TA Title: Delivery Unit to Implement the Universal Health Coverage (UHC) Roadmap

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 (2023-2027) provides technical assistance (TA) to Punjab and also to the Federal and Khyber Pakhtunkhwa (KP) governments. The Punjab component is being implemented by Palladium along with Oxford Policy Management (OPM).

Through its flexible, embedded, and demand-driven model, E4H Punjab will support 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 will deliver 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.

E4H-Punjab works in partnership with the Punjab Department of Health (DOH).

Terms of reference

Background and Problem Statement

Accelerating the implementation of Universal Health Coverage (UHC) is one of the core objectives and key thematic areas of the Evidence for Health (E4H) Programme in Punjab. Under SDG 3.8, UHC is considered the best investment in human capital and a foundational driver of sustainable and inclusive economic growth and development.

Despite improvements in the National UHC Service Coverage Index (SCI), which increased from 39.7 in 2015 to 52.7 in 2022, only half of Pakistan's population has access to essential health services. According to Pakistan's UHC Monitoring Report 2023, achieving an SCI of 80+ by 2030, as targeted by SDG 3.8.1, will be challenging.

In Punjab, the SCI was slightly higher than the national average, at 53.8 in 2022. A notable milestone was the finalisation of the UHC Benefit Package/Essential Package of Health Services (EPHS) by the provincial government in 2021. This comprehensive package underscores the government’s commitment to UHC by ensuring the provision of essential health services to all residents of Punjab, marking a significant step towards improving population health and achieving UHC.

Despite these efforts, UHC implementation in Punjab faces significant challenges on governance, accountability, and use of data systems for evidence based decision making. There are also socioeconomic and geographic disparities in healthcare access across the province, particularly in the southern regions where SCI scores remain low. The Primary & Secondary Healthcare Department (P&SHD) plans to enhance UHC investments and optimise existing resources while maintaining rigorous service delivery monitoring.

Strategic Approach

The E4H Programme will provide Technical Assistance (TA) to establish a delivery unit to monitor the roadmap for UHC. Creating this unit must align with expanding the existing Family Planning Delivery Unit under the DAFPAK programme.

This TA Package in Punjab will be linked with three other ongoing/or proposed activities including: 

1. The UHC Roadmap

2. Trickle down TA of the District Action Plans for UHC in which E4H may choose to select/socio-economically deprived districts aligning with major reforms and revamping plan of the health facilities

3. Track progress the of the UHC monitoring and evaluation framework developed in the previous FCDO investment and also assess the need to update some of the baseline figures of the proposed indicators.

•  The Government of Punjab has adopted a roadmap approach for six priority areas, including the health sector.

• The Health Sector Reform Plan (HSRP) 2024-2029 for Punjab encompasses reviving the Roadmap approach for comprehensive reforms, revamping Basic Health Units (BHUs) and Rural Healthcare Centres (RHCs) with substantial investments, shifting the focus on family planning to healthcare facilities, outsourcing facility management and community health workers, launching mobile health units under the Chief Minister Clinic on Wheel Initiative, implementing EMR and HMIS for data integration, enhancing preventive care with new vaccine and improved immunisation services, continuing and revising Universal Health Insurance, formulating a Stunting Reduction Programme, and developing a significant initiative to address non-communicable diseases such as diabetes and Hepatitis C.

• In the budget—in the first three months—four schemes cost around PKR 40 billion to rehabilitate and revamp BHUs and RHCs. These are part of the provincial Annual Development Plan (ADP).

• The Delivery Unit will be housed within HISDU. It will act as the secretary's operational arm to ensure that the P&SHD’s UHC roadmap is implemented, monitored, and reviewed to ensure any strategic interventions at the Secretary’s level.

• To enhance the Delivery Unit's operational support, E4H plans to execute a parallel TA focusing on developing the UHC roadmap. This strategic TA aims to engage key stakeholders at the level of the Health Minister for P&SHD and the Chief Minister. It is designed to facilitate the UHC Steering Committee's reestablishment, ensuring that UHC SCI's improvements are achieved through combined strategic and operational efforts.

