Programme Overview

The Fleming Fund, established in 2015, is a UK aid programme, by the UK's Department of Health and Social Care that seeks to gather and share antimicrobial resistance data. The programme supports up to 25 countries across Africa and Asia to address the global threat of drug-resistant infections, also known as antimicrobial resistance (AMR). The programme aims to enhance the capacity of targeted countries to diagnose drug-resistant bacteria, generate data, and strengthen surveillance to inform policy and practice at national and international levels.

DAI has been partnered with the Fleming Fund programme in Pakistan since 2019. Following the successful completion of Fleming Fund Phase 1, the UK Department of Health and Social Care approved DAI’s application to lead the Phase 2 of the Fleming Fund Country Grant in Pakistan (FFCGP) for an additional two years (i.e. January 2024 to December 2025). DAI acts as the lead grantee, responsible for the overall technical, financial, and management implementation of the project. Other partners of Country Grant Pakistan in Phase 2 include: the Liverpool School of Tropical Medicine (LSTM), Health Security Partners (HSP), and Shifa International Hospital. Phase 2 of the CGP focuses on achieving the following four intermediate outcomes:

• Intermediate Outcome 1: Production of quality AMR/C/U and burden of disease data
• Intermediate Outcome 2: Conducting quality data analysis
• Intermediate Outcome 3: Sharing quality data analysis with decision-makers
• Contribution to Long-term Outcome: Promoting sustainable investment at country and global levels to counter AMR
• Context and Background of the Assignment

Since 2019, FFCGP has been supporting the establishment and operationalisation of sentinel surveillance sites in both the Human Health (HH) and Animal Health (AH) sectors. This support has included significant investments in strengthening laboratory functions, particularly in enhancing data management systems and capacities for AMR surveillance. These efforts are aligned with Pakistan’s National Action Plan (NAP) on AMR and are implemented through a One Health lens to ensure multisectoral coordination and sustainability.

Phase 2 of FFCGP places strategic emphasis on the production of quality AMR data, its robust analysis, and the dissemination of user-friendly, high-quality data outputs to inform decision-makers at federal and provincial levels. In this context, the quality of data being generated from the sentinel sites is of paramount importance. Without consistent, complete, accurate, and timely data, the utility of surveillance outputs for decision-making is severely compromised. It is therefore essential to undertake a systematic assessment of the quality of AMR surveillance data produced by these sites.

The Data Quality Audit (DQA) is one of the core deliverables under the approved FFCGP Year 2 Workplan. It seeks to examine the data management processes at selected HH and AH sentinel sites, assess the fidelity of data flow across all levels of the surveillance system, and identify technical and procedural gaps that may hinder the production of high-quality data. The audit will also examine the application of standard AST interpretation guidelines (e.g., CLSI/EUCAST), evaluate data security and confidentiality protocols, and verify the alignment between electronic and paper-based systems.

The findings from this audit will inform targeted technical support and corrective measures, leading to strengthened data systems and improved reporting practices. In doing so, the DQA will enhance the reliability of AMR data submitted to national repositories and global platforms such as GLASS, ultimately contributing to more accurate trend analyses and evidence-based policy recommendations.

Through this assignment, the FFCGP reinforces its commitment to building a robust, sustainable, and high-quality AMR surveillance system that supports evidence-informed decision-making at all levels.

This assignment will be jointly conducted by the M&E Expert / DQA Coordinator and the AMR Technical Expert, who will work in close coordination to ensure comprehensive planning, implementation, and reporting of the Data Quality Audit across selected sentinel sites.

Assignment Purpose
The primary purpose of this assignment is to assess the quality of AMR surveillance data being generated and reported by selected sentinel sites in the HH and AH sectors, in alignment with the One Health approach. The DQA will evaluate key dimensions of data quality—such as accuracy, completeness, timeliness, consistency, precision, integrity, and confidentiality—across both electronic and paper-based data systems.

The selected consultants will be responsible for planning and conducting the audit using standardised tools and checklists, verifying data across all levels of the surveillance system, and documenting findings through a structured scoring framework. The ultimate aim is to identify technical and procedural gaps, and provide actionable recommendations to improve data quality at the site, institutional, and system levels—thereby contributing to the generation of high-quality AMR data that can be effectively used for national and global decision-making.

Assignment Scope
The scope of the assignment includes:

• Geographic Scope: The Data Quality Audit (DQA) will be conducted at a total of six sentinel sites, including:

1. Four (04) HH sites
2. Two (02) AH sites

This selection ensures alignment with the One Health framework and represents a cross-section of provincial and institutional contexts.

