This call for proposals from the Gates Foundation aims to advance health financing and strategic purchasing reforms in Pakistan. The initiative seeks to strengthen the equitable delivery and quality of essential health services at the primary health care level, supporting the country's commitment to Universal Health Coverage (UHC).

Background and Objectives

Pakistan's National Health Support Program (NHSP) addresses critical system-level barriers to primary health care (PHC) service delivery. These barriers include low service readiness, ineffective governance, and inadequate financing. The NHSP is a multi-partner program financed by the Government of Pakistan and several development partners.

The overall objective of this technical assistance is to provide comprehensive support to provincial governments in designing, operationalizing, and institutionalizing health financing reforms. This includes strengthening strategic purchasing functions and building robust contract management systems for outsourced services.

The initiative also aims to enhance institutional capacity for health financing governance, oversight, and implementation. It will facilitate national and provincial dialogue on strategic purchasing and PFM reforms, leveraging national and global expertise.

Scope of Work

The technical assistance will deliver support across several core components. These include conducting a comprehensive diagnostic of current health financing, strategic purchasing, and PFM arrangements in each of the three NHSP provinces. The work also involves mapping existing government mechanisms for purchasing health services.

Support will be provided for the development or strengthening of provincial Health Financing Units (HFUs), Contract Management Units (CMUs), or Strategic Purchasing Units (SPUs). Assistance will also be given in developing frameworks and operational guidelines for purchasing essential health services from public and private providers.

Further activities include reviewing prevailing PFM rules, systems, and processes, and proposing reforms aligned with strategic purchasing and contracting mechanisms. The initiative will also design and deliver structured training programs, workshops, and mentoring for relevant government officials and providers.

Key Deliverables

The selected consortium will be responsible for producing several key deliverables. These include an inception report and detailed work plan, as well as situational analysis and diagnostic reports for each province. Strategic purchasing frameworks and institutional design options for HFUs, CMUs, and SPUs are also required.

Contract management frameworks, SOPs, KPIs, and performance management tools are essential deliverables. Additionally, public financial management reform proposals and expenditure reporting guidelines, that incorporate gender-responsive budgeting principles and sex-disaggregated expenditure tracking are expected.

The consortium must also provide capacity building plans, training materials, and workshop reports. Knowledge products, including policy briefs, technical notes, and presentations, are also part of the deliverables.

Eligibility and Qualifications

Applicants should have demonstrated experience in health financing reforms, strategic purchasing design and implementation, and public financial management. Experience in health contracting, provider payment system design, and contract management is also required.

• Proven capacity in institutional development and capacity building is essential.

• Prior experience working with governments in LMICs, particularly federal and devolved systems, is necessary.

• Access to international and national health financing experts is needed, with demonstrated ability to bring global knowledge to country-level reforms.

Expertise in equity and gender-responsive health financing is a must. Experience in legal and regulatory frameworks in health sector governance is advantageous.

Important Dates and Submission Details

The opening date for submissions is July 7, 2025. The deadline for submitting proposals is August 7, 2025, at 11:59 PM (PDT). Proposals must be submitted through the provided online portal.

To submit a proposal, applicants must complete the Proposal Questionnaire Form and upload the Budget Template. The Budget Template should be downloaded, completed with proposed figures, and uploaded during the application process.

For any questions or clarifications, please contact the designated email address: PHCRFP@gatesfoundation.org.