AGA KHAN FOUNDATION

(Pakistan)

The Aga Khan Foundation (AKF), an agency of the Aga Khan Development Network (AKDN), is a private, non-denominational, international development agency established in 1967. It seeks sustainable solutions to long-term problems of poverty, hunger, illiteracy and ill-health with special emphasis on the needs of rural communities in mountainous and other resource poor regions, primarily in Asia, Africa and the Middle East. Its main areas of focus are education, health, rural development, environment and strengthening civil society.

The Aga Khan Foundation (Pakistan) [AKF(P)] is seeking high caliber professional for the following position.

“Consultancy for Health System Strengthening”

  1. Background

The Aga Khan Foundation, Pakistan (AKF)P and its partners seek to address the interconnected causes of poverty through a long-term, multi-input approach that empowers individuals and communities.

In 2015, the Central Asia Health System Strengthening Project (CAHSS) mid-term evaluation recommended that standard protocols and clinical guidelines, particularly for Integrated Management of Childhood Illness (IMCI,) Antenatal care (ANC) and Family Planning (FP) should be reviewed with health facilities on a more frequent basis. Any new adherence strategies should be incorporated into QA plans. CAHSS Annual Health Facility Assessments (HFAs) has also identified that adherence to approved protocols where they do exist is low – so that patient examination practices are weak, and work distribution among medical staff is sometimes uncoordinated.

In response to recommendations made in CAHSS mid-term evaluation, and findings of the project HFAs, AKF is seeking a qualified consultant(s)/consultancy firm to carry out an assessment and review of targeted secondary health facilities in order to assess the level of adherence of procedures and protocols against international standards; to identify successes and barriers to implementation of procedures and protocols; assess gender responsiveness of procedures and protocols and to what extent gender-specific strategies are implemented; and make recommendations for improvement. The assessment will provide information on the state of existing MNCH service operating procedures, clearly identifying common strengths and weaknesses, as well as strategies to ensure quality sustained implementation of gender responsive standard operating procedures.

Consultant will be based in Pakistan and will require travelling to Tajikistan, Kyrgyz Republic and North of Pakistan. Travel to Afghanistan may not be possible due to security reasons, and the interviews may be conducted remotely.

  1. Background of Project

CAHSS is a $31 million, five-year project implemented by Aga Khan Foundation Canada (AKFC) and co-funded by Global Affairs Canada.

CAHSS is designed to improve the health of 1,025,257 people, including 564,880 women, and 50,911 children under five in target areas of Afghanistan, Pakistan, Tajikistan, and Kyrgyz Republic, particularly for reproductive-aged women, newborns and children under five. The overall goal of CAHSS is to Strengthen health systems to improve the health of men and women in target areas of Central Asia, especially women of reproductive age, newborns and children under five. CAHSS is designed to intervene at the primary (community), secondary (district) and tertiary (provincial and national) levels of the health system.

To address health system gaps and weaknesses, and strengthen the ability of systems to contribute to improved health in the target areas of Central Asia, the project plans to 1) strengthen service delivery; 2) foster professional development; 3) promote community health; and 4) promote learning. Specifically the project’s outcomes are:

  • Increased availability of quality care provided by project supported health facilities
  • Improved capacities of female and male health professionals to manage and provide quality care
  • Enhanced awareness of male and female community members on health promoting and disease preventing behaviors
  • Improved awareness of targeted healthy behaviors among male and female community members
  • Enhanced knowledge of key stakeholders to inform and improve the functioning of the health system in Central Asia
  1. Scope and Target Population

CAHSS works in a total of 20 secondary health facilities across four countries including Afghanistan, Kyrgyzstan, Pakistan and Tajikistan. These facilities serve approximately more than 1 million people.

Countries / Total Facilities / Sampled Facilities
Afghanistan / 5 / 1 (1 CHC access from Khorog)
Kyrgyz Republic / 3 / 2 (1 Family medicine center, 1 hospital)
Pakistan / 8 / 3 (2 Secondary – 1 – Chitral, 1 – Gilgit, GMC)
Tajikistan / 4 / 2 (1 district hospital and Family medicine center, KOGH)
Total / 20 / 9

In each of the sampled facilities, it is envisioned that Key informant interviews with doctors, nurses and system managers will be carried out as well as facility observations and analysis across a standard checklist (developed by the consultant). It is expected that at least three interviews per facility will take place.

