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SHORT TERM CONSULTANCY (STC) – Revision of Minimum Package of Activities and Development of Referral policy

Purpose of the consultancy

The consultant will provide support (technical and coordination) to the Royal Government of Cambodia for the review and updating on national essential health service packages (EHSPs) for primary health care to support their consistent and quality delivery along with a referral policy and guideline. He will also support the development of the referral guidelines and of a monitoring framework to track implementation of the EHSPs, optimizing the functionalities of DHIS 2 to populate this framework.

The consultant will work with the Ministry of Health and World Health Organization to

Provide coordination support - (35% time) – monitoring progress against implementation plans and facilitating alignment across steering & working groups, packages and guidelines (35%).

Provide technical support – (65%) including:

- collecting, consolidating, and communicating evidence for input to EHSPs and guidelines, influencing content and structureSupporting resource and systems requirements analysis of the packages to facilitate relevant feasible implementation (working together with the WHO health economist and health financing / HR technical officer)
- ensuring needs-based priority setting on the guidelines and package elements developed based on burden of disease and recency / availability of needed existing guidance to support priority MoH programming such as for non-communicable diseases and mental health conditions
- drafting guidance on standard procedures for the future development and regular update of the packages and guidelines
- support the development of the referral national guidelines
- support the development of a M&E framework for referral, and the optimized used of the national HMIS system (DHIS 2) to track effectiveness of referrals
- support the PHC demonstration site activities

Background

Universal health coverage (UHC) means that all people have access to the quality health services they need, without facing financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course. Quality of service provision is therefore core to UHC.

When appropriately designed and linked to implementation, Essential Health Service Packages (EHSPs) can advance UHC supporting coordinated and continuous services and referral across levels and types of care that can make best use of available and guide further allocation of resources and considering and addressing systems capacity.

Cleary defined packages can support clarity in referral pathways and processes, including the emergency care to be delivered at each level and stabilisation requirements and in transit care to minimize adverse outcomes including death due to delayed or inadequate care in the referral process.

To ensure their effectiveness, such packages and guidelines should be clearly and explicitly evidence-based, developed in participation with end users, consider relevant delivery contexts and resource constraints (human, financial etc) and be regularly reviewed and updated.

The MPA forms Cambodia’s essential “packages of care” defining and forming an operational guideline for health centres on what services should be delivered and the resources needed to support this (material, human and financial). The MPA guideline was last revised in 2018 and referral guidelines not since 2006. Whilst referred to in benefit packages and policy documents, in practice they are at best occasionally used in practice to guide service delivery at provider levels, monitoring or resource allocation at management levels.

The Roadmap to Universal Health Coverage in Cambodia 2024 – 2035, released in May 2024, emphasises the strengthening of essential health services including reference to MPA updates currently underway.Globally it is recommended that essential packages be updated every 3 to 5 years. It is therefore an important time to finalize review of the primary and hospital packages of health services.

Review and update of the MPA package and referral policy and guidelines has recently commenced. In general, across countries, updated EHSPs take between one and three years to complete and hence this work is expected to continue at least to the end of 2026. Continuity in the consultant to support this work from the revision and updating process of Complementary Package of Activities and Clinical Practice Guidelines being finalized in December 2025, is important for consistency and coordination of the guidelines.

Specific Objectives

Provide support (technical and coordination) to the Royal Government of Cambodia for the review and updating on national essential health service packages (EHSPs) for primary health care to support their consistent and quality delivery along with a referral policy and guideline. He will also support the development of the referral guidelines and of a monitoring framework to track implementation of the EHSPs, optimizing the functionalities of DHIS 2 to populate this framework.

Duration of contract

Start date : 1 Mar 2026

End date : 31 Aug 2026

Total duration – 6 months

Deliverables

Output 1:Facilitate Effective Revision of Essential Packages and Guidelines

Deliverable 1.1: Draft updated Minimum Package of Activities (MPA) and referral policy; monitor progress and actively raise risks, delays, and concerns with WHO and the Ministry of Health.
Deliverable 1.2: In consultation with the Ministry of Health, consolidate inputs to package contents, support development of drafts, and maintain version control of essential packages, referral policy, and clinical guidelines documentation.
Deliverable 1.3: Conduct routine comparison and ensure consistency within and across relevant packages and guidelines to support clarity and ease of use by health providers.
Deliverable 1.4: Support the revision of the service model towards more coordination and integration in the PHC implementation sites

Output 2: Provide Evidence-Based Inputs for Decision-Making

Deliverable 2.1: Develop and consolidate evidence on barriers and facilitators to the use of current guidelines and delivery of service packages by providers to inform priority changes.
Deliverable 2.2: Support MPA assessment and essential packages resource requirements analysis and costing, including primary data collection.
Deliverable 2.3: Refer and integrate evidence from WHO key service packages, guidelines, UHC Compendium, and DCP3 packages, as well as other relevant country policies and guidelines, highlighting considerations for the Cambodian context; draft short briefs as requested by WHO and the Ministry of Health.
Deliverable 2.4: Support coordination and facilitation of care process mapping and other workshops and visits for relevant data collection and institutional strengthening related to referral policy, essential packages, and clinical guidelines.

Output 3: Facilitation and Coordination of Meetings and Consultations (up to 35% of time)

Deliverable 3.1: Support relevant secretariats and coordinators of working and steering groups in preparing agendas and background technical documents for key high-level consultation meetings related to essential packages of care and referral policy.
Deliverable 3.2: Ensure updated and revised drafts of packages, key guidelines, and referral policy are available to WHO HSD team at regular intervals for review in both Khmer and English.

Output 4: Technical Development and DHIS 2 System Optimization

Deliverable 4.1: Optimize DHIS2 functionalities to ensure relevant indicators are tracked for evaluating PHC service model performance.
Deliverable 4.2: Develop a Monitoring and Evaluation (M&E) framework for service continuity and referral, including key indicators, data sources, and reporting mechanisms.

Output 5: Assist the HSD team in technical report writing, monthly report on the revision of the essential packages, development of referral policy and relevant work including translations between English and Khmer where necessary.

Qualifications, experience, skills and languages

Qualifications:

Education:

Essential: University degree in medicine, public health, social science, business administration, or related field of study

Desirable: Postgraduate degree in medicine, public health, hospital or health service management, planning and administration, or related field of study

Skills and Experience:

Essential:

- Minimum 8 years working experience in a public sector clinical setting in Cambodia.

- Previous experience in provision of technical support to Ministry of Health in areas of health systems, quality improvement and/or clinical management
 

Desirable

- Good understanding of service delivery system of Cambodia.

- Project planning and management skills including development and monitoring of plans and coordinating across numbers of working groups

- Previous experience in evidence gathering and use for clinical practice / service delivery management

- Highly developed computer skills including use of Microsoft Office suite of programs and tools (Excel, Word, PowerPoint and Outlook)

- Strong language and communication skills in English and Khmer both oral and written including for technical reporting and presentations

- Experiences in development of packages of care and other treatment guidelines or protocols for medicine / health service delivery is an advantage.

Language requirement:

Good oral and written English language skill

Technical Supervision

Coordinator, Health Systems Development

Location

Phnom Penh, Cambodia

Travel

The contractor may be expected to travel to the provinces as and when required
 

Remuneration

To be determined

Additional Information:
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