National Lead Advisor PFM/ Team Lead

E4H KP TA: Fast Track Extended PFM Support for Upstream Reforms in Khyber Pakhtunkhwa

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 TA is to support the Director General Health Services (DGHS) in spearheading efficient, inclusive, and results-oriented budgeting through strengthened PFM systems and upstream reforms in HR, budgeting processes, financial systems, and governance frameworks.

 We will achieve this by pursuing 4 objectives:

Objective 1: Standardize and rationalize HR structures in line with approved sanctioned strength and service delivery needs.

Objective 2: Strengthen financial and budgetary data systems by streamlining IFMIS master data hierarchies.

Objective 3: Enhance inclusivity and allocative efficiency in the budget formulation process through participatory planning with DHOs, facilities and allied formations working under the administrative control of DGHS.

Objective 4: Update Delegation of Financial Powers Rules (2018) to better align with health sector operational realities.

Strategic Approach

Contributions to health systems strengthening

This TA strengthens KP’s provincial health system by addressing cross-cutting bottlenecks that undermine efficiency, accountability, and service delivery at both provincial and district levels. By rationalising Human Resources (HR) structures, improving the coherence of financial and planning data systems (including IFMIS integration), enhancing participatory and evidence-based budgeting, and updating delegation of financial powers, the TA shifts the system away from fragmented, input-driven management toward a more integrated and performance-oriented model. Collectively, these reforms improve allocative efficiency, strengthen sub-national governance (particularly DHOs as frontline implementers), and enable more responsive and results-driven health financing aligned with PHC and UHC.

Alignment with other E4H TAs/investments

This TA builds directly on E4H-supported reforms, particularly the Human Resource Management Information System (HRMIS), DHO reforms, and the ongoing work on Facility Level Budegting (FLB) implementation, where persistent challenges in HR structuring, data inconsistencies, and budget alignment have constrained effective execution. By addressing HR rationalisation, standardisation of designations, and alignment of financial and HR systems (including IFMIS and HRMIS), this TA provides the upstream systems fix required to resolve structural bottlenecks affecting FLB implementation and HR data integrity. It complements the HRMIS TA by translating system-level data improvements into actionable workforce planning and budgeting reforms. Overall, it strengthens the enabling environment for both HRMIS functionality and improved budget execution under FLB arrangements within the health sector.

Alignment with other donors (if relevant)

This TA is closely aligned with ongoing supported reforms in Khyber Pakhtunkhwa, which focuses on strengthening fiscal management, institutional capacity, and public sector efficiency. By addressing core bottlenecks in HR rationalisation, IFMIS data integrity, budget formulation processes, and delegation of financial powers, the TA complements PRID’s emphasis on improving PFM systems and expenditure efficiency. It also reinforces broader donor-supported efforts in the health sector to improve budget credibility, strengthen digital financial systems, and enhance results-based service delivery. The TA therefore provides a critical operational bridge between health sector reform priorities and wider provincial governance and fiscal reform initiatives supported by the World Bank.

Scope of Work and Methodology

This TA will provide technical support to the DGHS across two budget cycles for the FY 2026/27 and FY 2027/28 while simultaneously advancing upstream PFM reforms. The work will focus on improving HR structures, strengthening financial and data systems, enhancing inclusive budgeting practices, and updating financial delegation frameworks to enable more efficient, equitable, and results-oriented health financing. The TA team will work closely with the DGHS and relevant stakeholders and will undertake frequent field visits to Peshawar and selected districts to ensure continuous engagement, validation, and ground-truthing of reforms.

The TA will be implemented through four integrated and mutually reinforcing workstreams, delivered in close coordination with the DGHS, FMC, Finance Department, DHOs, and relevant oversight institutions. The approach will combine technical diagnostics, iterative co-creation, and embedded support during the budget cycles.

Standardisation and Rationalisation of HR

The TA will begin with a comprehensive review of existing HR structures across the health sector, including mapping all designations, positions, and pay scales against approved service delivery norms (e.g., EHSP standards). This will involve identification of redundancies, overlaps, and inconsistencies that have led to an overly complex HR architecture.

A harmonised HR framework will then be developed to standardise designations and align roles with functional requirements. This process will be informed by structured consultations with DHOs, facility in-charges, and administrative stakeholders, supported by frequent field visits to districts to validate findings and ensure practical feasibility.

