Junior National STTA – Research Associate

E4H FED TA: TECHNICAL SUPPORT TO PAKISTAN MEDICAL AND DENTAL COUNCIL FOR ADVOCACY AND DEVELOPMENT OF AN IMPLEMENTATION-ORIENTED PROPOSAL FOR INTEGRATION OF PRIMARY HEALTH CARE (PHC), UNIVERSAL HEALTH COVERAGE (UHC), INTERNATIONAL HEALTH REGULATIONS (IHR), INCLUDING ANTIMICROBIAL RESISTANCE (AMR), INTO PRE-SERVICE MEDICAL AND DENTAL EDUCATION

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.

Goal and Objective(s)

Pakistan's health system is increasingly required to respond to interconnected priorities including SDG 3, universal health coverage (UHC), primary health care (PHC), International Health Regulations (2005)/health security and preparedness for public health emergencies. These priorities require a health workforce equipped not only with clinical competencies, but also with an understanding of burden of disease, epidemiological and population-health trends, the importance of preventive, promotive and essential health services, health-system stewardship, antimicrobial stewardship, disease surveillance and coordinated response to public health threats.

Pakistan has developed important national policy and strategic frameworks relevant to these priorities. These include the draft National Health and Population Policy 2026–35, the Essential Package of Health Services (EPHS), UHC-related commitments, and the national health security architecture, including the National Action Plan for Health Security (NAPHS-II) 2024–28. Antimicrobial resistance (AMR) is also recognised as a growing health-system and public health priority, requiring strengthened prevention, surveillance, rational use of antimicrobials and antimicrobial stewardship. These priorities are interlinked and require health professionals to understand their application across primary, secondary and tertiary levels of care.

Pre-service medical and dental education provides an important opportunity to establish these competencies before graduates enter the health system. Undergraduate education can equip future doctors and dentists with foundational knowledge and practical competencies related to comprehensive PHC, UHC and essential health services, health-system organisation and referral pathways, public health surveillance, infection prevention and control, rational antimicrobial use, antimicrobial stewardship, and preparedness and response to public health emergencies.

The Pakistan Medical and Dental Council (PMDC), as the national regulatory body responsible for regulating medical and dental education and professional standards, has an important role in establishing the regulatory and academic environment within which medical and dental institutions develop and deliver undergraduate education. Systematic integration of these cross-cutting competencies therefore requires engagement with PMDC and relevant stakeholders, including medical and dental universities/colleges, curriculum and examination bodies, public health and clinical faculty, and relevant government and technical institutions.

At present, there is an opportunity to strengthen alignment between national health priorities and the competencies expected of medical and dental graduates. This includes identifying where PHC, UHC/EPHS, health security/IHR and AMR-related concepts and competencies are currently reflected in pre-service education; identifying gaps and feasible opportunities for strengthening, particularly within Community Medicine, corresponding public health disciplines in BDS and integrated curricula; and developing a practical, evidence-informed proposal for consideration and ownership by PMDC and relevant stakeholders.

Overall Goal

To strengthen alignment between Pakistan's evolving health-system priorities and pre-service medical and dental education, and to develop an evidence-informed, stakeholder-owned, feasible and implementation-oriented proposal for integration of PHC, UHC/EPHS including family planning and nutrition, relevant IHR/health security and surveillance competencies, and AMR competencies into undergraduate medical and dental education.

Specific Objectives

Build the evidence and advocacy case for strengthening PHC, UHC/EPHS including family planning and nutrition, relevant IHR/health security and AMR competencies within pre-service medical and dental education.

Map existing coverage and identify gaps and entry points for these competencies within relevant medical and dental education and regulatory frameworks, across all relevant years, disciplines and clinical/community rotations, identifying where competencies are introduced, reinforced and assessed for MBBS and BDS, particularly Community Medicine and integrated curricula, without duplicating existing curriculum-review processes.

Facilitate structured consultation and consensus building among PMDC, government, medical and dental universities/colleges, medical and dental education experts, public health and clinical faculty, and relevant technical partners; use these consultations to validate pre-identified areas and identify additional feasible competencies and curriculum entry points.

