Team Lead/ Governance Specialist

E4H FED TA: Revamping of Pakistan Nursing & Midwifery Council (PNMC) Secretariat

 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.

Background

Pakistan is committed to the 2030 Agenda for Sustainable Development. In health, Universal Health Coverage (UHC) is the key policy goal. The Human Resources for Health (HRH) Vision 2018–30 and the upcoming National Health and Population Policy (NHPP; 2025-34) both aim to address workforce shortages and enhance national and provincial capabilities for health workforce planning and development. The HRH vision emphasizes strategies, governance, legislation, and resources required to ensure a workforce of appropriate size, skills, and distribution to meet people’s needs.

The Pakistan Nursing Council (PNC) Act 1973 is the cornerstone for regulating Pakistan's nursing profession. Amended by the National Assembly of Pakistan on Thursday, 19th January 2023. The amendment act is called the Pakistan Nursing and Midwifery Council (Amendment) Act, 2023.

The act empowers the PNMC to set educational standards, license and register practitioners, regulate professional practice, and ensure continuous professional development, quality assurance, and accreditation of academic institutions. To effectively implement the act, the Pakistan Nursing & Midwifery Policy Framework (PNMPF; 2025-2034) was developed with the support of the Evidence for Health (E4H) Programme and under the directives of the Prime Minister of Pakistan. The PNMPF identified revamping the PNMC secretariat as one of its key priorities, along with reorganizing the management, education, and quality assessment units within the council’s secretariat. 

Problem Statement

The PNMC Secretariat currently faces significant structural and operational challenges that limit its ability to effectively regulate the nursing and midwifery professions. Key issues include an outdated organisational structure, limited human resource capacity, weak accreditation processes, and the absence of modern digital systems. These gaps result in inefficiencies in core functions, including institutional accreditation, professional licensure, quality assurance, and ongoing professional development. To address these challenges, there is an urgent need to review the Secretariat’s functions as outlined in the Act, reorganize its structure and key units, and build stronger regulatory capacity. This will help improve performance, enhance service delivery, and ultimately strengthen the quality of the nursing and midwifery workforce across Pakistan.

Goal and Objective(s)

The goal is to revamp the PNMC Secretariat to strengthen the regulatory capacity of the council for a qualified, skilled, and ethical nursing and midwifery workforce that contributes to achieving UHC and improved health outcomes in Pakistan.

The objectives are to Conduct a rapid assessment of the existing PNMC Secretariat to identify gaps in the mandate, workflows, staffing, skills, and systems.

Develop a revised organisational structure (organogram) of the PNMC Secretariat, through a consultative process and under the guidance of the Joint Secretary (Admin), while considering provisions in the Act.

Develop clear job descriptions / TOR of all staff of the secretariat and three units: 1) Management, 2) Education, and 3) Quality Assessment, etc., with clear responsibilities, reporting lines, staffing norms, appointment criteria, competency profiles, and key performance indicators (KPIs) for an efficient and modernised secretariat.

Identify staff positions that could be outsourced, along with a detailed description of their associated processes.

Strategic Approach

Contributions to health systems strengthening: This activity will directly contribute to health systems strengthening by enhancing the regulatory oversight and governance of a critical segment of the health workforce. Additionally, improving the quality of education, training, and professional standards for nurses and midwives has a direct impact on service delivery in both the public and private sectors, as well as on the delivery of results.

Alignment with other E4H TAs/Investments/National Standards: The TA activity is aligned with the HRH Vision 2018-2030, the PNM Framework (2025-2034), and the upcoming draft National Health & Population Policy (2025-2034).

Alignment with other donors (if relevant): No direct financing from different development partners is foreseen in this TA. However, key stakeholders, including WHO, will be consulted throughout the process to ensure ownership.

Scope of Work and Methodology

The team will work closely with the Ministry of NHSR&C and PNMC. Below is a list of the sequence of activities that the consultants will be expected to undertake.

A. Inception Phase

Review relevant legislation, policies, strategies, and the mandate of the secretariat.

Develop an inception report that includes a methodology, stakeholder mapping, work plan, risk matrix, and mitigation measures.

B. Rapid Assessment

Consultations with key stakeholders and conduct a rapid assessment of the current secretariat, mandates, workflows, staffing, and skills, and identify capacity gaps and strengthening needs

Review the functions of the secretariat, staffing, availability of job descriptions/ TOR, qualifications, competencies, experience, etc, in line with the act. 

Share findings with the Ministry of NHSR&C and PNMC for their views and comments.

C. Revamping of the PNMC Secretariat

Propose a revised organisational design (organogram including units), with clear responsibilities, reporting lines, staffing norms, appointment criteria, competency profiles, and KPIs for an efficient and modernised secretariat.

Based on the assessment, restructure/reorganise the three units as follows:

Management Unit: Responsible for the overall management of the PNMC, including implementing Council and Ministry decisions, setting strategic direction and monitoring its implementation, handling litigation, overseeing human resource recruitment and deployment, and managing operational functions such as information systems, procurement, and finance.
Education Unit: Serves as the academic backbone of the PNMC, tasked with maintaining and enhancing the educational standards of nursing and midwifery programmes throughout Pakistan.
Quality Assurance Unit: Focuses on monitoring nursing and midwifery institutions, enrolled students, and the workforce, as well as driving continuous quality improvement initiatives in education and practice.

As per government policy, identify the work for which positions could be outsourced and mention the process in the report.

Draft and share the revamped report with stakeholders, incorporating their feedback.

D. Finalise the revamping report

Finalise the report and facilitate notifications of the three units.

Sustainability: Capacity Building, Institutionalisation, and/or Transition Planning

Focal Point Engagement: Focal points nominated by the Joint Secretary (Admin), Director General (Health), and Secretary PNMC will be actively involved in capacity development activities wherever feasible.

Capacity Building: The TA will integrate capacity building across all stages of the process. This will include the hands-on participation of nominated PNMC and Ministry staff in the review and design activities, structured orientation sessions on the new systems and processes, and the preparation of a comprehensive reference report for ongoing use.

Institutionalisation: The proposed reforms will be embedded within the PNMC Secretariat by aligning all new roles and processes with the PNMC Act and its mandated functions.

Transition Planning: The implementation plan will outline clear, sequential steps for phasing in the new structure and processes.

Deliverables

The consultant will work to achieve the following deliverables:

• Inception report
• Rapid Assessment
• Draft Revamping Report
• Final Revamping Report and draft notifications of units

Timeline and Days

The level of effort for the role is 40, working days from October – December 2025.

Requirement

Technical Expertise

• Postgraduate degree in social sciences/ governance, policy, management, or related field.
• 15+ years of experience including health system, organisational development, and regulation. Strong convening, strategic planning, and report writing skills.

Competencies

Planning and delivering work; Analysis and use of information; Decision making; Influencing