TORs: Health System Expert with Expertise in Trainings

KP TA – 11: Operationalise the Sustainable Training System in Khyber Pakhtunkhwa

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 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.

Problem Statement

• The Provincial Health Services Academy (PHSA), established in 1999, aims to provide high-quality education and training programs for healthcare professionals.
• PHSA faces critical challenges that hinder its capacity to deliver effective training:
  • Lack of coordination among stakeholders leads to isolated efforts and inefficiencies in the training system.
  • Capacity limitations restrict PHSA's ability to meet the increasing demand for quality training programs, exacerbating skill gaps among healthcare workers.
  • Significant shortage of trainers for both skill-based and non-skill-based training underscores the need for internal capacity-building efforts.
• Human resources for health remain a persistent challenge within the KP health system, resulting in compromised quality of care and poorer health outcomes for the population.
• Currently, there is a significantly low level of Essential Health Workforce Index in the health sector, hindering efforts to achieve universal health coverage (UHC) and implement the Essential Package of Health Services (EPHS) to meet SDG targets.
• There is a lack of a structured Continued Professional Development (CPD) programme to address the diverse and increasing skill development needs of healthcare staff, such as UHC, International Health Regulations (IHR), and Integrated Disease Surveillance and Response System (IDSRS).
• Current capacity-building practices inadequately equip healthcare providers with the skills needed to deliver quality health services to the province's population.
• The curriculum, learning objectives, and duration (credit hours) lack standardisation.
• There is no established system for training monitoring, supervision, and licensing to ensure healthcare providers meet learning objectives and enhance their skills.
• The E4H program has developed a sustainable training system that needs to be implemented by the PHSA.
• There is a lack of a strategic approach to managing human resources for health and specifically building the capacity of service providers to meet the evolving needs of service delivery in primary healthcare facilities.

Objectives

The TA aims to operationalise the sustainable training system through strategic coordination, curriculum standardisation, infrastructure enhancement, and effective monitoring, ensuring high-quality education and skill development for healthcare professionals in KP.

The specific objectives of this TA are:

• To develop a strategic plan and roadmap for operationalising the system parts that were developed by the Sustainable Training System TA.
• Develop and implement an integrated training plan in collaboration with stakeholders to achieve the capacity-building objectives of the DOH and the PHSA.
• Strengthen the PHSA's capacities to establish and implement a CPD Programme by developing an initial framework for the DOH.

Scope of Work and Methodology

The consultants will work closely with the DOH by embedding themselves within the PHSA. This approach aims to minimise implementation risks and enhance the capacity of selected DOH staff. By providing hands-on support, the consultants will mitigate potential risks while actively building the skills and capabilities of DOH personnel. This will empower the DOH staff to independently manage the TA following its handover and completion.

They will be tasked to deliver the following scope of work:

• Review the documents developed by the TA for the "Sustainable Training System" to gain a clear understanding of the strategic actions required for its implementation.
• Review PC-Is and other project documents to assess the DOH’s training requirements as outlined in the project and programme documents, utilising previous information and materials developed by the E4H programme.
• Submit an inception plan within the first two weeks of the consultancy, detailing the proposed methodology, work plan, and key milestones for the project.
• Establish a training alliance comprising key partners and government stakeholders involved in supporting the training environment within the province. The consultant team will assist the PHSA in drafting detailed TORs, establishing operational mechanisms, and facilitating meetings to effectively engage partner support, ensuring alignment with the strategic plan and training standards developed earlier.
• The team will perform an institutional review of PHSA in alignment with DOH-planned reforms, focusing on transitioning to a digitalised system, establishing a performance management system, and implementing UHC and IHR reforms. The team will prepare a focused brief for senior leadership at DOH, derived from the review, outlining specific actions to enhance PHSA's role as a training hub during ongoing reforms.
• Develop a draft costed strategic plan to launch the "Sustainable Training System," outlining a roadmap for implementation by identifying significant and priority actions in that direction. This includes close collaboration with key stakeholders from PHSA, the Directorate of General Health Services (DGHS), and Program Management Units (PMUs) of various programmes. Begin with an extensive literature review to draw insights from national and international best practices and assess all current training programs conducted by the DOH.
• Ensure that all trainings imparted by the DOH and PHSA are aligned with the standards developed by the Sustainable Training System. If not, translate the trainings on the developed CPD standards and checklists through development partners.
• Following the development of the training plan, the consultant team will conduct a thorough desk assessment to determine optimal locations for training centres. This assessment will evaluate the suitability of various nursing schools and District Health Development Centres (DHDCs) for accommodating classroom arrangements specified for the trainings in the training plan
• A comprehensive compilation of trainers will be developed, detailing the availability of trainers in each district. This will include a district and provincial classification of trainers.
• Develop a comprehensive database to document information about individuals trained across districts, incorporating details of both trainers and participants. Parameters will be agreed upon by PHSA and the training alliance, leveraging existing efforts in this area. This database will include critical details such as certification status, institute, training dates, duration, CPD credit hours, and other relevant information to ensure a thorough record of training activities. Integration with Human Resource Management Information System (HRMIS) and an online training learning Management System (LMS) is planned as part of DOH's efforts to synchronise the training database with HRMIS and link it with performance management systems. This database aims to monitor and evaluate the effectiveness of training initiatives, ensuring adherence to professional development standards and supporting informed decision-making in the healthcare sector.
• Develop an integrated IT dashboard that seamlessly integrates with the database and Learning Management System (LMS). This dashboard will feature modules detailing training subjects, trainer profiles, credit hours, accreditation standards, and options for self-paced learning. It will provide real-time insights into training progress, certification statuses, and compliance with CPD standards, enabling efficient monitoring and management of training initiatives within the healthcare sector.
• Establish and implement an M&E system for monitoring and supervision of training and develop coordination and governance mechanisms for it.

Timeline and LOE

The level of effort for the role is 108 working days, from August 24 – January 25.

Requirement

Technical Expertise

1. Proficiency in using LMS for training administration and tracking.
2. Experience with simulation tools for training healthcare professionals.
3. Proficiency in implementing and managing healthcare information systems.
4. Proficiency in using and administering LMS platforms for training program management, content delivery, and learner assessment.

Competencies

1. Design and implement training programs for healthcare professionals.
2. Evaluate and analyse health systems for efficiency and effectiveness.
3. Manage and guide change within health systems and training programs.
4. Conduct research and apply evidence-based practices in health system improvements.
5. Experience with conducting trainings.

 Deliverables

1. Training Alliance Mechanism
2. Meeting Minutes of Training Alliance
3. Targeted Brief for Senior Leadership
4. Costed Strategic Plan
5. Detailed Trainer and Trainee Database