Develop a practical, feasible and implementation-oriented proposal for PMDC setting out priority competencies, potential integration points, implementation options, institutional responsibilities and key enabling requirements, including implications for curriculum revision/integration, assessment, faculty capacity, regulatory/accreditation requirements such as World Federation of Medical Education and World Health Organisation resource needs and sequencing of next steps.

Strengthen PMDC's institutional capacity to advocate for and take forward the proposed integration through its existing regulatory, accreditation and medical and dental education mechanisms.

Strategic Approach

Contributions to Health Systems Strengthening: This TA is an institutional-strengthening and policy-support intervention that will link national health-system priorities with the competencies required of future medical and dental graduates. The approach will emphasise PMDC ownership; evidence-informed advocacy; integration through existing medical and dental education structures; feasibility and prioritisation; structured stakeholder engagement and consensus building; and handover of the evidence and final proposal to PMDC for continued action beyond the assignment. This TA will focus on evidence generation, stakeholder advocacy, consensus building and proposal development. It will not substitute for PMDC's regulatory mandate or undertake formal curriculum approval or regulatory decisions, which will remain with the relevant competent authorities. The review will cover both MBBS and BDS and identify feasible entry points for PHC, UHC/EPHS, IHR/health security and AMR competencies within relevant public health disciplines and integrated curricula.

Alignment with other E4H TAs/Investments/National Standards: The TA will align with relevant national health priorities, including the draft National Health and Population Policy 2026–35, UHC priorities, the EPHS including family planning and nutrition, NAPHS-II 2024–28, relevant IHR preparedness and response capacities, and Pakistan's AMR priorities. It will also align with relevant E4H support on UHC, health security/IHR, AMR and the health workforce to avoid duplication and ensure coherence with broader system-strengthening work.

Alignment with other Donors: The TA will engage relevant technical and development partners, as appropriate, including WHO and academic or technical partners supporting medical and dental education, UHC, health security and AMR. Existing initiatives and technical work will be mapped to identify complementarities and avoid duplication.

Scope of Work and Methodology

The technical support will be delivered through three phases and will cover both medical and dental education. PMDC will be the primary institutional owner and technical counterpart for the TA, including ownership of the final proposal and any subsequent regulatory or curriculum decisions. M/o NHSR&C, through DG (Health), will provide coordination and linkage to national health priorities. PMDC will nominate the lead focal point/counterpart during inception.

Phase 1: Inception, Stakeholder Mapping and Evidence Review

• Confirm with PMDC the scope, objectives, institutional roles, decision-making processes and priority areas for the assignment, covering both MBBS and BDS.
• Confirm the designated PMDC focal point/curriculum committee and relevant counterparts and agree a mechanism for regular technical engagement.
• Map key stakeholders and relevant decision-making and engagement forums within PMDC and the wider medical and dental education system, covering curriculum development, accreditation, assessment and relevant health-system policy.
• Review relevant national and global policies, strategies, standards and evidence relating to PHC, UHC/EPHS including family planning and nutrition, IHR/health security and AMR.
• Undertake a preliminary review of available MBBS and BDS curricula and relevant medical and dental education documents, including Community Medicine, corresponding public health disciplines in BDS, integrated curricula and ongoing curriculum-review processes, to inform the detailed assessment in Phase 2 and avoid duplication.
• Assess the nomenclature and positioning of Community Medicine and corresponding public health disciplines in BDS. In consultation with PMDC, assess options such as Public Health and Preventive Medicine or Public Health and Community Medicine, including academic, administrative, financial and management implications, for PMDC consideration.
• Develop and submit an Inception Report and detailed Workplan for PMDC endorsement and E4H approval.

