E4H Punjab TOR – Technical Assistance to H&PD for UHC Monitoring & CM Reform Agenda Initiatives through Embedded Delivery Unit

Evidence for Health (E4H) is a Foreign, Commonwealth & Development Office (FCDO)-funded programme aimed at strengthening Pakistan's healthcare system, thereby decreasing the burden of illness and saving lives. E4H (2023–2027) provides technical assistance (TA) to Punjab, Federal, and KP governments, implemented by Palladium in partnership with Oxford Policy Management (OPM).

Through its flexible, embedded, and demand-driven model, E4H supports governments to achieve a resilient health system that is prepared for emergencies, responsive to evidence, and delivers equitable, quality, and efficient healthcare services. Specifically, E4H delivers TA across three outputs:

• Output 1: Strengthened governance and institutional capacity for integrated health and population services.

• Output 2: Strengthened evidence-based decision-making for accountability and performance.

• Output 3: Improved implementation of Universal Health Coverage (UHC).

Background and Problem Statement

The Evidence for Health (E4H) Programme, funded by the Foreign, Commonwealth & Development Office (FCDO), supports the Health & Population Department (H&PD), Punjab, in advancing Universal Health Coverage (UHC) and implementing the Chief Minister’s Reform Agenda. To strengthen evidence-based decision-making and performance management, E4H supported H&PD in establishing the UHC Delivery Unit (DU) within the Health Information and Service Delivery Unit (HISDU) in 2023. The DU functions as the Secretary’s operational arm, translating routine data from HISDU, HMIS, and EMR systems into actionable insights for reform monitoring and progress tracking under the UHC Implementation Roadmap.

Since its inception, the DU has evolved from a pilot analytical team into an embedded institutional mechanism for monitoring reforms, rationalising resources, and aligning departmental performance with UHC and HSRP 2024–29 objectives. It has produced real-time dashboards and quarterly snapshots of UHC progress, enabling leadership to identify gaps, prioritise reforms, and allocate resources effectively. The Unit’s analytics have informed Secretary and Chief Minister stocktakes, supported rationalisation of HR and facility workloads, and guided initiatives such as the Maryam Nawaz Health Clinics, outsourcing of RHCs/BHUs, and digitisation under EMR integration. The DU also provided technical inputs for the Health & Population Department merger, monitoring of field hospitals, and development of the M&E Directorate framework. It has been commended repeatedly by H&PD leadership (including during the British High Commissioner’s visit), and the Secretary Health formally requested the DU’s extension beyond December 2025 in recognition of its institutional value.

Under the Health Sector Reform Plan (HSRP) 2024–29, Punjab is scaling up reforms in outsourcing, digital health, and service-delivery integration. The DU remains central to keeping these reforms data-driven, performance-oriented, and aligned with UHC/EPHS objectives. This TA revision seeks to enhance monitoring and analytical integration, and embed sustainability through formal capacity transfer to HISDU and departmental staff.

Problem Statement

The DU currently supports H&PD through analytics, performance insights, and evidence-based reviews. As the reform portfolio expands, the Unit must deepen analytical capacity (including financial-service linkages), strengthen analytical support for the better use of administrative data for decision-making, and secure sustainability through structured capacity transfer and formalised data-sharing protocols with H&PD (ensuring consistent access to administrative datasets).

Goal and Objective(s)

Overall Goal: Consolidate and enhance the DU’s institutional and analytical capacity for sustained UHC monitoring and reform tracking across H&PD.

Specific Objectives:

1. Institutionalise stronger coordination and data integration between the DU, HISDU, PIU, and MNCHI.
2. Enhance analytical depth by integrating financial and service-delivery data and improving data visualisation.
3. Support implementation of the UHC Roadmap through routine analytics, reporting, and evidence translation.
4. Ensure sustainability by structuring capacity transfer (e.g., developing SOPs, templates, and an LMS) to help the department reduce reliance on external TA for technical needs.
5. Maintain methodological alignment with the Embedded Public Health Adviser TA and the Data Governance TA.

