KPTA Governance Reform - Senior Health System Expert with experience in reforms at policy and strategy level

Senior National - Health System Expert with experience in reforms at policy and strategy level

KP TA - Embedded Technical Assistance for Health Sector Reform Unit– Good Governance Reform Roadmap Implementation

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 overall goal of this technical assistance is to strengthen HSRU’s capacity to lead, coordinate, and implement governance and health reforms in line with KP’s Good Governance Reform Roadmap. We will achieve this by pursuing three objectives:

Objective 1: Strengthen the institutional capacity of the HSRU to lead and coordinate health governance reforms in line with the Good Governance Roadmap.

Objective 2: Provide technical guidance and day-to-day advisory support for the design, operationalisation, and monitoring of governance and policy reforms, including regulatory and institutional strengthening.

Objective 3: Promote sustainability and accountability by embedding reforms into government systems through improved HR management, digital transformation, and evidence-based oversight mechanisms.

Strategic Approach

Contributions to health systems strengthening

KP’s health system faces persistent bottlenecks, including fragmented governance, limited institutional capacity, weak regulatory oversight, and underutilization of digital and human resource management tools. Donor-driven initiatives have often introduced valuable innovations, yet they have struggled to achieve institutionalisation when not embedded within government-led reforms. By strengthening the HSRU and aligning its work with the province’s Good Governance Reform Roadmap, this technical assistance directly addresses those challenges. The embedded support will reinforce government ownership, improve coordination and accountability, and enable reforms to be sustained within provincial systems — ensuring that improvements in governance translate into more efficient, transparent, and resilient health services for the people of KP.

Alignment with other E4H TAs/investments

This technical assistance complements and builds upon previous Evidence for Health (E4H) initiatives in KP, including the Universal Health Coverage (UHC) Roadmap, the Quality of Care Strategic Plan, the Climate and Health Adaptation Plan, and the Multisectoral Health Workforce Strategy. It also reinforces ongoing support in areas such as facility-level budgeting and district action plans. By anchoring these initiatives within the HSRU and aligning them with the provincial Good Governance Reform Roadmap, chaired by the Chief Secretary, the technical assistance ensures that E4H’s past, current, and future contributions are more effectively institutionalised, coherent, and sustainable within government systems.

Alignment with other donors (if relevant)

This technical assistance will provide an institutional platform within the HSRU to anchor and sustain donor-supported initiatives. By aligning these efforts with the provincial Good Governance Reform Roadmap chaired by the Chief Secretary, it ensures that contributions from the World Bank, the Foreign, Commonwealth & Development Office (FCDO), Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), the United Nations Children’s Fund (UNICEF), the World Health Organization (WHO), Gavi, and other Global Health Initiatives (GHIs) are integrated into provincial systems. These efforts will be backed by governance mechanisms and financing arrangements that secure long-term sustainability.

Scope of Work and Methodology

The Reform Team will be embedded within the HSRU to provide continuous technical assistance in strengthening governance systems, supporting reform implementation, and institutionalising processes in alignment with the provincial Good Governance Reform Roadmap, chaired by the Chief Secretary. The team will also provide technical support to implement roadmap priorities on short deadlines, ensuring the timely delivery of reform commitments, and offer direct assistance to the Secretary of Health’s office and the Chief HSRU in advancing governance priorities, coordinating with stakeholders, and engaging development partners. The assignment will focus on enabling HSRU to function as the central coordinating mechanism for health governance reforms, ensuring that these reforms are sustained within government systems.

The technical assistance will be delivered through a phased, hands-on approach that combines strategic advisory, institutional support, and capacity building:

• Strategic Alignment: Review and align HSRU’s reform priorities, strategies, and institutional plans with the Good Governance Reform Roadmap to ensure coherence across provincial health reforms.
• Policy and Framework Development: Support the design and operationalisation of policies, guidelines, and frameworks directly linked to the Good Governance Reform Roadmap priorities, with a focus on strengthening accountability, enhancing regulatory capacity, and integrating reforms into provincial health systems.
• Institutional Coordination: Facilitate coordination between the HSRU, Directorate General Health Services, Health Foundation, Health Care Commission (HCC), and other agencies while also supporting the Secretary Health’s office and Chief HSRU in coordinating with development partners and provincial stakeholders to deliver on reform priorities under short deadlines.
• Monitoring and Accountability: Technical assistance will support weekly progress reviews on reform implementation, led by the Advisor to the Chief Minister on Health and the Secretary of Health, and will facilitate the development of monitoring tools and digital dashboards to track progress, generate evidence, and strengthen decision-making.
• Capacity Building and Mentorship: Build the technical and managerial capacity of HSRU staff and associated institutions through on-the-job mentoring, targeted training, and systems support to embed sustainability.
• Phased Support: Consistent with the phased approach preferred by leadership, technical assistance delivery will be structured in stages — beginning with institutional strengthening of HSRU, followed by development of reform tools and frameworks, and culminating in the capacity transfer and institutionalisation within government structures.

This approach ensures that the technical assistance not only provides immediate technical inputs but also strengthens institutional systems, enabling the HSRU to sustain governance reforms beyond the duration of external support.

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

• This technical assistance is designed not only to deliver immediate technical inputs but also to embed skills, systems, and practices within the HSRU. As outlined in the methodology, capacity building will be achieved through targeted mentoring, structured training, and on-the-job support, enabling HSRU staff to manage reform processes independently.
• Institutionalisation will be achieved by anchoring reforms in government systems and aligning all activities with the provincial Good Governance Reform Roadmap, chaired by the Chief Secretary. This ensures that tools, processes, and governance mechanisms developed through the technical assistance become part of routine provincial operations, reducing dependency on external actors.
• Transition planning will focus on ensuring that ownership of reform implementation and oversight rests entirely with HSRU and related institutions, with financial and administrative mechanisms integrated into provincial systems to sustain reforms beyond the life of E4H support.

Responsibilities

The Health System Expert will work to achieve the following:

• Inception report and workplan.
• Reform Implementation Plan aligned with the Good Governance Reform Roadmap.
• Institutional coordination mechanism across HSRU, HF, HCC, and development partners.
• Oversight of quarterly reform progress reports submitted to senior leadership (quarterly).
• Transition and sustainability plan for embedding reforms into government systems.
• Strategic advisory support to Secretary Health and Chief HSRU on governance priorities (monthly/ongoing).
• Monthly progress to E4H KP Team.
• Records of technical inputs provided, including a log of support maintained by TA team members and validated by HSRU.

Timeline and Days

The level of effort (LOE) for the role is 90 days from September 2025 – March 2026 .

Requirement

Technical Expertise

• Master’s degree or higher in Public Policy, Public Administration, Health Systems, or related field.
• Minimum 15 years of progressively responsible experience in governance reform and institutional strengthening.
• Expertise in health systems governance and accountability.
• Proven experience in stakeholder coordination with government and development partners.

Competencies

• Strategic leadership and advisory skills
• Strong political economy understanding
• High-level negotiation and consensus-building
• Excellent communication with senior policymakers