• The successful implementation of the roadmap should improve UHC SCI across all districts in the province.

• The Delivery Unit will take advantage of the improved data flow following the execution of the TA of data governance that E4H is concurrently providing and report quarterly to the Roadmap Oversight Team housed in the Chief Minister’s (CM) office in Punjab.

It is important to note that given Punjab’s current UHC SCI score, the country’s strained economic resources, and the CM’s roadmap approach, the Delivery Unit will prioritise the primary care level as the first phase of the health sector reform strategy. The fact that Punjab has historically focused on tertiary care also factors into this strategic priority for the province now. 

Objectives

The main objective of the delivery unit is to monitor progress of the UHC roadmap which will be developed through TA under E4H  and to build institutional capacities for evidence-based decision-making and accountability. It will define key performance indicators for the South, North, and Central districts in Punjab, monitor them regularly, and analyse data to report regularly in stocktakes.

(The unit will be providing support to the Secretary Health and the CM to hold the department accountable through regular performance stocktakes).

Sub-objectives

1. To work on the UHC SCI in Punjab, focusing on Primary Health Care (PHC).

2. To coordinate and liaise with the STTA UHC implementation roadmap team to develop a roadmap aligned with the Department's 5-year HSRP and CM’s health sector priorities.

3. To liaise with the Data Governance embedded TA team (including DHIS II and EMR) to ensure the Delivery Unit can identify areas of data quality improvement.

4. To liaise with international development partners engaged in all UHC-related activities to create synergies and avoid duplication of efforts.

Scope of Work

Phase 1: In the first phase, the Delivery Unit is expected to establish a solid foundational strategy aligned with the UHC roadmap and provincial health policies. This may include, among other tasks:

Checkpoint(s)

• Conduct a kick-off workshop to align the Delivery Unit’s strategic objectives with the UHC roadmap

• Establish an understanding of clear goals, responsibilities, and timelines for the Delivery Unit

• Approval of TORs and action plan by the Secretary

Phase 2: In the second phase, the Delivery Unit is expected to execute the action plan and ensure coordination among various stakeholders and decision-makers, which is essential for UHC implementation and decision-making.

• Implement a monitoring system to track progress against the UHC roadmap using indicators identified through a rigorous consultative process between the P&SHD and the CM office.

• Report the data to the CM’s health roadmap focal points and present data in quarterly stocktakes.

• Utilise data analytics to provide the Secretary with insightful, actionable feedback for Department’s internal monthly review (CEOs, Medical Superidentent, DC IRMNCH&N Conferences).

• Oversight on UHC implementation trends, challenges, and opportunities such as:

  • Set up an integrated data dashboard connected to data flowing into HISDU that collates real-time data.
  • Monitor the progress in relevant data indicators in the province and develop KPI to highlight equity gaps through disaggregation of data by region (North, Centre & South), districts, poverty and other possible equity indicators.

• Provide the Secretary with policy briefs, talking points, and advocacy briefs presenting the need for financial and non-financial resources. This will enable the Secretary to advocate for sustained investment in UHC implementation.

• Focal points within the Department, specifically from HISDU, will be identified for capacity building to carry out the Unit's functions, especially the capacity to analyse data to facilitate evidence-based decision-making.
• The analytics, policy briefs, reports etc developed by the Unit will be disseminated on regular basis on the Government forums such as CEOs, Medical Superidentent, DCs IRMNCH&N Conferences and any other learning events organised by Departments.
• The Unit will identify any possible areas where they can help cross validate data collected by the MERL component of this Programme such as Health Facility Assessment findings. Conversely, the Unit’s deliverables such as policy briefs and analytics can be reviewed by the Programme’s MERL team. This collaborative effort will further help identify areas for implementation research.