Strategic Approach

Contribution to Health-System Strengthening

• Establish sustained evidence-to-action loops in H&PD decision forums.
• Improve data quality, interoperability, and use for reform management.
• Link financial, operational, and service-delivery data for accountability.
• Strengthen institutional capacity to maintain dashboards and analytical products.

 Alignment with other E4H TAs and Investments

• Embedded Public Health Adviser TA (technical/methodological backbone for DU/HISDU).
• Data Governance TA (interoperability, standards).
• HMIS and EMR interoperability TA.

Alignment with Other Partners

• Alignment with other development partners to improve data-driven decision-making, ensuring synergy and no duplication of work, including the World Bank (NHSP), WHO, UNICEF, and UNFPA.

Scope of Work and Methodology

Period: June 2024 – September 2026 (covering the work already initiated and extending beyond the current date of December 2025).

Phase 1 – Institutional Strengthening & Coordination

• Review/refine DU SOPs, workflows, templates; validate coordination with HISDU, PIU, MNCHI.
• Targeted capacity building for DU staff.
• Support to H&PD to formalize and evolve data sharing protocols for essential indicator calculation and mandatory reporting in line with global commitments.
• Align indicator logic/methods with the Embedded Public Health Adviser TA.

Phase 2 – Data Integration, Analytics & Reporting

• Operationalise integrated dashboards (HISDU, EMR/HMIS, PIU, MNCHI).
• Produce monthly analytical snapshots (UHC updates, departmental contributions, success stories, reform insights).
• Produce quarterly performance reports (equity splits, financial linkages).
• Maintain CM-level reporting and leadership policy briefs.
• Ongoing technical engagement with the Embedded Public Health Adviser TA for better decision making by the secretary office.

Phase 3 – Sustainability & Handover

• Sustainability/transition plan and role assignment.
• Finalise SOPs; integrate tools/templates into HISDU’s LMS.
• Final mentoring and handover to departmental counterparts.
• Final TA Report (achievements, lessons, recommendations).

Team configuration: The Public Health Adviser (through a separate E4H TA stream) will provide technical and methodological oversight to the Delivery Unit. DU The Team Manager will directly supervise two Associates and four Analysts.

Deliverables

Timeline of the TA is from January 2026 – September 2026

1. Monthly Snapshots - Compiled reports capturing DU’s analytical updates pertaining to UHC areas, reform insights, departmental contributions, success stories and coordination role in link with the E4H TA support through Public Health Expert.
2. Quarterly Reports - Comprehensive reports covering reform progress, UHC Roadmap indicators, and financial linkages.
3. Policy and Advocacy Briefs - Concise briefs summarising reform insights and recommendations for H&PD leadership and the CM Office.
4. Final Sustainability Report - Detailed handover document outlining capacity-transfer milestones, lessons, and continuity measures.

All team members of the Delivery Unit will be engaged through results- and deliverable-based contracts. The Team will have joint deliverables in the form of monthly progress reports, QPRs etc.

Analyst (Service Capacity) (Junior)

LOE: 162 days (subject to change)

Period: January 2026 – September 2026

Role Requirements

• Monitor bed density and workforce ratios across districts and facility types.
• Identify infrastructure and HR gaps and prepare data-backed recommendations for redistribution and investment.
• Collaborate with HISDU for integration of facility-level readiness indicators.

Technical Expertise

Bachelor’s or Master’s degree in Public Health, Epidemiology, Health Systems, Statistics, Pharmacy, Economics, Business Administration, Project Management or related field. 2–7 years of experience in facility performance or infrastructure analytics.

Core Competencies

Capacity analytics; HR/infrastructure metrics; Data-backed recommendation writing; Visualisation; Coordination with HISDU/PIU.

Deliverables

Same as above.