meeting will be covered by CHAI Indonesia.

Submission and Evaluation

Submission Deadline: 15 April 2026

Submission Method: Electronic submission to  Indonesiaoffice@clintonhealthaccess.org

and cc to: lsari@clintonhealthaccess.org