![Palladium Pakistan Pvt. Ltd](/static/company.png)
Posted date | 19th July, 2024 | Last date to apply | 31st July, 2024 |
Country | Pakistan | Locations | Peshawar |
Category | STTA | ||
Type | Consultant | Position | 1 |
Experience | 15 years | ||
Status | Closed |
TORs: Economist
KP TA – 02: Climate Health Vulnerability Assessment in Khyber Pakhtunkhwa And Development Of Climate Health Adaptation Plan
Programme
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.
Problem Statement
KP has experienced serious climatic challenges, leading to life lost, illnesses, and additional burden on an already weak health system. The 2022 floods also affected millions of people in the KP province. Conducting Climate Health Vulnerability Adaptation Assessments (CHVAs) is crucial for effective health adaptation measures. The KP CHVA will determine existing and future risks of climate change on public health and will enable the government to assess the capacity of its health system to effectively respond to challenges.
- During the 26th United Nations Climate Change Conference (COP26) in 2021, the health community agreed on the development of two key initiatives: 1) climate resilient health systems; and 2) low-carbon sustainable health systems.
- The Government of Pakistan approved a multisectoral NAP on Climate Change in 2023. The NAP recognises health as an adaptation priority amidst implementation hurdles.
- The M/o NHSR&C conducted a scoping study, which led to the development of a Framework of Action for Climate Resilient Health Systems in Pakistan in 2023. A key recommendation was the need to conduct a CHVA that will inform future climate health adaptation plans.
- A roundtable discussion among stakeholders was held in September 2023, with agreement to develop a coordination mechanism at national and provincial levels for a coordinated response.
- The KP DOH has initiated sensitisation of stakeholders in the province on climate resilient health systems and has expressed commitment to develop an evidence-informed KP CHAP.
Objectives
The overall objectives of the technical support are as follows:
- To institute a coordination, communication, and monitoring mechanism for conducting the CHVA and for the development and subsequent implementation of the CHAP;
- To comprehensively assess climate-health vulnerability across KP province through the CHVA, including clearly identifying at-risk geographical areas, health facilities, and key populations.
- On the basis of the assessment and in alignment with the NAP, to develop a costed CHAP that will serve as the roadmap for adaptation going forward; and
- Through the above, to identify capacity transfer and building initiatives for DOH officials involved so that they are able to conduct a future CHVA independently or with minimum support.
Scope of Work and Methodology
Throughout this assignment, a team of local consultants will work in collaboration and under the oversight of an international expert, who will provide guidance and technical support. The team will cover the following scope of work:
Thoroughly and critically analyse published and available tools for CHVA and conduct a cross-comparison of commonly used tools such as the World Health Organisation Strategic Toolkit for Assessing Risks (STAR) tool, Centres for Disease Control and Prevention (CDC) Building Resilience against Climate Effects (BRACE) tool, and the Health Canada Climate Change and Health Vulnerability and Adaptation Assessment (CCHVAA) etc. After selecting the tool, the scope of work will be as follows:
- Formation and activation of KP technical working group (TWG) on climate resilient health systems and Steering Committee
- Analysis of the vulnerability factors, exposure pathways, and gaps in health and social system to develop an understanding of the prevalence of climate-sensitive diseases across the diverse geographical landscapes of KP
- Employment of an iterative methodology in data collection and analysis to adapt and refine the process based on evolving insights
- On the basis of the assessment, projection of future health risks
- Identify and prioritise policies and programmes to increase the climate-resilience of health systems
- Establish an iterative process for managing and monitoring health risks with both consultations of internal and external stakeholders
- Examine the possibility of the development of intersectoral linkages with an aim of improving health
- Incorporate key results into a costed CHAP for KP
- Ongoing knowledge translation and dissemination of messages to stakeholders, community partners, and other organisations to promote positive public policy change
Considering the complexity and nuanced nature of this exercise, a detailed outline of the phases has been provided for easy reference. Please note that these steps are subject to iterative adjustments, particularly following the preparatory phase.
Preparatory Phase
Step 1: Framing and scoping the assessment
- Stakeholder engagement
- Methodology assessment/refinement
- Inception report detailing the chosen methodology, framework(s), and chosen tool(s) with rationales for the CHVA and development of a CHAP in KP
Data Synthesis and Analyses
Step 2: Review current vulnerabilities and capacities through an analysis of the following:
- KP climate vulnerabilities in general, as well as status and vulnerabilities in select districts. These districts will be a sample decided during the inception phase. It is expected that they will be representative of other similar districts in either close proximity or in terms of geographical and infrastructure landscape.
