Introduction:

The Fleming Fund (FF) is a U.K. Department of Health and Social Care program to help low- and middle-income countries fight Antimicrobial Resistance (AMR). AMR poses a severe global threat, expected to cause 10 million deaths annually by 2050. With potential costs reaching $100 trillion, its impact on the global economy is significant. Fleming Fund Grants aim to tackle the AMR challenge in developing countries including Pakistan. The grants are funded by the UK Department of Health and Social Care and managed by Mott MacDonald for the country, regional, and fellowship grants. Pakistan has received Fleming Fund support since 2019 in the form of two Country Grants, 9 Fellowships, and central and local procurement of equipment, reagents, and consumables. Between 2017 and the end of phase-1 of the program in March 2023, the program has provided financial support to grantees to establish and support local development of national AMR surveillance systems. 

In partnership with the Fleming Fund, DAI's program in Pakistan collaborates with the Pakistani government to strengthen systems using a “One Health” approach – a multisectoral approach to complex health problems that reaches across human health, animal health, and environment sectors. As global leaders in One Health, the DAI team helps incorporate One Health across program interventions. DAI is helping Pakistan become a leader in combating antimicrobial resistance, and a model for better management of antimicrobials in human and animal populations. DAI and its consortium partners have successfully secured an additional round, Phase 2, of the Fleming Fund Country Grant in Pakistan which spans from January 2024 to December 2025. Phase 2 of the FFCG program focuses on achieving four intermediate outcomes: 1) Production of quality AMR/U/C and burden of disease data; 2) Conducting quality data analysis; 3) Sharing quality data analysis with decision-makers; and 4) Contributing to sustainable investments at both the country and global levels to counter AMR.

Purpose of the Assignment

The overall purpose of developing ‘Data and Evidence Use Plan’ is to establish a strategic roadmap that will ensure the effective and integrated utilization of available data and evidence from across the One Health disciplines in the formulation of policies, regulations and guidelines designed to reduce the impact of AMR. The plan should aim to enhance decision-making processes, inform policies, and drive overall improvement in the use of information for achieving goals. Specifically, the plan should provide information on: where data should go, what analytics need to be done, and how this will be presented to key stakeholders, policy makers and practitioners. 

Assignment Scope

Building on the Political Economy Analysis (PEA) exercise, which will also be conducted during the inception phase, the 'Data and Evidence Use Plan' should outline the programme's strategy for enhancing the utilization of data and evidence to improve both practices and policy. The anticipated scope of the assignment encompasses the following key areas:

• Conduct a landscape analysis of the presence or absence of policies and guidelines on antimicrobial stewardship (AMS), infection prevention and control (IPC), animal food production regulations, prescribing of antibiotics in clinical care, regulation of private sector outlets, etc.
• Conduct an assessment of current and near-future / planned sector-wide reforms or policy reviews that AMR data and evidence should influence, e.g. steps towards universal health coverage, revision of user fees.
• Identify priority areas where Fleming Fund generated data could contribute to guideline, practice and policy improvement.
• Gather information on the following:
  • what data is required and by whom, in order to influence these priority guideline, practice and policy areas.
  • how data will be packaged and summarised (e.g., annual reports; annual conferences) for the relevant audience (e.g. Ministry of Health, professional societies, etc).
  • what fora are used currently or could be developed, to disseminate data (e.g. National AMR, Multisectoral Steering Committee (NMSC) and Technical Working Groups).
• Develop a customised and implementable ‘Data and Evidence Use Plan’ based on the information gathered and in consultation with stakeholders that should also provide a roadmap for implementing the plan, including timelines, milestones, and responsibilities.

The scope of the assignment will be finalised during the inception phase in consultation with DAI. 

Assignment Approach and Methodology

Overall, the consultant will follow a participatory and collaborative approach for the development of the Data and Evidence Use Plan. In accordance with the scope of work outlined above, the indicative methodology for the development of the Data and Evidence Use Plan involves a multifaceted approach, which is described below.

• Scope Clarification and Objectives Setting: Conduct inception meeting with DAI team to clarify the specific objectives and scope of the Data and Evidence Use Plan, ensuring a shared understanding of the programme’s goals.
• Stakeholder Engagement and Mapping: Identify and engage key stakeholders to conduct a stakeholder mapping exercise to understand their roles, interests, and expectations regarding data and evidence use.
• Landscape Analysis: Conduct a thorough landscape analysis to assess the presence or absence of policies and guidelines related to antimicrobial stewardship, infection prevention and control, animal food production regulations, antibiotic prescription practices, and the regulation of private sector outlets.
• Sector-Wide Reforms Assessment: Evaluate current and near-future sector-wide reforms or policy reviews that AMR data and evidence could influence, particularly focusing on initiatives such as steps towards universal health coverage and revisions of user fees.
• Priority Area Identification: Engage stakeholders in collaborative sessions to identify priority areas where data generated by the FFCG could significantly contribute to guideline, practice, and policy improvement.
• Data Requirements and Packaging: Conduct meetings and interviews to: gather information on the specific data requirements for influencing priority areas; and determine how data will be packaged and summarized for relevant audiences, considering formats such as annual reports or presentations at conferences.
• Dissemination Fora Identification: Explore existing fora, such as the National AMR, Multisectoral Steering Committee (NMSC), and Technical Working Groups, where data is disseminated; and collaboratively identify new fora if needed, ensuring effective channels for disseminating data to target audiences.
• Customized Plan Development: In consultation with stakeholders, develop a customized and implementable Data and Evidence Use Plan by ensuring that the plan: aligns with stakeholder expectations, integrates the identified priority areas, leverages the available data sources effectively, and includes an implementation roadmap.
• Feedback and Iteration: Obtain feedback from stakeholders to ensure the plan is comprehensive, feasible, and meets the diverse needs of the target audience.

The consultant will liaise with DAI team throughout the assignment process to ensure the tasks are being undertaken as per agreed scope and share all interim outputs, tools, reporting formats, and deliverables for review, feedback, inputs, and final approval. The methodology for the assignment will be finalised during the inception phase in consultation with DAI. 

Timeframe / Duration

The assignment is planned to be completed during the Country Grant inception period (January to March 2024), in sufficient time to inform other inception deliverables planned to be completed in parallel within first 3 months period.

Deliverables

The Consultant will be responsible to produce the following deliverables:

1. A brief note on the agreed scope, methodology, plan structure, and timeline for undertaking the assignment.
2. Data collection tools or templates for stakeholders mapping, landscape analysis, identification of priority areas, and interviews with relevant stakeholders
3. Draft Data and Evidence Use Plan for review and feedback.
4. A PowerPoint Presentation for DAI and stakeholders
5. Finalized Data and Evidence Use Plan incorporating feedback from DAI and stakeholders.
6. The assessment will be considered completed once the final plan is approved by DAI and/or its client.

Requirements (Education, Experience, Skills, Languages etc.):

• The ideal candidate for this position must hold a Master's or higher degree in public health, health statistics, social sciences, or other relevant fields, coupled with a minimum of 10 years of experience.
•  He/she should demonstrate a robust track record of developing data management and evidence use plans, particularly within the public health sector. 
• The candidate is expected to possess a deep understanding of the One Health sector in Pakistan, including familiarity with challenges related to insufficient data and evidence use across key departments. 
• The individual should showcase proven expertise in facilitating participatory approaches and effectively engaging diverse stakeholders within both public and private sectors. 
• Excellent written, editing, and oral communication skills in English are imperative. 
• Preference will be given to candidates with prior experience working on FCDO programmes.