National Senior - Capacity Building Expert

KP TA: Support to the Department of Health in the Implementation of Facility Level Budget and Expenditure Management Policy (Health Sector) 2024 in Additional 04 Districts

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.

Position Summary

The proposed TA aims to support the DOH in scaling up the implementation of the FLB-EMP in four additional districts. Building on the institutional momentum, technical foundations, and inter-departmental buy-in developed during the initial TA in District Peshawar, this extension will focus on translating policy into practice at scale and deepening systemic reforms in health facility budgeting and expenditure management. Specific objectives of the proposed TA are:

• Support DOH in operationalising the FLB-EMP in four new districts by providing technical assistance to DHOs, facility managers, and PCMCs in these districts in undertaking facility-level planning, budgeting, and expenditure management in line with FLB-EMP guidelines.
• Strengthen the institutional and operational capacity of district and facility-level stakeholders through structured orientation, on-site mentoring, and practical training sessions to enable development of annual action plans, budget estimates, and expenditure tracking mechanisms.
• Facilitate the activation and tagging of cost centres and disaggregation of HR and non-salary budgets, from pooled budgets in these districts to facility level cost centres, to ensure accurate facility-level financial reporting and resource tracking through the IFMIS system, enabling evidence-based planning and efficient budget execution.
• Provide support for monthly and quarterly budget execution reviews at both facility and district levels, using the defined KPIs to monitor performance and inform course correction.

• Promote cross-district learning and policy refinement by capturing implementation insights, challenges, and lessons learned, and sharpening the strategy for province-wide institutionalization, developed under the existing TA.

Scope of Work and Methodology

This proposed TA will provide hands-on support to the DOH, DGHS, HSRU, and district health offices in extending the implementation of the FLB-EMP to four additional districts. The TA will follow a structured, step-by-step approach—combining provincial-level coordination with district-level capacity building and on-site support. The methodology will focus on enabling district and facility teams to lead budgeting and expenditure processes, guided by the FLB-EMP. This support will be delivered through a blend of orientations, practical tools, planning templates, and regular technical mentoring to institutionalise routine budget planning, monitoring, and reporting at the facility level. The scope of work is detailed below:

1. Endorsement and Selection of Additional 04 Districts

• Conduct session of the Working Group to appraise on initial implementation, present the strategic rationale for scaling up to new districts ensuring full provincial buy-in and providing the overarching strategic direction for the subsequent phases of the expanded rollout.
• Secure the formal directives required to extend policy implementation support to the four additional districts.
  • Checkpoint 1: Submit Minutes of the meeting of the Working Group endorsing approval for expansion of the TA support and selection of 04 additional districts.

-   Deliverable 1: Minutes of Working Group meeting.
Due Date: 04 weeks from the award of the TA.

 Capacity Building and Development of Draft Budgets

• Conduct orientation sessions (12 session) at selected 04 districts with officials of DHO office, BHUs, RHC and Cat-D hospitals and respective PCMCs on facility level budgeting and expenditure management policy and guidelines.
• Undertake HR reconciliation process in selected 04 districts to distribute the pooled HR within the existing budget codes (i.e., pooled budgets for BHUs, RHCs, and Cat-D hospitals, respectively. It shall be noted that separate cost centres for each BHU, RHC, and Cat-D hospital have been created in the Integrated Financial Management Information System (IFMIS), however, these remain notional only and no expenditure transactions are conducted within any of these cost centres).
• The HR reconciliation process will include:
• Conduct sessions with the facility managers to support in undertaking the needs assessment process, preparation of annual action plans, and preparation of budgets for their respective health facilities.
• Conduct sessions with the DHO offices in these districts for review and compilation of facility level budgets.  Support DHO offices in consolidating facility-level action plans and budget estimates into a unified budget submission that will also serve as an input for the Integrated DAP’s Financial and Operational Plan.
• Support configuration of position codes in HR Module of IFMIS in respective cost centres of BHUs, RHCs, and Cat-D hospitals.
• Support RHCs and Cat-D hospitals in developing customised books of accounts and other templates for sanctioning and incurring expenditures out of their designated cost centres in 04 additional districts.
• Provide handhold support to RHCs and Cat-D in exercising routines and protocols for incurring expenditures.
• Support the DHO office, RHCs and Cat-D hospitals in generating various financial statements as per the Policy and Guidelines.
• Support the DHO office, DGHS, and HRSU in undertaking budget execution reviews for these districts.
  • Checkpoint 2: Orientation sessions in 04 additional districts conducted.
  • Acquire Sanctioned Posts for FY 2025-26 for respective districts from Budget Officer VI of Finance Department
  • Obtain latest standard posts criteria for each health facility from DG Health 
  • Distribute BPS and Designation wise posts among concerned facilities (BHUs, RHCs & Cat-D Hospitals)
  • Collect Payroll data from District Accounts Officer (DAO)
  • Assign each individual employee to respective Facility based on Sanctioned Strength

-   Deliverable 2: Report of the orientation sessions.
Due Date: 12 weeks from the award of TA.