  1. Purpose of Mandate

The Consultant(s) be responsible for overall design, data collection tool development, quality-control, analysis and report writing. Specifically, the main objectives of the consultancy are to:

  1. Carry out an assessment of health facilities focusing on the compliance to the ANC, FP and IMCI protocols, as well as on systems for maintenance, utilization and repair of the medical and diagnostic equipment.
  2. Recruit and coordinate with local evaluation teams in each of the four CAHSS countries
  3. Produce a detailed assessment report including findings and recommendations
  4. Produce a summary of the assessment for each facility and country
  5. Coordinate with CAHSS PCU throughout the duration of the evaluation.
  6. Develop a set of tools to facilitate facility staff to implement recommendations. These may include schedules, checklists, discussion guides, monthly reminders, maintenance/ protocol review plans, guidelines on how to set up inventory service/ repair plans – and will vary depending on the nature of the recommendations.
  1. Scope of Study

This study will include three main components:

  • Document review and analysis of primary and secondary sources from the project’s reports, MNCH standard operating procedures, National Policies, international best practice, and other relevant information, as well as other data collected through the project’s monitoring system (HFAs) and health facility standard operating procedures.
  • Collection of qualitative information through Key Informant Interviews with health facility staff and management and health department personnel and completion of health facility implementation review.
  • Development of practical tools to help facility staff implement recommendations and apply learnings from the consultation. These may include schedules, checklists, discussion guides, monthly reminders, maintenance/ protocol review plans, guidelines on how to set up inventory service/ repair plans – and will vary depending on the nature of the recommendations.

The following areas of enquiry are of particular interest:

1. Clinical Protocols and compliance:

  • Existence of MNCH standard operating procedures
  • Quality of standard operating procedures compared with global best practice (WHO)
  • Level of knowledge of health facility personnel on policies and procedures
  • Institutionalization of policies and procedures
  • Gender responsiveness of policies and procedures and extent to which relevant strategies are implemented
  • Mechanisms in place to monitor adherence to standard operating procedures and report inconsistent implementation for professional development and management review

2. System for monitoring, maintenance and proper utilization of the project equipment:

  • Existence of health facility equipment management policies and procedures
  • Quality of policies and procedure compared with global best practice (WHO)
  • Level of knowledge of health facility personnel on policies and procedures
  • Level of adherence/ implementation of policies and procedures
  • Institutionalization of policies and procedures
  • Mechanisms in place to monitor adherence to policies and procedures
  1. Key Activities and Deliverables

The key deliverables expected from the Consultant(s) for this assignment are as follows:

  • Review all relevant documents, studies and other data sources regarding health systems equipment maintenance, service and management policies and procedures relevant to CAHSS in each of the countries. Prior to the commencement of the assessment, an inception meeting via Skype with the PCU will be carried out to clarify mandate.
  • Revise and finalize Study Plan[1]: a detailed study plan is to be finalized including the following elements:
  • Evaluation design and methodology
  • Detailed work plan that includes all tasks by the Consultant and team members and incorporating the overall timelines[2]
  • Level of effort of each team member
  • An analysis plan for the data collected
  • Detailed budget including professional fees, expected reimbursable(s), etc.
  • Develop Data Collection Tools

Develop the set of data collection tools and revise according to PCU and country unit feedback.

  • Internal Orientation for each country team through an in-person workshop prior to facilitator training is recommended.
  • Ensure Quality of information Collected
  • Ensure Transcription and Translation of all information collected through field work conducted.
  • Coding and Analysis ofqualitative data and other relevant information, based on the analysis approach in the study plan.
  • Draft and Finalize Report including Executive Summary and Full Report. The final Report is to be submitted in both Word and PDF versions with all annexes included. A suggested Table of Contents (ToC) will be provided by AKF.
  • Draft and Finalize a PowerPoint Presentation including summary of methods, tools, findings and recommendations. AKF will provide a suggested outline for this in advance.
  • Draft and Finalize Health Facility Reports including key findings and recommendations for each health facility sampled. The Consultant will provide a suggested outline for this report based on the evaluation tool.
  • Copies of Translated Transcripts and all Data including any field notes are to be submitted to the PCU with the draft report.
  • Develop practical tools in consultation with PCU and key facility personnel to help facility staff implement recommendations and apply learnings from the consultation, including guidance notes on how to use the tools.

