KP TA: PFM REFORMS - CAPACITY BUILDING EXPERT

KPTA Strengthening Financial Management, Digital Accountability, and Institutional Capacity for Effective Implementation of PFM Reforms 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 has adopted the Facility Level Budget and Expenditure Management Policy (Health), 2024 (FLB-EMP) to move primary healthcare financial management from pooled, centralised arrangements towards facility-level planning, budgeting, execution and accountability. E4H technical assistance has supported the Department of Health (DOH) to pilot and subsequently expand the reform, with facility-level budgets now incorporated into the government budget for the E4H-supported districts.

The reform has now reached an important execution stage. The Health Department is in the process of establishing Drawing and Disbursing Officer (DDO) functions at Rural Health Centre (RHC) level by authorising RHC in-charges to spend the budgets allocated to their respective facilities. This administrative process is expected to be completed within the coming weeks, creating an immediate need to ensure that the new DDOs can exercise their responsibilities in a compliant, confident and accountable manner.

The institutionalisation priorities are therefore threefold: convert the approved FLB/DDO Manual into standard PHSA training modules and materials; build the practical financial-management capacity of RHC in-charges and their support teams; and establish a government-owned, searchable expenditure-tracking dashboard linked with IFMIS/HISDU for routine monthly budget execution review and management use.

This assignment is an extension of the existing E4H FLB implementation TA. The existing PFM Expert and Capacity Building Expert will therefore be extended to preserve institutional memory, established working relationships and technical continuity from policy operationalisation and district implementation into the institutionalisation phase. Both experts have led or supported the development of FLB tools, the DDO Manual, district capacity building, budget preparation and government coordination; retaining them avoids a new learning curve and enables the six-month extension to focus immediately on institutional transfer, DDO readiness and practical implementation.

Problem Statement

FLB has moved successfully from policy design and facility-level budget preparation to the point where RHC in-charges are expected to assume DDO responsibilities. The remaining challenge is to ensure that these responsibilities are supported by institutionalised PHSA training, practical DDO capacity and routine digital visibility of facility-level expenditure through existing government systems, rather than by continued intensive TA or parallel tools..

Goal and Objective(s)

The overall goal of this TA extension is to institutionalise the execution-side requirements of FLB-EMP within routine Health Department systems so that newly authorised RHC DDOs can manage facility budgets effectively, while sustainable training and digital expenditure monitoring are embedded within government structures.

The TA extension will achieve this by pursuing three objectives:

Objected 1: Institutionalise FLB/DDO capacity building within PHSA by converting the approved FLB/DDO Manual into standard training modules, facilitator and participant materials, assessment tools and an institutional delivery mechanism for induction, promotional and refresher training.

Objected 2: Strengthen the practical capacity of RHC in-charges and nominated support staff to exercise DDO responsibilities, including budget execution, delegated financial powers, procurement, AG/DAO requirements, financial records, reconciliation, reporting, internal controls and audit readiness.

Objected 3: Establish a government-owned, searchable digital expenditure-tracking dashboard on the Health Department or DGHS website, linked with IFMIS/HISDU and accessible to DDOs across the province for monthly budget execution review reports and management decision-making.

Scope of Work and Methodology

The TA will be implemented over six months from October 2026 to March 2027. E4H will provide focused technical assistance for module conversion, initial DDO capacity strengthening and establishment of the expenditure-tracking dashboard, while PHSA, FMC, DGHS, DHOs, and relevant digital-system counterparts provide the institutional platform, resource persons, data access and routine follow-up required for government ownership. The scope is organised around three workstreams.

Workstream 1 – Institutionalisation of FLB/DDO Training through PHSA: The approved FLB/DDO Manual will be converted into standardised PHSA training modules, including defined learning outcomes, facilitator and participant materials, presentations, practical exercises, case studies, and assessment tools. The modules will be embedded within PHSA’s routine training system, including relevant induction and promotional training, while providing a standardised platform for future refresher and DDO training. PHSA and FMC will jointly own the technical content and delivery arrangements, with E4H providing technical support for module development, instructional design, and initial institutionalisation

Workstream 2 – Capacity Strengthening of RHC DDOs: A five-day, competency-based programme will strengthen the practical financial management capacity of RHC in-charges in preparation for DDO authorisation: Training will cover delegated financial powers, budget execution, Chart of Accounts, procurement, payment processing, AG/DAO requirements, cash book and inventory management, reconciliation, financial reporting, internal controls, and audit readiness. The programme will target at least two officials from approximately 48 RHCs and two from each of 10 DHO offices (approximately 116 participants), delivered in manageable cohorts. Government will support participant nomination, training infrastructure, and resource persons from PHSA, FMC, DGHS, Finance Department and AG/DAO. E4H will provide technical adaptation, initial delivery support, practical assessment and quality assurance, with subsequent refresher training transitioning to government institutions.

Workstream 3 – Digital Expenditure Tracking through Routine Government Systems: Existing facility-level budget and expenditure flows will be reviewed to develop a searchable FLB expenditure dashboard within the Health Department/DGHS digital environment. Linked with IFMIS/HISDU, the dashboard will enable DDOs to routinely monitor approved budgets, expenditure, utilisation, balances, and agreed performance indicators, strengthening transparency and evidence-based financial management. E4H will support process and data mapping, dashboard design and configuration, testing, user guidance, and initial operationalisation. The Health Department/DGHS, HISDU and FMC will assume ownership of data access, hosting, security, administration, maintenance and continued operation, supporting sustainability within routine government systems.

Capacity building will be competency-based and directly linked to the DDO responsibilities being assigned to RHC in-charges. Government will nominate the RHC/DHO participants, provide PHSA/DHDC or other available training infrastructure and designated resource persons from PHSA, FMC, and DGHS. E4H will provide focused technical adaptation, initial facilitation and quality assurance during the training sessions.

PHSA will be the permanent institutional home for the standard FLB/DDO modules and training materials, with FMC maintaining technical PFM content and DGHS/DHOs supporting operational application. Once the modules and initial cohorts are completed, refresher and future DDO training should be delivered through government training arrangements and recurrent resources rather than repeated stand-alone trainings.

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

The digital component will also be embedded in routine government systems. The searchable dashboard will sit on the Health Department or DGHS website and will draw data from IFMIS/HISDU for its analysis and use. Government counterparts will retain responsibility for data governance, hosting, user access, administration, maintenance and continued use for monthly budget execution review, while E4H provides time-bound technical support for design, establishment, testing and handover.

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

Requirement

Technical Expertise

• Postgraduate degree (master’s or higher) in Public Financial Management, health management, education/training, PFM or related field, or a related discipline, with a minimum of 15 years of relevant professional experience.
• Demonstrated experience designing/delivering competency-based public-sector training;
• Experience with FLB/DDO functions and PHSA/STS-type institutional training systems.

Competencies

• Adult learning and facilitation; ToT/master-trainer systems; mentoring; curriculum implementation; institutionalisation/change management; ability to work with clinicians and financial staff.