• Checkpoint 3: Compiled facility level draft budgets submitted by respective DHO offices to DOH for inclusion in the annual budget.

-   Deliverable 3: Evidence of submission of draft budgets by DHO offices to DOH.
Due Date: 35 weeks from the award of TA.

• Checkpoint 4: Finance Department incorporates FLB for 04 districts in budget for FY 2026-27.

-   Deliverable 4: Demand for Grant (Current Budget) for Health for FY 2026-27.
Due Date: 40 weeks from the award of TA.

• Checkpoint 5: Facilities prepare financial statements and budget execution reviews conducted at district and provincial levels all 04 districts.

-   Deliverable 5: Budget Execution Review Report for 1st Quarter FY 2026-27
Due Date: 52 weeks from the award of TA.

-   Deliverable 6: Budget Execution Review Report for 2nd Quarter FY 2026-27
Due Date: 64 weeks from the award of TA

 Review and Updated Strategy for Up-scaling

• Review and assess implementation progress and key lessons from the four additional districts.
• Engage stakeholders from DOH, DGHS, HSRU, and participating districts to validate findings.
• Update the scale-up strategy document to incorporate revised timelines, resource needs, digital tool integration (e.g., apps, IFMIS improvements), and lessons learned. The scale-up strategy will also integrate standardised tools and frameworks to be developed under the DAP TA (e.g., equity profiles, performance scorecards, bottleneck analysis) to inform facility level planning and budgeting.
• Validate the updated rollout strategy in a final consultative session to ensure broad stakeholder ownership and commitment beyond the TA implementation.
  • Checkpoint 6: Revised and updated implementation strategy prepared containing strategic approach and methodology with detailed plan to rollout the policy and guidelines across KP.

-   Deliverable 7: Updated Scale-up Strategy.
Due Date: 70 weeks from the award of TA.

Responsibilities

The CB Expert will work to achieve the following:

1. Supporting the implementation of the facility-level budget and expenditure management policy and guidelines in the select district.
2. Assist the HSRU, DGHS, and district-level health teams build the necessary skills and knowledge to operationalise this policy.
3. Train facility managers, PCMCs, and relevant district health officials on budget preparation, resource allocation, expenditure management, and financial reporting.

Timeline and Days

The level of effort (LOE) for the role will be 160 days from Sep ’25 – Jan ‘27.

Requirement

Technical Expertise

• Advanced degree in Public Financial Management, Economics, Public Administration, or a related field.
• Deep understanding of andragogy principles, participatory training techniques, experiential learning, coaching/mentoring approaches, and digital learning platforms.
• Proven ability to conduct systematic TNAs, skills gap analyses, and institutional capacity assessments using mixed methods (surveys, interviews, focus groups, observation).
• Expertise in designing structured learning curricula, modules, toolkits, job aids, and facilitator guides tailored to diverse audiences (technical staff, managers, policymakers).
• Experience developing comprehensive, multi-year capacity building strategies aligned with project goals, institutional reform objectives, and sustainability plans.
• Understanding of change management principles and experience supporting institutional strengthening, process improvement, and embedding new skills/knowledge into organizational routines.
• Familiarity with the health financing and economics to ensure capacity solutions address relevant technical competencies.

Competencies

• Ability to engage diverse audiences, manage group dynamics, deliver interactive training sessions, and present complex concepts clearly and compellingly.
• Strong interpersonal skills to build trust, collaborate effectively with government counterparts, training institutions, beneficiaries, and project teams.
• Ability to tailor approaches to different cultural, institutional, and resource contexts, and adjust plans based on feedback and changing circumstances.
• Excellent written and verbal communication skills for preparing reports, strategies, training materials, and communicating progress to stakeholders.
• Proactive in identifying capacity gaps, developing creative solutions, and overcoming challenges in resource-constrained environments.
• Focus on achieving measurable improvements in capacity and performance, with commitment to delivering high-quality outputs on time.
• Ability to work effectively within multidisciplinary teams, lead consultants/trainers, and foster a collaborative learning environment.
• High level of sensitivity and respect for local norms, protocols, and power dynamics, especially when working with government institutions.