Finally, agreed HR rationalisation measures will be translated into budget inputs.

Streamlining IFMIS Master Data Hierarchies

The TA will conduct a detailed review of health sector master data structures within IFMIS, focusing on entity, fund, and functional classifications across all spending units. This will identify inconsistencies and structural gaps affecting budgeting, expenditure tracking, and performance reporting.

Based on findings, practical recommendations will be developed to improve data integrity and alignment with budgeting requirements. The TA team will work closely with the Finance Department, Accountant General KP, and CGA MIS wing to ensure technical validation and institutional ownership, including in-person consultations in Peshawar as required.

Allocative Efficiencies through Inclusive Budget Making

The TA will design and deploy interactive budget planning tools to support more inclusive and evidence-based budgeting, particularly for HR and procurement allocations.

A structured bottom-up planning process will be facilitated through regular engagement with DHOs and facility-level stakeholders, supported by frequent field visits to districts to capture service delivery realities and resource needs. These inputs will be consolidated into provincial budget proposals in coordination with the Health and Finance Departments.

The TA will also support policy dialogue to address allocative inefficiencies and improve alignment of budgets with service delivery priorities.

Update to Delegation of Financial Powers Rules (2018)

The TA will review existing Delegation of Financial Powers Rules (2018) to assess adequacy for health sector operational needs. This will include identification of gaps in financial authority, particularly at district and facility levels.

Based on this analysis, the TA will support drafting of revised provisions, including new or enhanced powers for health formations and officers. This will be undertaken in close consultation with the Finance Department and relevant stakeholders through iterative engagements and validation sessions in Peshawar.

The TA will follow a phased and iterative implementation model aligned with the budget cycle. The approach will combine rapid diagnostics, co-development of reform instruments, and integration into budget processes. Continuous engagement with DGHS, FMC, Finance Department, and DHOs will be ensured through frequent coordination meetings and field visits, including regular travel to Peshawar and selected districts to maintain strong operational grounding and stakeholder ownership.

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

Capacity building will be embedded throughout the TA through hands-on, embedded working sessions with DGHS, FMC, Finance Department, DHOs, and relevant technical units. This will include practical support in HR rationalisation, IFMIS data use, and participatory budget formulation, enabling government counterparts to progressively take ownership of tools, processes, and analytical approaches.

Institutionalisation will be achieved by embedding the outputs of the TA into formal government systems and processes, including revised HR structures, improved IFMIS master data hierarchies, and updated Delegation of Financial Powers Rules. These reforms will be developed in close coordination with government counterparts to ensure formal adoption and integration into routine planning and budgeting cycles.

Transition will be ensured by progressively shifting implementation responsibility to provincial and district health authorities through joint delivery during the TA period, supported by structured handover of tools, frameworks, and guidelines. By the end of the assignment, core functions such as HR planning, budget preparation tools, and financial management improvements will be fully operational within government systems without external support.

Responsibilities

The Lead Advisor PFM/ Team Lead will be responsible for: 

• Inception/Work Plan                    
• HR Standardization Phase-1       
• HR Standardization Phase-2      
• IFMIS Master Data                       
• Planning & Budgeting                  
• DoFP Rules Update                      

Timeline and Days

The level of effort (LOE) for the role is 80 days.

Requirement

Technical Expertise

• Public Financial Management (Budgeting, MTBF, PIM);
• Budget Analytics & Evidence-Based Decision Making;
• Governance & Institutional Development; New Accounting Model;
• IFMIS; Service & Financial Rules; Sectoral Policy & Planning;
• Public expenditure tracking systems;
• PEFA Assessments

Competencies

• Plans and acts transparently, actively works to removes barriers
• Gains trust of peers, partners, clients by presenting complex concepts in practical terms to others.
• Creates new and relevant ideas and leads others to implement them.
• Models’ high professional standards and motivates excellence in others.
• Catalyzes new ideas, methods, and applications to pave a path for innovation and continuous improvement in professional area of expertise.
• Leadership and analytical skills with demonstrated experience managing complicated portfolios and establishing relationships with stakeholders.
• Good ICT literacy, i.e. MS. Word, MS PowerPoint, and MS Excel