The Project Coordinating Unit (PCU) will make available all relevant documents and information during the inception phase.

  1. Time Frame and Level of Effort

The period of the contract is estimated to be from July 25, 2017 to October 31, 2017 with an expected contribution of approximately 30 working days over this period. The consultant is expected to carry out all the preparation required to roll out the study as per the suggested time frame below.

Task/Output / Level of Effort / Expected Time Frame
Inception Meeting (Skype) / 0.5 / July 26
Document Review and LiteratureReview / 6 / August 10
FinalizeStudy Plan includingdevelopment of all tools, and reporting formats / 5 / August 20
Integratecommentsfrom AKF and submit Final Study Plan. AKF willprovideanycommentswithinsevendays of receipt / 2 / August 25
Data Collection and Quality Control / 18 / September 30
Transcription and Translation / 6
Coding and Analysis of qualitative information / 7 / October 15
DraftAssessment Report, includingindividualfacility reports by country / 6 / October 23
Developpracticaltools / 4 / October 27
Incorporate feedback and submit Final Report / 2 / October 28
Summary of Findings and Power Point Presentation / 1 / October 30
Total EstimatedDays / 57.5
  1. Qualifications of Consultant(s)
  • A master degree in Public Health or Medicine is required
  • Minimum of 5 years of experience in conducting health system assessments and evaluations, preferably for international non-profit organizations or multilateral agencies and multi-country studies
  • Demonstrated experience in designing health system evaluations and assessments, including proven experience in methodology and tool development, etc.
  • Demonstrated experience in qualitative analysis and using qualitative analysis software
  • Experience managing multi-country evaluations desired
  • Extensive knowledge and experience in gender equality issues required
  • Specialization in health systems in Central Asia desired;
  • Fluency in English is mandatory. Additional Central Asian languages is an asset
  • Ability to produce high quality work under tight timeframes
  1. Application Packages and Procedures

Qualified and interested parties are asked to submit the following:

  1. Letter of interest, including the names and contact information of two previous clients who can be contacted regarding relevant experience
  2. Detailed Technical Proposal of not more than 8 pages clearly demonstrating a thorough understanding of this request for proposals and including the following:
  3. Description of evaluation approach and methodology
  4. Proposed sampling strategy
  5. Demonstrated previous experience in similar evaluations and other qualifications outlined in this RFP
  6. A proposed timeframe detailing activities and a schedule/work plan (including a Gantt chart)
  7. Team composition and level of effort of each proposed team member, including country teams
  8. Curriculum Vitae(s) of all proposed staff outlining relevant experience (annexed to technical proposal)
  9. A Financial Proposal with a detailed breakdown of costs for the study
  1. Itemized consultancy fees/costs
  2. Itemized field data collection expenses
  3. Itemized administrative expenses
  4. Expected payment plan and method
  1. A copy of a previous report of similar work undertaken on:

a) Health facility operational evaluation OR

b) Qualitative study related to health facilities

  1. A Consulting Firm profile (if applicable).

Proposals will be evaluated only if the complete package as outlined above is received, including a sample of previous work.

  1. Management and Reporting

The successful candidate(s) will work closely with AKF’s Project Coordination Unit (PCU) located in Islamabad, Pakistan, and all country M&E leads. The consultant will be directly accountable to PCU Project Director on all matters related to the contract.

  1. Disclosure of Information

It is understood and agreed that the Consultant(s) shall, during and after the effective period of the contract, treat as confidential and not divulge, unless authorized in writing by AKF, any information obtained in the course of the performance of the Contract. Informationwill be made available for the consultants on a needtoknow basis. Any necessary field visits will be facilitated by AKF. The selected consultant will commit to respect AKF Policies.

  1. Conflict of Interest

Applicants should state clearly whether they have an actual or potential conflict of interest with a staff, volunteer or board member of AKF

AKF(P) offers a competitive remuneration package and conducive working environment. We are an equal opportunity employer - Women are encouraged to apply.

Only online applications will be entertained. The deadline for applications is July09, 2017.

Only short-listed candidates will be contacted.

For more information about AKDN, please visit

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[1] The study plan is an elaborated version of the initial proposal submitted. An outline for the study plan will be provided to the successful candidate(s) prior to the inception meeting.

[2]Final timelines will need to be coordinated with AKF country offices and the Project Coordination Unit (PCU) in Islamabad. The PCU will facilitate this with the consultant team.