KP TA: SENIOR NATIONAL STTA – M&E / FP Performance Expert

(Strengthening Integrated District Health Systems, Family Planning Performance Monitoring and Governance through Functional Integration of Health and Population Welfare Department Initiatives in Khyber Pakhtunkhwa)

Programme Overview

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 provides technical assistance (TA) to the Federal, Khyber Pakhtunkhwa (KP), and Punjab governments, and is being implemented by Palladium along with Oxford Policy Management (OPM).

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

Output 1: Strengthened integrated health security, with a focus on preparing and responding to health emergencies, including pandemics.

Output 2: Strengthened evidence-based decision-making to drive health sector performance and accountability.

Output 3: Improved implementation of Universal Health Coverage, with a focus on ending preventable deaths.

Background

The Government of Khyber Pakhtunkhwa is pursuing stronger integration of family planning (FP) within mainstream health services, including the relocation/co-location of approximately 350 Population Welfare Department (PWD) Family Welfare Centres within health facilities and wider efforts to strengthen FP delivery through PHC, district hospitals and community platforms.

However, physical co-location does not in itself ensure functional integration. Effective integration requires PWD and the Department of Health (DoH) to work through coherent arrangements and mechanisms for service delivery, referrals, commodities, outreach, data and performance monitoring, supervision, planning and district-level accountability.

There is an immediate opportunity to embed FP/population stabilisation within existing district health-system mechanisms, particularly District Action Planning (DAP), Facility Level Budgeting (FLB), District Health Planning and Management Teams (DHPMTs), and routine performance review, rather than establishing or sustaining parallel systems.

This opportunity is reinforced by ongoing PHC investments and service reforms that can provide additional entry points for FP, particularly through maternity, postnatal, immunisation and community services, including postpartum family planning (PPFP). Previous work in KP has specifically identified post-natal and routine immunisation contacts as opportunities for integrating FP counselling and services.

This opportunity is further supported by the provincial reform direction provided through the Good Governance Reform Roadmap (GGRR) and the broader national population agenda, which provide an enabling platform for strengthening FP governance, policy implementation, planning, accountability and financing. Alignment with these reform priorities can help position FP and population stabilisation as an integral part of routine health-sector planning and performance management, while strengthening coordination between DoH, PWD and other relevant institutions at provincial and district levels.

Problem Statement

Despite progress in bringing PWD and DoH services closer together, there is no clearly defined and consistently applied operational model for functional integration across service delivery, district planning, performance monitoring and accountability. As a result, opportunities to embed FP within routine PHC and district health systems, improve coordination and optimise existing resources are not yet being fully realised.

Goal and Objective(s)

The overall goal of this TA is to strengthen the integration and performance of family planning and population stabilisation services within routine primary health care and district health systems in Khyber Pakhtunkhwa, through stronger functional integration of the Population Welfare Department and Department of Health.

We will achieve this by pursuing three objectives:

Objective 1: Assess how functional integration between PWD and DoH is currently operating at facility, district and provincial levels, identifying system and service-delivery bottlenecks, good practices and opportunities to strengthen integration.

Objective 2: Develop and support the operationalisation of a practical, sustainable and scalable model for PWD–DoH functional integration that embeds FP within routine PHC service delivery, district planning, performance monitoring and accountability mechanisms.

Objective 3: Provide targeted implementation support in the four districts and at provincial level where E4H has supported District Action Plans (DAP) and roll-out of Facility Level Budgeting (FLB), using these existing health-system platforms to strengthen FP service delivery, joint planning, performance monitoring and district-level accountability.

Scope of Work and Methodology

The assistance will strengthen FP service delivery and functional integration between the PWD and DoH through two linked components. The first will assess existing arrangements and develop a practical model for functional integration; the second will provide targeted implementation support in the four E4H DAP/FLB districts to strengthen FP services through existing PHC and district management systems. The components will be implemented in phases but will inform each other, enabling implementation experience to shape a realistic and scalable integration model.

Component 1: Assess and develop a model for functional integration of FP within PHC

The assistance will undertake a rapid assessment of existing integration arrangements, with particular attention to PWD facilities/services relocated or co-located within DoH facilities. Using document and data review, key informant consultations and a purposive sample of facility and district visits, the assessment will examine how integration works in practice across service delivery and client pathways; FP commodities; referrals and outreach; workforce roles and supervision; data and performance monitoring; planning and budgeting; and governance and accountability at facility, district and provincial levels.

The assessment will look beyond physical co-location to determine the system functions required for effective integration. This will include examining the respective roles of DHOs, District Population Welfare Officers (DPWOs), DHPMTs and PWD Technical Committees (DTCs), and whether DTC functions could be aligned with or serve as a technical arm of DHPMTs rather than operating through parallel arrangements. It will also assess opportunities to link PWD's Regional Training Institutes (RTIs) with PHSA for more coordinated pre- and in-service capacity development.

