TORs for SP02 Health Minimum Services Delivery Standards Office: Tel: Fax: Email: 37 Sarwar Road Lahore Cantt., Pakistan +92 (0) 42 6603123 +92 (0) 42 6603124 info.pdssptama@gmail.com pd.pdssp@gmail.com tama Technical Assistance Management Agency Service Provider for Punjab Devolved Social Services Program (PDSSP) TERMS OF REFERENCE HEALTH PLANNING SPECIALISTS FOR PREPARATION OF DETAILED PLAN AND ACTIONS TO IMPLEMENT MSDS, SMPs and SOPs for HEALTH Relates to MDG Goals 3, 4, 5 and 6 Impact: Improved health services in the Punjab Date 1 st draft: 8 July 2008; Date 2 nd draft: 23 August 2008 Date 3 rd draft: 26 August 2008 Reference number: SP02 Output: Action plan to implement plan MSDS, SMPs and SOPs Lead Specialist: Lynne Elliott Lead Project Officer: Jahanzeb Waheed Decision Date: 14 th October Expected starting date: December 2008 Drafted By: Lynne Elliott and Jahanzeb Waheed Final/draft: Final 1. Background and Objectives The Government of Punjab is committed to reaching the standards set out internationally in the Millennium Development Goals (MDGs). It recognises that in order to reach these goals it must focus not only on improving the coverage of health facilities but also the quality of care provided. With this in mind a series of documents were commissioned which set out minimum standards across the different levels of care from primary to tertiary care. Three documents were prepared: 1. Minimum Service Delivery Standards (MSDS) for primary and secondary health care in Punjab 2. Standardised Medical Protocols (SMPs). 3. Standard Operating Procedures (SOPs). The work on all three documents has been completed and the documents fully sanctioned and agreed by the Government of Punjab. They are now ready to be implemented. A series of workshops have been planned by the Programme Support Unit (PSU) of the PDSSP over the coming months to raise awareness of these documents at all levels.
At the same time, in order to implement the Minimum Service Delivery Standards (MSDS) for health, the SMPs and SOPs, a comprehensive action plan needs to be developed which details how the MSDS, SOPs and SMPs will be rolled out across the Punjab. This work will be carried out in close coordination with the Health, Finance, and Planning and Development Departments, the Government of the Punjab and the Director General Health Services, and other key programmes such as the Punjab Health Sector Reform Program (PHSRP). Scope of Work 2. Overall Goal and Purpose The Department of Health aims to improve the quality of health services across the Punjab in line with the newly developed standards and protocols. The purpose of these TORs is to assess the implications of the new standards and protocols for health service provision in the Punjab; assess systems which require development/ improvement to implement the new standards; and identify gaps and priorities to bring current health services into line with the requirements of the new standards and protocols. Once the systems review has been undertaken and gaps and priorities have been identified, an implementation plan will be developed and detailed key actions will be defined aimed at improving health service delivery across the Punjab in line with the new standards and protocols. The implementation plan will highlight key areas of focus and actions for improvement over the coming years. While it is recognised that some improvements will be achieved over a number of years, it is important to identify immediate actions which if implemented can provide immediate improvements to health service provision in the Punjab. The plan therefore will outline short, medium and longer-term goals and actions to improve health services. An indicative outline of requirements will be developed for each key focus area. The key focus areas and timelines for implementation will decided in partnership with Government Departments including Health, Finance and Planning and Development and with other programmes such as the PDSSP and Punjab Health Sector Reform Programme (PHSRP). These focus areas are likely to include but will not be limited to: Systems development in general but more specifically Improving maternal and child health including improvements in reproductive health services and how these are delivered. Continuing professional development (CPD) for health professionals. Drug management. Improving service delivery for the most disadvantaged and difficult to reach groups; and other service improvement issues such as gender mainstreaming. This includes issues such as improving health services for men who often access health services less frequently than women; and improving services for women. Communication and behaviour change campaigns to promote service use and community participation. Developing strategic planning and management, including HR and financial management, at all levels. Improving health management information systems and use of data at all levels to shape practice and policy in the health sector.
The purpose of this initial phase is to develop the implementation plan and define in detail the key areas of action required, with individual time-scales for each action and how these will be achieved. Specific objectives will be to: 1. Review the MSDS, SOPs and SMPs and assess the gaps and key priority areas for improving health services across the Punjab. The key areas are likely to focus on the topics listed above and on strengthening systems used to deliver effective healthcare, and should be decided and agreed with the Department of Health. 2. Identify areas of service improvement which could be undertaken immediately to improve health service delivery in the Punjab. 3. Develop an implementation plan for the MSDS, SOPs and SMPs for health across the Punjab. The implementation plan will outline short, medium and longer-term goals and actions to improve service delivery in key focus areas. 4. Develop an indicative outline of requirements for each action which will form the basis of the next phase of work for the Department of Health. These will be used as a basis on which subsequent TORs will be designed and developed for the whole MSDS programme which is likely to run for the duration of TAMA s operation. 3. Duties and Responsibilities The consultants will: In addition: Review the TORs, flag any flash-points, and propose any amendments. Use a fully participatory and inclusive approach in order to ensure long-term sustainability. The consultants will work in full collaboration with the Department of Health, and line departments and districts as agreed with the Department of Health. Meet with the Department of Health, TAMA and PSU for a consultancy briefing session and de-briefing sessions at the start and end of the consultancy. Undertake a desk based review of all relevant documentation provided by TAMA and the Department of Health. An indicative list is provided within these TORs. In preparation for the commencement of the assignment the national consultants will develop a list of key people to be consulted during this assignment, and share this with the Department of Health for their review, amendments and additions. Undertake a variety of group and one-to-one interviews, focus-group discussions and site visits as required. A fully collaborative and consultative approach is being used since the work on service improvement will have implications across several departments, including Planning and Development, and Finance; across other programmes such as the Punjab Health Sector Reform Programme; and across new initiatives including the ADB funded MDG health programme. An outline of the implementation plan will be developed with short-term actions and goals for MSDS, SOPs and SMPs which will lead to immediate improvements in service delivery. By the end of the assignment a draft implementation plan, and outline of requirements for each key focus area, will be developed. These will provide details of short, medium and long-term goals.