Phase 2: Evidence Generation, Advocacy and Stakeholder Consultation

Workstream 1: Evidence and Gap Assessment

• Analyse how PHC, UHC/EPHS including family planning and nutrition, IHR/health security and AMR are currently reflected within relevant MBBS and BDS curricula, frameworks and education processes.
• Identify priority competency gaps and feasible entry points for strengthening or integration, particularly within Community Medicine, corresponding public health disciplines in BDS and integrated curricula, without duplicating ongoing curriculum-review processes.
• Assess how priority competencies could be integrated through existing curriculum content, learning objectives, teaching approaches, clinical/community exposure, assessment and related education mechanisms with competencies defined in terms of knowledge, practical skills and professional behaviours and differentiated for MBBS and BDS graduates.
• Assess faculty capacity and training needs, availability of teaching and facilitator materials, and feasible practical exposure through PHC facilities, communities, surveillance systems, public health laboratories, emergency-response structures and antimicrobial stewardship programmes, including dental infection prevention, prescribing and stewardship requirements.
• Include accurate and validated reporting of health events and individual cases, including notifiable diseases and relevant case-based reporting, within the assessment of IHR/health security and surveillance competencies.
• Develop an evidence synthesis and gap-analysis matrix covering MBBS and BDS for PMDC consideration.

Workstream 2: Advocacy and Stakeholder Engagement

• Develop a concise, evidence-based advocacy narrative and stakeholder-specific briefing materials on the case for strengthening these competencies within pre-service medical and dental education.
• Facilitate structured consultations with PMDC, medical and dental universities/colleges, medical and dental educationists, public health and clinical faculty, relevant government institutions and technical partners.
• Use consultations to validate the evidence and proposed areas for integration, identify additional feasible competencies or curriculum entry points, and build shared understanding and consensus around priorities and feasible approaches.
• Support PMDC to use the evidence and advocacy materials through relevant committees, technical forums and stakeholder engagements to build institutional ownership and support for the proposed integration.
• Document stakeholder feedback, areas of convergence, outstanding issues and additional opportunities requiring consideration in the proposal.

Workstream 3: Proposal Development

Based on the evidence assessment and stakeholder consultations, the TA team will support PMDC to develop a consolidated, implementation-oriented draft proposal for MBBS and BDS that:

• Sets out the rationale and priority competencies for PHC, UHC/EPHS including family planning and nutrition, IHR/health security and AMR.
• Identifies feasible curriculum entry points, including within Community Medicine, corresponding public health disciplines in BDS, integrated curricula and other opportunities identified through consultation.
• Presents feasible options for integration through existing curriculum, teaching, learning, prototype learning and facilitator materials, clinical/community exposure and assessment mechanisms, including written, OSCE, case-based and workplace/community assessment, with key implementation considerations.
• Sets out implications for curriculum revision/integration, assessment, faculty capacity and faculty development/training-of-trainers, regulatory/accreditation and examination requirements, technical validation and institutional arrangements for implementation.
• Defines proposed institutional roles and responsibilities, including those of PMDC and medical and dental universities/colleges, and identifies relevant financial, human and technical resource implications.
• Presents the assessed options for the nomenclature and positioning of Community Medicine for PMDC consideration.

Phase 3: Proposal Finalisation, Implementation Roadmap and Handover to PMDC (Institutionalisation)

• Support PMDC to review and refine the draft proposal and finalise the PMDC-owned integration proposal, incorporating agreed feedback.
• Translate the agreed recommendations into a practical implementation roadmap setting out sequenced actions, institutional responsibilities, regulatory approval and adoption steps, resource requirements, dependencies and institutional rollout arrangements and key decision points relating to curriculum integration, assessment, faculty capacity and regulatory/accreditation requirements.
• Define indicators and review arrangements to monitor institutional adoption, faculty readiness, delivery of teaching and practical exposure, student competency, examination and accreditation compliance, and periodic updating of content as EPHS, IHR/health security and AMR priorities evolve.
• Conduct a final knowledge-transfer and orientation session with designated PMDC counterparts on use of the evidence, advocacy materials, proposal and implementation roadmap to support continued engagement and follow-up through PMDC's existing regulatory, accreditation and medical and dental education mechanisms.
• Hand over the evidence synthesis and gap-analysis matrix, Community Medicine nomenclature options, final proposal, implementation roadmap and advocacy materials to PMDC as a consolidated handover package.

Timeline and Days

The proposed LOE is 45 days from November 2026 to March 2027, subject to final mobilisation, contracting and confirmation from client.

Requirement

Technical Expertise

Master's degree in public health, health policy, medical education, health systems, social sciences or a relevant field. At least 5 years of relevant experience in policy/programme support, medical education, health systems or public health.

Competencies

Analytical, coordination and communication skills.