TAKP14: National Senior STTA: Evaluation Specialist - E4H Programme KP and Federal

Palladium Pakistan (Pvt.) Limited
Full time Full day
Posted date

1st February, 2024

Last date to apply

11th February, 2024












15 years

TORs: National Senior STTA – Evaluation Specialist

Evaluating Effectiveness of Outsourcing of Hospitals by Khyber Pakhtunkhwa Health Foundation


Evidence for Health (E4H) is a new 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 the Federal and Khyber Pakhtunkhwa (KP) governments and will subsequently operate in Punjab. The KP and Federal component is being implemented by Palladium along with Oxford Policy Management (OPM).

Through its flexible, embedded, and demand-driven model, E4H KP & Federal 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: Enhanced capacity for 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 works in partnership with the Ministry of National Health Services, Regulations & Coordination (M/o NHSR&C) at the Federal level, and the Health Department in KP.

Background and Problem Statement

In pursuit of its goal to foster innovative healthcare delivery models, the Khyber Pakhtunkhwa Health Foundation (HF) has effectively implemented several outsourcing initiatives in the past. Leveraging technical assistance provided by the FCDO's earlier project to strengthen the foundation's contract management and procurement functions, the foundation has successfully outsourced 19 hospitals in the province, with 16 in the Newly Merged Districts (NMDs) and 3 in settled areas of KP. Additionally, plans were initiated to outsource primary healthcare services in eight districts and 58 secondary healthcare facilities. However, the outsourcing of primary and secondary healthcare services has been put on hold due to the dissolution of the provincial assembly.


This evaluation aims to assess the impact of outsourcing hospitals on service quality, accessibility, patient satisfaction, operational efficiency, financial management, and overall healthcare outcomes.

Specific Objectives

The primary objective of this evaluation is to assess the effectiveness of the outsourcing of hospitals by the KP Health Foundation. Specifically, the evaluation should:

  • Determine the impact of outsourcing on the accessibility and affordability of healthcare services.

  • Assess the quality of healthcare services provided through outsourcing arrangements.

  • Analyse the efficiency and cost-effectiveness of outsourcing compared to traditional models.

  • Identify any challenges or issues encountered during the outsourcing process.

  • Determine the extent to which outsourcing has improved the quality of healthcare services.

  • Assess the impact of outsourcing on accessibility to healthcare services for different demographic groups.

  • Evaluate the operational efficiency and cost-effectiveness of outsourced hospitals.

  • Analyse the financial management practices of the outsourced hospitals.

  • Identify any unintended consequences or challenges associated with outsourcing and recommend mitigation measures.

  • Provide recommendations for improving the outsourcing strategy, if necessary.

Scope of Work

The evaluation will cover all hospitals that have been outsourced by the KP Health Foundation within the province of Khyber Pakhtunkhwa. The team is expected to include a combination of data collection techniques, such as surveys, interviews, focus group discussions, document review, and secondary data analysis. Sampling strategies will be employed to ensure representation from various stakeholder groups. Both urban and rural hospitals will be included in the evaluation. The evaluation should include, but not be limited to, the following elements:

  • Reviewing relevant project documents, including evaluations, outsourcing agreements, policies, and procedures.

  • Identifying best practices and lessons learned from other regions or countries that have implemented similar outsourcing initiatives.

  • Conducting interviews and surveys with key stakeholders, including hospital administrators, healthcare professionals, patients, and community members.

  • Analysing quantitative data on hospital performance, patient satisfaction, and cost efficiencies.

  • Assessing the impact of outsourcing on access to healthcare services in different geographic areas within the Khyber Pakhtunkhwa province.

  • Comparing the performance of outsourced hospitals to non-outsourced hospitals in terms of quality indicators, patient outcomes, and financial sustainability.

  • Examining the role and effectiveness of the oversight mechanisms established by the KP Health Foundation to monitor outsourced hospitals


The consultant team should produce the following deliverables:

  • An inception report outlining the evaluation methodology, draft data collection tools, stakeholders identified, work plan, and timeline.

  • A comprehensive evaluation report presenting the evaluation findings, analysis, conclusions, and recommendations. The draft report should include an executive summary, methodology, detailed results, and an action plan based on the recommendations.

  • Presentation of evaluation findings to the DOH and other stakeholders. The finalised report incorporating any feedback or comments received, providing a clear roadmap for immediate and long-term improvements in the outsourcing strategy.

Timeline and LOE

The level of effort for the role is 40 working days, from February 2024 to May 31, 2024


  • Education: A bachelor's degree in a relevant field such as social sciences, statistics, or public health. An advanced degrees such as a Master's or Ph.D. in evaluation, program evaluation, or a related discipline.

  • Research and Data Analysis: Expertise in research design and methodologies. Possess skills in collecting and analysing both qualitative and quantitative data, using various evaluation techniques and statistical methods to extract meaningful insights.

  • Evaluation Design: Skilled in designing evaluation frameworks that align with program goals and objectives. Knowledge of different evaluation models, such as formative, summative, and developmental evaluation, and can tailor the approach according to the specific context and needs of the program.

  • Data Collection Methods: Well-versed in a range of data collection methods, including surveys, interviews, focus groups, observations, and document reviews. Knowledgeable about best practices in data collection to ensure reliability and validity.

  • Data Analysis and Interpretation: Expertise in analysing and interpreting data to identify patterns, trends, and outcomes. Proficient in using statistical software and techniques to analyse quantitative data and employ qualitative data analysis methods to extract themes and insights from qualitative data sources.

  • Evaluation Reporting and Communication: Skilled in effectively communicating evaluation findings to diverse audiences. Can prepare comprehensive evaluation reports, presentations, and visualizations that clearly convey the results and recommendations of the evaluation to stakeholders.

  • Program Improvement and Decision-making: Adept at using evaluation findings to inform program improvement and decision-making processes. Can identify strengths, weaknesses, and gaps in program implementation and effectiveness and provide evidence-based recommendations for program refinement.

  • Ethics and Cultural Competence: Understand and adhere to ethical guidelines and principles in evaluation practice. Aware of cultural considerations, including cultural competence and sensitivity, in conducting evaluations to ensure equitable and unbiased evaluation processes and outcomes.

  • Project Management: Possess project management skills, allowing them to effectively plan, coordinate, and execute evaluation activities within the given timeframe and resources.

  • Experienced in designing and implementing evaluations of healthcare projects, with a strong understanding of outsourcing arrangements and healthcare service delivery models.

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