• Technical Scope: The audit will focus on routine AMR surveillance data and assess:

1. Data sources such as sample registers, AST results, and microscopy logs
2. Electronic systems including LIMS, WHONET, DHIS2, Excel forms, and AMR dashboards
3. Data flow across site-level, aggregation platforms, and national repositories (e.g., NIH database, GLASS templates)
4. Quality dimensions including accuracy, completeness, timeliness, consistency, integrity, confidentiality, and standardised AST interpretations

• Timeframe: The assessment will cover data from the last two completed quarters:

1. Q1: January–March 2025
2. Q2: April–June 2025

The assessment scope will be finalised during the inception phase in consultation with Country Grant Pakistan team.

Proposed Methodology

The DQA will use a mixed-method approach combining desk review, site visits, data verification, interviews, and direct observation. Key focus areas will include data accuracy, completeness, timeliness, consistency, integrity, precision (including AST interpretation practices), and confidentiality. Desk review will cover surveillance protocols, SOPs, and system architecture. Field visits to selected sentinel sites will include structured interviews with lab and data staff, and observation of data management workflows. A sample of raw data entries will be verified against electronic reporting systems (e.g., LIMS, WHONET, DHIS2), and AST interpretations will be cross-checked for adherence to CLSI/EUCAST standards. A standardised scoring system will be applied to assess site performance and document findings.

The final methodology, including tools and checklists, will be agreed upon during the inception phase.

Position Summary and Key Responsibilities
The AMR Technical Expert will provide technical oversight and subject-matter expertise for the DQA of AMR surveillance data across selected sentinel sites in the HH and AH sectors. This short-term assignment supports the Fleming Fund Phase 2 objectives by ensuring that data generation and reporting practices are technically sound, standardised, and aligned with national and international AMR surveillance protocols. The expert will focus on reviewing laboratory procedures, assessing the application of AST methodologies (e.g., CLSI/EUCAST), and verifying the quality and consistency of data across surveillance systems. The role requires strong expertise in AMR surveillance, laboratory standards, AST interpretation, and technical advisory support. Key responsibilities of the expert include:

• Provide technical guidance for reviewing surveillance protocols, inclusion criteria, and testing standards used at sentinel sites.
• Support the review and verification of laboratory procedures, including specimen collection, AST methodologies, and interpretation practices (CLSI / EUCAST).
• Assess consistency and quality of AST data, including accuracy of zone diameter readings and interpretations.
• Review the application of SOPs, lab guidelines, and use of software (LIMS, WHONET, AMR Dashboards).
• Participate in site visits to observe lab and data workflows, ensuring adherence to AMR surveillance standards.
• Support scoring and documentation of technical aspects in DQA tools.
• Contribute to the DQA report with technical insights, gap analysis, and standard-compliant recommendations.
• Support the presentation of findings to stakeholders and technical working groups.

Assignment Deliverables
The AMR Technical Expert, in collaboration with the M&E Expert / DQA Coordinator, will be responsible for producing the following deliverables:

1. Inception note detailing DQA implementation plan, tools/checklists. and timelines.
2. Daily/weekly fieldwork updates and summaries.
3. Completed DQA checklists for each site.
4. Draft and final DQA Report covering the following key aspects:

• Executive Summary
• Introduction – Objectives, background, and relevance to AMR surveillance strengthening
• Methodology - Tools, criteria, and site selection
• Findings – Site-specific and aggregated insights
• Conclusion – Summary of key findings and identified gaps
• Action Plan and Recommendations – Targeted corrective actions (Short and medium term/ immediate and strategic) addressing technical gaps, procedural inefficiencies, and capacity-building needs

5. Presentation of findings to the FFCGP team and relevant stakeholders.

Assignment Timeframe
The assignment is expected to commence from 1st July 2025 and will continue till 31st August 2025. Key milestones and timelines will be agreed upon at the inception meeting.

Required Qualification and Experience

• Advanced degree (Master’s or above) in Microbiology, Public Health, Veterinary Medicine, or a relevant field.
• Minimum 8 years of experience in AMR surveillance, laboratory systems, or infectious disease control.
• Proven understanding of national and global AMR standards and guidelines (e.g., GLASS, CLSI, EUCAST).
• Familiarity with AMR surveillance systems such as WHONET, LIMS, and dashboard platforms.
• Experience with One Health approaches and inter-sectoral coordination in AMR.
• Strong technical writing and presentation skills.