Delivery Unit to Implement the Universal Health Coverage Roadmap

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 (2023-2027) provides technical assistance (TA) to Punjab and also to the Federal and Khyber Pakhtunkhwa (KP) governments. The Punjab component is being implemented by Palladium along with Oxford Policy Management (OPM).

Through its flexible, embedded, and demand-driven model, E4H Punjab will support 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 will deliver 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.

E4H-Punjab works in partnership with the Punjab Department of Health (DOH). 

Terms of reference

Accelerating the implementation of Universal Health Coverage (UHC) is one of the core objectives and key thematic areas of the Evidence for Health (E4H) Programme in Punjab. Under SDG 3.8, UHC is considered the best investment in human capital and a foundational driver of sustainable and inclusive economic growth and development.

Despite improvements in the National UHC Service Coverage Index (SCI), which increased from 39.7 in 2015 to 52.7 in 2022, only half of Pakistan's population has access to essential health services. According to Pakistan's UHC Monitoring Report 2023, achieving an SCI of 80+ by 2030, as targeted by SDG 3.8.1, will be challenging.

In Punjab, the SCI was slightly higher than the national average, at 53.8 in 2022. A notable milestone was the finalisation of the UHC Benefit Package/Essential Package of Health Services (EPHS) by the provincial government in 2021. This comprehensive package underscores the government’s commitment to UHC by ensuring the provision of essential health services to all residents of Punjab, marking a significant step towards improving population health and achieving UHC.

Additionally, the Sehat Sahulat Programme, initially designed to support individuals below specific poverty markers, was expanded in 2021 to cover 100% of Punjab’s population, significantly advancing UHC efforts. To address EPHS implementation gaps at the community and Primary Health Care (PHC) level, the provincial government, with support from the World Bank's National Health Support Programme (NHSP) and Human Capital Investment Project (HCIP), has been actively investing in necessary resources.

Despite these efforts, UHC implementation in Punjab faces significant challenges. The province’s health information system has made strides with adopting Electronic Medical Records (EMRs) for case-based data and public health data reporting via the District Health Information System 2 (DHIS 2) to the Director General's office. Over 100 Basic Health Units (BHUs) have implemented the EMR system under the Health Information System Delivery Unit (HISDU), with plans for province-wide expansion. HISDU’s EMR system, which includes 68 modules for various health services, is fully integrated with the provincial dashboard and accessible via web-based and Android platforms.

The Integrated Disease Surveillance and Response (IDSR) system reports weekly through DHIS2, and efforts are underway by the Punjab Information Technology Board (PITB) to integrate EMR systems in 53 specialised hospitals. District-level digitised data processes are being integrated into HISDU, although national-level linkage of DHIS or DHIS2 data is still in development. These ongoing improvements aim to achieve comprehensive data integration and interoperability across various levels and programmes.

Addressing socioeconomic and geographic disparities in healthcare access is critical for achieving UHC in Punjab, particularly in the southern regions where SCI scores remain low. The Primary & Secondary Healthcare Department (P&SHD) plans to enhance UHC investments and optimise existing resources while maintaining rigorous service delivery monitoring. The E4H Programme will provide Technical Assistance (TA) to develop a cohesive and comprehensive roadmap for UHC implementation.

Creating this roadmap must align with expanding the existing Family Planning Delivery Unit, which will centralise and prioritise reforms through an integrated approach, thereby strategically guiding UHC implementation improvements across the province. The previous Family Planning (FP) initiatives under DAFPAK PSSD established a robust Delivery Unit, which initially focused on improving Contraceptive Prevalence Rates. This Unit's capacity and analytical support capabilities will be leveraged and expanded within the new UHC Delivery Unit, continuing to upskill the existing team and drive strategic improvements in UHC implementation across Punjab.

Objectives

The unit's objective is to monitor data and build institutional capacities for evidence-based decision-making and accountability. It will define key performance indicators for the South, North, and Central districts in Punjab, monitor them regularly, and analyse data to report regularly in stocktakes.

(The unit will be providing support to the Secretary Health and the CM to hold the department accountable through regular performance stocktakes).

Sub-objectives

1. To work on the UHC SCI in Punjab, focusing on Primary Health Care (PHC).
2. To coordinate and liaise with the STTA UHC implementation roadmap team to develop a roadmap aligned with the Department's 5-year HSRP and CM’s health sector priorities.
3. To liaise with the Data Governance embedded TA team (including DHIS II and EMR) to ensure the Delivery Unit can identify areas of data quality improvement.
4. To liaise with international development partners engaged in all UHC-related activities to create synergies and avoid duplication of efforts.
5. To build the capacity of the Department to use data for evidence-based decision-making, performance and accountability.

Scope of Work and Methodology

The unit's objective is to monitor data and build institutional capacities for evidence-based decision-making and accountability. It will define key performance indicators for the South, North, and Central districts in Punjab, monitor them regularly, and analyse data to report regularly in stocktakes.