Based on the findings, E4H will facilitate a government-led co-design process to develop a practical functional integration model. Rather than proposing organizational merger or a new vertical FP structure, the model will define how the two departments can work together through existing systems while retaining their respective mandates. It will set out practical arrangements for integrated FP/PHC service delivery and referrals; commodities and outreach; roles and coordination mechanisms; joint planning and budgeting; data and FP performance review; supportive supervision and accountability; and capacity development.

The model will explicitly consider how FP can be embedded within ongoing PHC reforms and investments, particularly 24/7 and maternity services through PPFP, ANC/PNC and immunization, and LHW/community platforms.

Component 2: Strengthen FP services through district health systems in four DAP/FLB districts

In parallel, the TA will provide targeted implementation support in the four districts where E4H has introduced DAP and FLB, using these existing platforms to strengthen FP services rather than establishing a separate district FP intervention. Dedicated RH/FP coordination support will work with DHOs, DPWOs, DHPMTs and facility teams to identify priority FP service and performance gaps and incorporate agreed actions, resource requirements and indicators into routine district and facility planning and review.

Support will focus on a limited number of practical system improvements identified with each district, including strengthening PWD–DoH coordination; strengthening the DTRC as a technical platform for joint FP review and linking its recommendations and follow-up with the DHPMT and routine district planning and performance-review processes; establishing or strengthening the appropriate district forum for joint FP review; improving referral and commodity arrangements; strengthening FP and PPFP linkages with PHC and 24/7 maternity services; and introducing a small set of actionable FP indicators into routine district performance reviews. Earlier provincial work similarly envisaged FP services across PWD and DoH outlets, commodity availability and joint performance monitoring.

The district support will also provide an opportunity to apply, learn from and progressively refine the functional integration model under Component 1. In the district where E4H's DHO reform model is being rolled out, the TA will specifically explore how FP integration, DTRC–DHPMT linkages, PWD–DoH coordination and joint accountability can be embedded within the strengthened DHO management model.

Phasing and institutionalisation

The assistance will therefore follow a phased but overlapping approach: an initial rapid diagnostic and early district mobilisation; co-development of the functional integration model alongside implementation support in the four districts; followed by consolidation of implementation learning, refinement of the model and agreement with government on institutionalisation and potential scale-up. Throughout, E4H will work through existing PWD and DoH structures, with RH/FP coordination support serving as a temporary facilitation function rather than a parallel delivery structure, so that responsibilities can progressively transition to district and provincial government systems.

Sustainability: Capacity Building, Institutionalisation, and/or Transition Planning

Capacity development will be embedded within existing government structures and progressively shift from TA-supported training and mentoring to government-led delivery. In particular, the assistance will support an RTI–PHSA institutional partnership to embed relevant curricula, strengthen and maintain a pool of trainers, and support continuous professional development beyond the life of the assistance, building on the capacity development approach described in the methodology.

Rather than E4H operating parallel district FP systems, RH/FP Coordinators will work alongside DHO, DPWO and DHPMT teams, strengthening their capacity to undertake facilitation, monitoring and follow-up as part of routine government functions. DAP, FLB and DHPMT performance reviews, together with existing PWD/DoH reporting mechanisms, will provide the principal vehicles for embedding assistance -supported practices, tools and accountability processes within routine government workflows.

Responsibility for TA-supported functions will be progressively transferred to designated government counterparts during implementation, rather than being handed over only at assistance closure. Roles and responsibilities for facilitation, monitoring, follow-up and oversight will be clarified and progressively assumed by relevant district and provincial institutions, with assistance support reducing as government ownership and capability increase.

This assistance is designed not only to provide immediate technical support but to ensure that core governance, coordination, and monitoring functions are fully embedded within DGHS and can be sustained independently beyond the TA period. Sustainability will be achieved through a structured and time-bound transition approach, combining institutionalisation of systems with progressive transfer of responsibilities to HSRU counterparts.

Timeline and Days

The proposed LOE is 60 days from October 2026 to March 2027 subject to final confirmation from client.

Requirement 

Technical Expertise

•  Master’s or higher in public health, epidemiology, biostatistics, M&E, health information systems, population studies/demography or related discipline.

• 15 years’ experience in M&E with substantive FP/RH experience.

• Expertise in FP indicators, routine information systems, data quality, RBM, performance frameworks and data use for management decisions.

• Familiarity with PWD/DoH reporting and CCI/FP monitoring desirable.

Competencies 

• Strong quantitative and analytical capability; ability to rationalise indicators and reporting requirements;
• Expertise in data-quality and data-use improvement; capacity building and facilitation;
• Ability to translate data into actionable management information.