- Geographical and climate influences
- Demographic disease patterns
- Health infrastructure assessment - in sampled districts and health facilities
- Environmental factors and health outcomes
- Identification and distribution of vulnerable populations
- Migration patterns and health risks
- Retrospective analysis
- Predictive analysis
- Model integration
Step 3: Projecting future health risks
- Retrospective analysis
- Predictive analysis
- Model integration
Step 4: Identifying and prioritising policies and programmes to increase the climate resilience of health systems
- Policy and strategy assessment
- Monitoring and evaluation framework
- Local engagement and adaptation
- Contextual recommendations
- Cross sectoral consultations
- Initiate a capacity-building programme to empower the DOH staff with the expertise to independently conduct CHVA and plan interventions
- Develop the DOH’s technical and managerial proficiency and maintain knowledge continuity through staff transitions
- Implement training, workshops, project collaboration, mentorship, a knowledge hub, and feedback loops for skills reinforcement
Step 5: Establishing an iterative process for managing and monitoring health risks
Step 6: Examining the potential health benefits and risks of adaptation and mitigation options in other health-related sectors
Step 7: Capacity transfer recommendations and activities
- Initiate a capacity-building programme to empower the DOH staff with the expertise to independently conduct CHVA and plan interventions
- Develop the DOH’s technical and managerial proficiency and maintain knowledge continuity through staff transitions
- Implement training, workshops, project collaboration, mentorship, a knowledge hub, and feedback loops for skills reinforcement
- Monitor and evaluate the programme's impact on skill application and CHVA management efficacy
CHVA Completion and CHAP Development
Step 8: CHVA finalisation and closure
- The CHVA will conclude with a workshop, presenting draft findings to relevant stakeholders. This will also serve as an opportunity to build the capacity of the stakeholders on climate health nexus
- After integrating feedback from the workshop, a final report will be submitted to the DOH.
- Using the CHVA recommendations, hold consultations with stakeholders to define and prioritise interventions and actions to produce the CHAP
- Develop a climate-health communication plan to inform health stakeholders and the public
- Conduct a cost analysis of the proposed interventions while ensuring value for money, discuss potential financing strategies if possible
- The proposed KP CHAP should be aligned with IHR strengthening, Universal Health Coverage (UHC) and other relevant system strengthening plans
- Propose a coordination mechanism and implementation modality for the plan, linking it with the TWG for the CHVA
- Produce a monitoring and evaluation framework to monitor the progress of the plan
Step 9: Development of a KP CHAP
- Using the CHVA recommendations, hold consultations with stakeholders to define and prioritise interventions and actions to produce the CHAP
- Develop a climate-health communication plan to inform health stakeholders and the public
- Conduct a cost analysis of the proposed interventions while ensuring value for money, discuss potential financing strategies if possible
- The proposed KP CHAP should be aligned with IHR strengthening, Universal Health Coverage (UHC) and other relevant system strengthening plans
- Propose a coordination mechanism and implementation modality for the plan, linking it with the TWG for the CHVA
- Produce a monitoring and evaluation framework to monitor the progress of the plan
Step 10: Integrating Climate Health into Medical Education: Course/Module Development
- Using the insights from the CHVA exercise gather relevant information and search resources for developing a course/module (as per agreement) focused on climate-health nexus.
- Design comprehensive learning materials that integrate climate health concepts into existing medical education.
- Develop engaging assignments, quizzes and learning exercises focusing on climate change's impact on public health and adaptation strategies
- Collaborate with stakeholders to gather feedback, make revisions, and finalise the course/module for implementation at Khyber Medical University.
A focal point nominated by the Director General of Health Services and another from the KP Health Sector Reform Unit will be actively engaged, where possible, in capacity development regarding complex and holistic analyses and the development of a KP CHAP.
Timeline and LOE
The level of effort for the role is 20 working days, from July 24 – October 24.
Requirement
Technical Expertise
- Advanced knowledge of microeconomics and macroeconomics.
- Proficiency in regression analysis, time-series analysis, and panel data analysis.
- Expertise in STATA, R, and SAS for data analysis and visualization.
- Skilled in handling and interpreting large datasets and complex databases.
- Competence in cost-benefit analysis and impact assessments.
- Proficiency in analysing financial statements and economic indicators.
- Expertise in economic development and poverty reduction strategies.
Competencies
- Experience in managing research projects and teams.
- Application of economic theories to real-world issues.
- Strong mathematical and statistical abilities.
- Proficiency in conducting thorough economic research and literature reviews.
- Flexibility to adjust methods and approaches based on new information and changing conditions.
- Knowledge of government budgets, fiscal policies, and tax policy analysis.
Deliverables
- Application of econometrics to calculate the economic costs of health risks from climate change impacts and costing proposed adaptation measures.
- Develop a transparent and replicable methodology for costing health adaptation options identified in the vulnerability assessment. This methodology should consider both capital costs (infrastructure, equipment) and recurrent costs (maintenance, personnel) over a defined timeframe.
- Collect and analyse relevant economic data (health service costs, etc.) specific to the context of KP province. This may involve collaborating with government agencies, NGOs, and other stakeholders to obtain accurate cost estimates.
- Conduct a cost-effectiveness analysis for prioritised health adaptation options. This analysis should evaluate the cost per unit of health benefit achieved for each option, allowing for informed decision-making based on both cost and effectiveness.