Senior National - Technical Consultant – RMNCH / Maternal & Newborn Health Specialist – Team Lead
KP TA - Capacity Strengthening of RMNCH Systems for Newborn Risk Identification & Essential Newborn Care in KP
Programme Overview
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 provides technical assistance (TA) to the Federal, Khyber Pakhtunkhwa (KP), and Punjab governments, and is being implemented by Palladium along with Oxford Policy Management (OPM).
Through its flexible, embedded, and demand-driven model, E4H supports 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 delivers 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.
Position Summary
The goal of this technical assistance is to strengthen the capacity of Skilled Birth Attendants and PHC-level providers in selected districts of KP to deliver high-quality Essential Newborn Care (ENC) and newborn risk identification, thereby improving early recognition, stabilisation, and timely referral of sick newborns.
We will achieve this by pursuing four objectives:
Objective 1: Build a group of master trainers (ToT) in newborn risk identification and Essential Newborn Care (ENC) using WHO-aligned clinical standards/ approved manuals by DOH.
Objective 2: Train frontline PHC providers on early identification of maternal and newborn danger signs, immediate newborn care, stabilisation, and referral protocols.
Objective 3: Establish a district-based mentorship and supportive supervision mechanism to ensure routine application of ENC practices.
Objective 4: Strengthen PHC-level referral systems and enhance the capacity of health workers to identify maternal and neonatal danger signs and initiate timely referrals to higher-level facilities (THQ/DHQ).
Strategic Approach
Contributions to health systems strengthening
This technical assistance will strengthen KP’s health system by addressing a critical bottleneck, the limited clinical capacity of Skilled Birth Attendants (SBAs) and PHC providers in newborn risk identification, early stabilisation, and Essential Newborn Care (ENC). By prioritising Training of Trainers (ToT) and hands-on clinical mentorship, the technical assistance will improve the quality and consistency of newborn care delivered across primary health care facilities. The intervention enhances clinical newborn care practices, early detection of high-risk newborns, data quality related to newborn care indicators, accountability for follow-up, and facility-level preparedness for timely referral. The work directly supports the development and future implementation of District Action Plans (DAPs) focusing on Reproductive, Maternal, Newborn, and Child Health (RMNCH), for which necessary funds will be requested through provincial planning and budgeting processes. Furthermore, the technical assistance aligns with the Good Governance Reform Roadmap, chaired by the Chief Minister of Khyber Pakhtunkhwa, which identifies expansion of 24/7 Basic Emergency Obstetric and Newborn Care (BEmONC) services to PHC facilities as a provincial priority. Strengthening the skills of SBAs in newborn care is essential for achieving this provincial goal. The technical assistance also aligns with and reinforces the system being developed under the National Health Support Programme (NHSP), including standardised newborn risk-screening tools, referral protocols, and service delivery improvements. By operationalising these tools through ToT and cascade trainings, the TA ensures that NHSP-supported systems become functional and embedded at PHC level. Through strengthened SBA skills, improved newborn risk screening, enhanced ENC practices, and better coordination between PHC and secondary care facilities, this technical assistance contributes to building a more resilient, responsive, and high-quality provincial newborn care system.
Alignment with other E4H TAs/investments
This technical assistance builds on previous E4H and FCDO-supported efforts that laid the strategic groundwork for health system strengthening in KP, including the Universal Health Coverage (UHC) Roadmap and the Quality of Care (QOC) Strategic Plan. It aligns closely with the District Action Plans (DAPs) being developed with a focus on RMNCH, supporting their successful operationalisation and integration into provincial planning and financing processes. The technical assistance also draws on the SBAs Manual developed under FCDO’s earlier Integrated Health System Strengtheing Delivery Project (IHSSDP) to ensure standardised training and mentorship across primary health care facilities.
Alignment with other donors (if relevant)
This technical assistance will closely work with the ongoing work of development partners including United Nations Children’s Fund (UNICEF) which supports Maternal and Perinatal Death Surveillance and Response (MPDSR) and Small and Sick Newborn Care (SSNCU); the World Health Organization (WHO) which provides technical guidance for Every Newborn Action Plan (ENAP) implementation and Quality of Care improvement; the United States Agency for International Development (USAID) which contributed strengthening Primary Health Care (PHC) and newborn survival systems; and Jhpiego, which focused on capacity building of midwives and SBAs. This alignment will promote synergy, reduce duplication, and reinforce coordinated action toward achieving provincial RMNCH and neonatal survival goals. Additionally, the team will also coordinate with the broader World Bank–funded initiatives, including the HCIP, National Health Support Project (NHSP), and the Primary Health Care Revamp Project, to ensure alignment, promote synergy, reduce duplication, and reinforce coordinated action toward achieving provincial Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) and neonatal survival goals.
Scope of Work and Methodology
This technical assistance aims to strengthen the capacity of Skilled Birth Attendants (SBAs) and primary health care (PHC) providers in Khyber Pakhtunkhwa by building their clinical competencies in newborn risk identification, Essential Newborn Care (ENC), early stabilisation, and timely referral. The TA will develop a strong district-level pool of master trainers who can sustain continuous capacity building and mentoring across facilities. The TA will complement newborn care systems being developed under the National Health Support Programme (NHSP), particularly standardised risk-screening tools, referral protocols, and facility-level documentation practices. Technical assistance will be delivered through a district-focused, phased approach:
Preparation and Adaptation of Training Materials
- Review and adapt existing training materials from DOH, NHSP, WHO, UNICEF, and development partners.