A de-brief meeting will be held with key strategic partners to discuss the implementation plan and key focus areas for improvement. A timetable for the completion of the implementation plan and an indicative outline of requirements for each key focus action will agreed and documents delivered within the agreed timeframe. The indicative outline of requirements for each key focus action will form the basis of the next phase of work for health service improvement. The implementation plan and key actions should combine national experience and best practice with regional and international best practice, with clear indications of how these practices can be combined to fully meet local requirements and conditions in the Punjab. The consultant requirements have been designed with this in mind. 4. Consultant Qualifications 2 national consultants 1 international consultant The National consultant (1) will have the following: A higher degree in human resource management (HRM) from a recognised institution; More than 10 years experience in the health field; At least 8 years practical experience in HRM provision for health or other social sectors in Pakistan; Experience of providing training and continuing professional development programmes for health professionals; Excellent negotiation skills and communication skills; Excellent computer and report writing skills in English. The National consultant (2) will have the following: Note: A higher degree in information systems and monitoring and evaluation from a recognised institution; More than 10 years experience in the health field; At least 8 years practical experience in the design and development of health information systems in Pakistan; Excellent communication skills; Excellent computer and report writing skills in English. It would be beneficial if one of the national consultants had regional as well as national experience. The international consultant will be a health systems development/ planning expert and will have: A higher degree in health planning and management ; More than 10 years experience in the health field; At least 10 years experience of working in the health and development sector in senior management roles, and experience in the implementation of minimum service delivery standards;
Knowledge of the public sector and the health sector is essential. Preference will be given to those with regional work experience; Excellent communication and negotiation skills; Excellent computer, report writing and planning skills are essential in English. This skills mix of national, regional and international experience aims to provide a solid basis on which to develop a comprehensive programme for service improvement for the Department of Health over a number of years. Given the size and strategic importance of this task it will be key to combine sound local knowledge with examples of regional and international best practice in order to build a solid base for a whole series of longer-term improvement programmes with the Dept of Health. 5. Duration of Inputs The review and planning mission will take a total of 37 days. We expect the TA to commence in late October 2008. 6. Reporting and Deliverables Draft action plan and indicative outline of requirements for each key focus action to be shared with strategic partners by the end of the in-country mission. This will likely consist of providing feedback at an interactive workshop session with key strategic partners. The action plan will include the main areas outlined on Scope of Work, points 1-4. Identification of key areas for immediate service improvement. Final action plan and indicative outline of requirements for each key focus action to be developed by the end of the in-country visit, incorporating feedback and any amendments from the in-country workshop session. The indicative outline of requirements will be comprehensive since it will form the basis of the next phase of work for health service improvement which is likely to span several years. 7. Management Arrangements: The consultant will link with the key focal person in the Department of Health (Department of Health to nominate a focal person) and with the Punjab Health Sector Reform Programme (Health Sector Reform Programme to nominate a focal person) The TAMA technical lead for this TOR will be the Team Leader and the TAMA Programme Officer will be Jahanzeb Waheed. The team of two national and one international consultants will work in full collaboration with the Department of Health Punjab. 8. Key Documents Department of Health and other key departments and stakeholders to add others: 1. Minimum Service Delivery Standards (MSDS) for primary and secondary health care in Punjab 2. Standardised Medical Protocols (SMPs) 3. Standard Operating Procedures (SOPs)
4. Estimated Timelines No. Activities 1 Review and finalisation of TORs by the consultants 2 Desk Review of documents 3 Briefing meetings with PSU, DoH and TAMA ACTIVITY SCHEDULE SP02 Health Minimum Service s Delivery Standards WEEKS/ DAYS 1 2 3 4 5 6 7 8 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 4 Development of Interview Guidelines 5 Conducting interviews and discussions 6 Development of implementation plan along with time table, and outline of requirements 7 De-briefing with PSU, TAMA and MoH 8 Finalisation and submission of implementation plan Factors which may alter the work plan Delay in the release of resources. Delay in the approval of steps, stages and tools required for carrying on the assignment Delay in supplying documents, data, statistics and other information related to the assignment Unavoidable political, security, law and order situation. Any unforeseen situation.