(The unit will be providing support to the Secretary Health and the CM to hold the department accountable through regular performance stocktakes).

1. 1.    Phase 1: In the first phase, the Delivery Unit is expected to establish a solid foundational strategy aligned with the UHC roadmap and provincial health policies. This may include, among other tasks:

• Develop the TORs of the Delivery Unit
• Notify the Delivery Unit
• Conduct a kick-off workshop to align the Delivery Unit’s strategic objectives with the UHC roadmap
• Hold a workshop with development partners and technical experts to get feedback
• Establish an understanding of clear goals, responsibilities, and timelines
• Create specific, actionable and timed implementation plans for each of the four proxy areas of UHC implementation aligned with the UHC roadmap

1. 2.    Checkpoint(s) Conduct a kick-off workshop to align the Delivery Unit’s strategic objectives with the UHC roadmap

• Conduct a kick-off workshop to align the Delivery Unit’s strategic objectives with the UHC roadmap
• Establish an understanding of clear goals, responsibilities, and timelines for the Delivery Unit
• Approval of TORs and action plan by the Secretary

1. 3.    Phase 2: In the second phase, the Delivery Unit is expected to execute the action plan and ensure coordination among various stakeholders and decision-makers, which is essential for UHC implementation and decision-making.

• Implement a monitoring system to track progress against the UHC roadmap using indicators identified through a rigorous consultative process between the P&SHD and the CM office. • Report the data to the CM’s health roadmap focal points and present data in quarterly stocktakes.
• Utilise data analytics to provide the Secretary with insightful, actionable feedback for Department’s internal monthly review (CEOs, Medical Superidentent, DC IRMNCH&N Conferences).
• Oversight on UHC implementation trends, challenges, and opportunities such as:
  • Set up an integrated data dashboard connected to data flowing into HISDU that collates real-time data.
  • Monitor the progress in relevant data indicators in the province and develop KPI to highlight equity gaps through disaggregation of data by region (North, Centre & South), districts, poverty and other possible equity indicators.
  • Provide the Secretary with policy briefs, talking points, and advocacy briefs presenting the need for financial and non-financial resources. This will enable the Secretary to advocate for sustained investment in UHC implementation.
  • Focal points within the Department, specifically from HISDU, will be identified for capacity building to carry out the Unit's functions, especially the capacity to analyse data to facilitate evidence-based decision-making.
  • The analytics, policy briefs, reports etc developed by the Unit will be disseminated on regular basis on the Government forums such as CEOs, Medical Superintendent, DCs IRMNCH&N Conferences and any other learning events organised by Departments.
  • The Unit will identify any possible areas where they can help cross validate data collected by the MERL component of this Programme such as Health Facility Assessment findings. Conversely, the Unit’s deliverables such as policy briefs and analytics can be reviewed by the Programme’s MERL team. This collaborative effort will further help identify areas for implementation research.

The UHC Delivery Unit will comprise a Team Manager (01), Associates (02), and Analysts (04) who will collectively work towards the successful implementation of the roadmap approach in UHC implementation. This Delivery Unit will work to improve the UHC SCI, a single indicator based on four proxy areas and their corresponding tracer indicators. The four proxy areas include Infectious Diseases (ID), Non-Communicable Diseases (NCD), Reproductive, Maternal, Newborn and Child Health (RMNCH) and Service Capacity and Access. Although the team knows that the UHC SCI Is currently calculated using data from demographic surveys, there will be an effort to map Input and outcome Indicators.

Roles and responsibilities:

• Establish regular performance management routines with key officials driving the UHC Roadmap at P&SHD, providing updates on progress towards the set goals, highlighting potential issues, and identifying potential risks.
• Support the team to achieve all monthly and quarterly milestones/deliverables on time and per required quality.

Timeline and LOE

The role is full-time for 5 months, from August 2025 to December 2025. The position will be based in Lahore and embedded in the Department of Health.

Reporting

The role reports to the Team Lead / E4H Program Team for the UHC Delivery Unit. 

Requirements

Technical Expertise

• Bachelor's or Master’s degree in Public Health, Economics, Development Studies, Social Sciences, Management Sciences, Public Policy, or a related field.
• Minimum 5 years of overall experience, with demonstrated contributions to health sector initiatives, preferably within Punjab.
• Proven experience in data analysis, visualization, and document creation using tools such as Microsoft Suite, SPSS, STATA, Power BI, or Tableau.
• Strong understanding of Non-Communicable Diseases (NCDs), Universal Health Coverage (UHC), and primary healthcare systems.
• Ability to prepare high-quality analytical briefs, presentations, and reports for decision-makers and stakeholders.

Core Competencies

• Planning and delivering work
• Analysis and use of information
• Communication and coordination
• Problem-solving
• Working with others