The UHC Delivery Unit will comprise a Team Manager (01), Associates (02), and Analysts (04) who will collectively work towards the successful implementation of the roadmap approach in UHC implementation. This Delivery Unit will work to improve the UHC SCI, a single indicator based on four proxy areas and their corresponding tracer indicators. The four proxy areas include Infectious Diseases (ID), Non-Communicable Diseases (NCD), Reproductive, Maternal, Newborn and Child Health (RMNCH) and Service Capacity and Access. Although the team knows that the UHC SCI Is currently calculated using data from demographic surveys, there will be an effort to map Input and outcome Indicators.

Expected Deliverables, Outputs, Outcomes

All team members of the Delivery Unit will be engaged through results/deliverables-based contracts. Each consultant will have a monthly deliverable in the form of a progress report detailing the exact nature and expected outputs of their TA over the previous month. The TA delivered in the progress report will be assessed for quality by the P&SHD and E4H. Achievement against quality will be used as criteria for final sign-off and payment by the Consortium Partners. 

Deliverables / KPIs

• Kick-off workshop slide deck.
• Quarterly snapshot
• Quarterly Progress Presentation & Report (template, equity disaggregated data, stockouts (actionable recommendations) Tracker of the recommendations, prioritising the top ones.
• Annual UHC monitoring report
• Policy and advocacy briefs for the Secretary 

Position Title: Team Manager — UHC Delivery Unit (Mid National)

Duty Station: Lahore (embedded within the Health & Population Department)
Duration / LOE: September 2025 –March 2026, full-time (LOE subject to change until the start of the TA)
Reporting To: Provincial Team Leader / E4H Programme Team 

Role Purpose

The Team Manager will lead the Delivery Unit, ensuring effective planning, execution, and monitoring of health sector reforms aligned with UHC goals. The role requires a blend of strategic leadership, stakeholder engagement, and technical expertise in health systems, public sector reform, and performance management.

Key Roles & Responsibilities

• Provide overall leadership and management to the Delivery Unit team.
• Coordinate with senior government officials, development partners, and technical departments to advance UHC reforms.
• Lead the design and implementation of performance dashboards, monitoring frameworks, and quarterly performance reviews.
• Define, monitor, and refine KPIs; lead stocktakes/performance routines; and translate analytics into actionable recommendations.
• Oversee preparation of high-quality reports, briefs, and strategic presentations for decision-making at the highest levels.
• Ensure effective integration of public health, population, and service delivery reforms into a unified agenda.
• Develop and manage project roadmaps, timelines, and deliverables in collaboration with stakeholders.
• Facilitate capacity building of departmental staff in planning, monitoring, and delivery management.
• Provide technical guidance on health systems strengthening, including service delivery, supply chain, financing, and governance.
• Oversee evidence-based decision-making by leveraging data analytics, health information systems (e.g., DHIS2, EMRs, HISDU dashboards), and digital solutions.
• Ensure compliance with donor requirements, reporting standards, and program governance structures.

All Programme/Terms of Reference content (Programme overview, Objectives, Sub-objectives, Phase-wise scope) remains unchanged.

Requirements

Technical Expertise

• Bachelor’s or Master’s degree in Public Health, Economics, Development Studies, Social Sciences, Management Sciences, Public Policy, or related fields (Master’s preferred).
• 10years of progressively responsible experience, including demonstrable leadership of public-sector initiatives.
• Proven track record of delivery/performance management of government-facing reforms.
• Experience leading stocktakes, defining/monitoring KPIs, and generating policy-relevant insights from analytics.
• Strong oversight of information systems and data workflows, including data-quality checks and understanding of interoperability/pipeline concepts.
• Advanced proficiency in Microsoft 365 (Excel, PowerPoint) and at least one analytics/BI or statistical tool (Power BI, Tableau, STATA, or SPSS).
• Excellent skills in drafting policy/advocacy briefs, analytical reports, and high-level presentations.
• Working understanding of UHC/PHC frameworks and indicators, including their application for monitoring progress and equity gaps.

Core Competencies

• Planning and delivering work to deadlines with quality assurance.
• Influencing and managing stakeholders, especially government and development partners.
• Analysis and use of information with strong commitment to data integrity and insight generation.
• Decision-making and problem-solving under time pressure.
• Leadership, team management, and collaborative working.