Job ID

2026-7728

Location

PK-Karachi

Category

Local

Employment Status

Consultant Opportunities

This consultancy pertains to assessing the referral pathway: community <-> primary care <-> secondary care   <-> tertiary care integrated with the blood banking and patient transportation services in the Jhpiego intervention districts of Matiari, TandoAllahyar and Mirpurkhas under the ACHIEVE Project. The ACHIEVE project under one of its objectives provides end-to-end MNCH services—from pregnancy through early childhood—focused on preventing the leading causes of death and improving health outcomes.

The purpose is to sketch the current landscape, undertake a situation analysis, recognize and assess bottlenecks and share recommendations for improvement.  

BACKGROUND:

Jhpiego is an International non-profit health organization affiliated with the Johns Hopkins University, USA. For more than 50 years, and in over 150 countries, Jhpiego has worked to prevent the needless deaths of women and their families. Jhpiego is dedicated to improving the health of women and families in developing countries and is implementing the ACHIEVE Project in Pakistan.

Pakistan has made notable progress in expanding access to maternal and child health services over the past decade, yet preventable maternal and neonatal deaths remain high. Despite higher institutional delivery rates nationally, gaps persist in the quality of care, readiness of facilities, and timely access to life-saving interventions, particularly in rural and underserved areas. Obstetric complications such as postpartum hemorrhage, hypertensive disorders, and sepsis continue to drive maternal mortality, while delays in care-seeking, referral, and treatment exacerbate risks. Sindh province bears a disproportionate share of maternal and newborn health challenges. These range from lack of facility readiness for continuous availability of comprehensive emergency obstetric and newborn care (CEmONC), skilled personnel and functional referral systems. These gaps contribute to preventable maternal deaths, particularly from hemorrhage, which remains the leading cause of maternal mortality in the province making access to safe blood and blood products a critical enabler of maternal and newborn survival.

Hemorrhage, severe anemia, and obstetric complications frequently require urgent transfusion, yet many public facilities in Sindh possess a rudimentary and unresponsive blood banking and transfusion system plagued by limited voluntary donor pools, weak quality assurance, inconsistent storage and cold chain management, timely availability etc. Addressing these challenges requires a comprehensive, system-level approach that strengthens facility readiness, builds provider capacity, and ensures timely access to safe blood along with a critical required but less well recognized emergency patient transport system embedded in the referral pathway.

The overall purpose of the project is to strengthen district-level health systems in high-burden Sindh districts—TandoAllahYar, Mirpurkhas, and Matiari-by improving MNCH outcomes through robust and responsive emergency obstetric and newborn care, improving management of neonatal and child illnesses, and ensuring timely access to safe blood and emergency transport.

Currently, referral pathways which play a pivotal role across levels of care are fragmented and undermine efforts of standardized quality care for saving lives. Referral pathways from community to facility and inter-facility whereas back-referral (step down), follow-up and feedback loops are rudimentary or almost non-existent. Gaps exist in:

• Community and facility early warning, identification and timely referral and escalation of high-risk cases
• Weak coordination/communication between primary and secondary care
• Weak coordination/communication and delays in escalation to tertiary care
• Limited integration of blood bank services within referral pathways where needed
• Inadequate and inappropriate ambulance and/or transport services
• Poor documentation, feedback and follow up mechanisms 

To address these systemic challenges, a comprehensive referral mechanism up or down the continuum and level of care pathway, which is integrated well with the required blood banking and ambulance / qualified transport service, is required to create and enforce a seamless and comprehensive quality of care model that can effectively deal with patient needs and facilitate in improving maternal and child morbidity and mortality indicators.

Deliverables:

A. The geographic scope pertains to the catchment area and communities availing services of the following intervention facilities:

The consultancy mandates a landscaping and situational analysis, gap and bottlenecking assessment translating into recommendations for corrective actions. This will entail a desk review and then further strengthening of information through meetings, key informant interviews and field validation etc.

The core areas of assessment:

• Early identification and referral from community level
• Coordination between primary, secondary, and tertiary care
• Existence and Integration of blood transfusion and banking services within emergency referral pathways
• Documentation, processes and SoPs, communication and feedback loops
• Ambulance and/or transportation services responsive to the referral loops for providing timely access to life-saving interventions.