- Develop an integrated training package covering:
- Newborn risk identification
- Essential Newborn Care (ENC)
- Early stabilisation of small and sick newborns
- Referral readiness and communication
- Use of NHSP newborn risk-screening and referral tools
- Prepare skill-based job aids, checklists, and practical demonstration materials for use in both facility trainings and mentoring sessions.
Phase 2: Training of Trainers (ToT)
- Conduct hands-on ToT sessions for selected SBAs from the districts.
- ToT will cover the following core competencies:
- Early identification of high-risk newborns (prematurity, LBW, birth asphyxia, sepsis risk, feeding difficulties).
- Essential Newborn Care (thermal care, breastfeeding support, cord care, infection prevention).
- Newborn resuscitation readiness (appropriate to facility level).
- Stabilisation before referral (oxygen therapy, feeding support, KMC, warmth).
- Use of NHSP newborn risk-screening/triage tools.
- Applying standardised referral protocols and documentation.
- Certify master trainers who meet competency thresholds based on skills assessments.
Phase 3: Cascade Trainings at PHC Facilities
- Master trainers, with support from NHSP, will conduct two batches of cascade trainings for PHC-level staff across BHUs, RHCs, and other service delivery points in at least one district.
- Focus will be on practical, hands-on competency development, including:
- Conducting newborn assessments at birth and during postnatal care.
- Identifying danger signs and risk categories.
- Implementing the full ENC package immediately after birth.
- Stabilising sick newborns for referral.
- Completing simplified newborn risk forms and referral notes (aligned with NHSP tools).
- TA team will supervise, quality-assure, and mentor master trainers throughout implementation.
Phase 4: Facility-Based Supportive Supervision and On-Site Mentorship
- Provide ongoing mentorship to trained providers within their facilities.
- Conduct periodic on-site coaching sessions using skills checklists, case simulations, and clinical observation.
- Support facilities in improving:
- Availability and use of ENC supplies and equipment
- Adherence to newborn care protocols
- Proper use of NHSP newborn risk tools
- Effective communication during referral
Phase 5: Strengthening Stabilisation and Referral Readiness
- Support PHC facilities to adopt and operationalise standardised referral pathways.
- Strengthen communication channels between PHC → THQ/DHQ facilities for emergency newborn referrals.
- Promote consistent use of structured referral documentation and pre-referral stabilisation steps.
- Provide coaching to improve facility readiness for newborn emergencies, including thermal care, feeding support, infection control, and emergency trays.
Phase 6: Monitoring, Learning, and Quality Improvement
- Develop simple monitoring tools to track training completion, skill competency, and adherence to newborn care practices.
- Conduct periodic reviews at district level to assess:
- Competency retention
- Facility-level practice improvements
- Use of newborn risk identification and stabilisation protocols
- Share findings with the district health leadership to support ongoing improvements and planning.
- Document good practices for scale-up across other districts.
Sustainability: Capacity Building, Institutionalisation, and/or Transition Planning
The technical assistance will create a sustainable pool of master trainers comprising LHVs, midwives, and medical doctors who will continue to train and mentor facility-level staff in perinatal and neonatal death reviews. These master trainers will serve as district-level resource persons for ongoing capacity building beyond the TA period.
Training and mentorship activities will be integrated into existing DOH systems and structures, including RMNCH units, TWGs, and DHPMTs. The materials and the skills laboratories developed under the FCDO’s DAFPAK programme will further embed these competencies into routine practice.
The technical assistance will support a gradual transition of implementation responsibilities to provincial and district health authorities. Provincial RMNCH units and DHMTs will be capacitated to independently convene review meetings, monitor progress, and ensure regular reporting and feedback loops are maintained after TA completion.
Timeline and Days
The level of effort (LOE) for the role is 80 days from November 2025- November 2026.
Requirement
Technical Expertise
- MBBS, BDS, or Nursing degree with a master’s in public health, Maternal and Child Health, or a related field.
- Minimum 15 years of progressive experience in RMNCH programme design, implementation, and technical assistance within government or development partner settings.
- Demonstrated expertise in newborn risk identification, Essential Newborn Care (ENC), early stabilisation, and referral systems.
- Proven experience leading and coordinating maternal and newborn health initiatives with government health departments and development partners.
- Extensive experience in capacity building, Training of Trainers (ToT), and mentoring of SBAs across PHC and secondary care levels.
- Strong background in quality improvement approaches for newborn care and facility-level service delivery.
- Proven track record in managing or providing oversight for donor-funded health system strengthening projects in Pakistan or similar contexts.
Competencies
- Leadership and coordination of complex, multi-level health initiatives.
- Effective stakeholder engagement and consensus-building with government and partners.
- Technical proficiency in RMNCH.
- Advanced analytical, problem-solving, and planning skills with the ability to interpret and use health data.
- Strong communication, advocacy, report writing, and presentation skills for technical and policy audiences.
- Demonstrated ability to build capacity, mentor teams, and facilitate learning across different cadres.
- Proven project management skills with a results-oriented approach and commitment to quality and timeline.