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Pakistan
E4H Punjab TA: Training of Trainers for Smog-Related Health Crisis Response
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 (2023–2027) provides technical assistance (TA) to Punjab, Federal, and KP governments, implemented by Palladium in partnership with Oxford Policy Management (OPM).
Through its flexible, embedded, and demand-driven model, E4H supports governments to achieve a resilient health system that is prepared for emergencies, responsive to evidence, and delivers equitable, quality, and efficient healthcare services. Specifically, E4H delivers TA across three outputs:
Output 1: Strengthened integrated health security and preparedness.
Output 2: Strengthened evidence-based decision-making for accountability and performance.
Output 3: Improved implementation of Universal Health Coverage (UHC).
Background and Problem Statement
Background
Problem Statement
Punjab lacks a sustainable pool of certified trainers within P&SHD/DGHS to cascade smog-related health crisis response training. Reliance on ad-hoc workshops limits scale, quality, and continuity, leaving frontline health workers underprepared for annual smog surges.
Goal and Objective(s)
The overall goal of this TA is to establish a cadre of master trainers capable of institutionalising and cascading smog-related health crisis response training across Punjab.
We will achieve this by pursuing 3 objectives:
Objective 1: Develop an advanced Training of Trainers (ToT) curriculum integrating IDSR protocols and respiratory crisis management.
Objective 2: Train 50 master trainers selected from previously trained participants, equipping them with facilitation and simulation-based skills.
Objective 3: Standardise training materials, SOPs, and IEC content for provincial rollout, and strengthen DHAs’ capacity to independently deliver refresher and cascade trainings beyond the TA lifecycle.
Strategic Approach
Contributions to health systems strengthening
This Technical Assistance will strengthen Punjab’s capacity to manage smog-related health crises by embedding ToT modules within the provincial training ecosystem. By equipping district-level master trainers with both technical expertise and facilitation skills, the intervention creates a sustainable cascade model for frontline health worker preparedness. Embedding the curriculum and materials within the Learning Management System (LMS), the Provincial Health Development Centre (PHDC), and District Health Development Centres (DHDCs) will ensure institutional ownership, reduce reliance on ad-hoc training, and promote continuity and quality in training delivery year after year.
Alignment with other E4H TAs/investments
The TA directly builds on previous E4H phases: Phase I (smog crisis response training for 200 professionals) and Phase II (embedded communications campaign for public awareness). It operationalises the Sustainable Training System Framework by linking smog-specific modules with the LMS, PHDC, and DHDCs. This complements broader E4H workstreams on climate-sensitive health security, PHC workforce strengthening, and the digitisation of training resources.
Alignment with other donors
The TA aligns with the Government of Punjab’s climate adaptation and health resilience agenda, particularly under the Punjab Green Development Programme and commitments to improve air quality. It is consistent with WHO’s IDSR framework for surveillance and case management, UNICEF’s focus on child health and air pollution, and World Bank investments in environmental and health system resilience. By institutionalising digital content and enabling provincial and district-level hubs to lead, this TA ensures complementarity with other donor-supported reforms while avoiding duplication.
Scope of Work and Methodology
This Technical Assistance will operationalise the ToT model by strengthening training content, equipping a selected pool of master trainers, and embedding tools and systems for sustainable cascade delivery across Punjab. The approach combines curriculum enhancement, adult learning methodologies, and hands-on clinical simulations to ensure trainers are both technically proficient and capable of facilitating high-quality trainings at the district level.
The TA will conduct the following activities:
Curriculum Enhancement: Upgrade Phase I training modules into ToT manuals (trainer guides, facilitation notes, simulation packs).
Trainer Selection: Develop criteria and shortlist 50 trainers in consultation with H&PD/DHAs.
ToT Delivery:Conduct 2× four-day ToT workshops, covering:
Sustainability: Capacity Building, Institutionalisation, and/or Transition Planning
Deliverables
Inception Report & Training Design Slide Deck.
Trainer Toolkit (manuals, SOPs, IEC materials, digital content).
ToT Delivery Report (trainer assessments).
Final ToT Report (with slide deck) & Cascade Plan.
STTA Mid National - Respiratory Specialist Trainers
LOE: 45 days each
Period: Sep – Nov 2025
Role Requirements
Deliver specialised respiratory modules on SARI, asthma, HAAD; design and deliver simulation-based sessions; support toolkit development.
Technical Expertise
Medical degree (MBBS) with specialization in Pulmonology or Internal Medicine. Minimum 10 years of clinical and teaching experience. Expertise in managing Severe Acute Respiratory Infections (SARI), asthma, and hospital-acquired acute disease. Experience in designing and delivering simulation-based training for healthcare professionals.
Core Competencies
Clinical acumen; Simulation-based teaching; Planning & delivering work; Communicating with others; Problem-solving.
Deliverables/KPIs
Same as overall TA deliverables.
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