B. The consultant will:

1. Provide a detailed workplan (and questionnaire) and perform a Desk Review initially
2. Situation Analysis

• Map communities, facilities, blood banking/storage facilities, ambulance/ transport services serving the catchment areas pertaining to the above Jhpiego intervention facilities
• Map current referral pathways at:
• Community level (LHWs, community midwives, outreach workers, village health committees, direct from homes)
• Primary Health Care facilities (BHU, RHC)
• Secondary care facilities (THQ/DHQ hospitals)
• Tertiary care hospitals serving the districts
• Public and private blood banking service linked to district facilities and health delivery services
• Ambulance and transport services
• Recognize and review existing early warning system and decision tree at all initiating levels, referral tools, registers, M&E, feedback and follow up mechanisms, coordination, communication and documentation (patient transfer protocols, registers, data bases of records, etc) and integration of blood banking and transport systems with community and facility needs. Any available processes and SOPs for the above linkages and systems

       3. Identify bottlenecks and Gaps

• Early detection, decision and referral initiation
• Inter-facility, and health worker to facility, communication and documentation
• Blood request and supply processes as needed
• Emergency transport and stabilization

       4. Document Recommendations

• Discussions with key stakeholders and field assessment

The consultant will take into account every contributing factor. (some examples are poor identification of the urgency, delayed decision making, lack of knowledge or trust in service, transport unavailability, service unavailability, cost restrictions, general apprehensions, cultural restrictions etc)

• Document existing services as described above
• Document baseline referral and communication workflows with flow diagrams
• Document available SoPs, if any and related documentation as per referral and service pathway
• Document obstacles and bottlenecks
• Document recommendations in consultation with stakeholders

       5. Final report comprising the above

The above guidance is for basic alignment of the requirements for the consultant to define an approach. The consultant should share a brief description of the methodology, approach and workplan derived from the above requirements along with the CV which will help in the final selection. This will be amended for a detailed approach after the final selection in consultation with the Jhpiego team.

N.B. Any other work may be assigned by supervisor for concluding the assignment comprehensively through mutual agreement.

Payment and Working Schedule:

Assignment duration:

(34 working days with an expected approximate upto 60% time in the field)

Travel:

To Matiari, TandoAllayar, Mirpurkhas, and/or Karachi, Hyderabad and Islamabad as deemed necessary. Travel, lodging and boarding arrangements will be organized by Jhpiego.

Check in:

Weekly check in every Friday for detailed debriefing. Daily coordination as and when needed.

Position Location and Reporting:

Hyderabad/Karachi with possibility of considering a hybrid model. The position will report to the Country Director (CD) or her designee.

Final Report Approval:

Approval of draft reports by CD / designee and final report approval by Jhpiego CD

• An MBBS, MPH, or an equivalent qualification in a relevant field is required.
• 5–10 years of work experience within the district healthcare system at the facility level, particularly in the MNCH space.
• Understanding and/or experience in managing blood transfusion and blood banking services will be an advantage.
• Prior experience in similar work will be preferred, including experience in report writing and/or published reports.
• Experience working with INGOs, UN agencies, or other international partner organizations will be an added advantage.
• Research and learning skills, data analytics and computer skills are essentially required to manage, interpret and show data in graphical form (charts, tables, trends etc).
• Strong English writing skills are required.

Please note that only shortlisted candidates will be contacted. Successful candidate selected for this position will be subject to a mandatory pre-employment background check. The position will be closed for further applications once it is successfully filled. We will be conducting interviews on rolling basis, so we encourage interested candidates to apply at their earliest convenience. Thank you for your interest in joining our team.

Jhpiego is an equal opportunity/Affirmative Action employer and does not discriminate in its selection and employment practices. Female candidates are strongly encouraged to apply. Failure to follow the instructions of applying, your application would be denied.

For further information about Jhpiego, visit our website at www.jhpiego.org

RECRUITMENT SCAMS & FRAUD WARNING:

Jhpiego has become aware of scams involving false job offers. Please be advised:

• Recruiters will never ask for a fee during any stage of the recruitment process.
• All active jobs are advertised directly on our careers page.
• Official Jhpiego emails will always arrive from a @Jhpiego.org email address.

Please report any suspicious communications to Info@jhpiego.org

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