Specialist - Primary Health Care (PHC) Framework and Transition

Job Description

This assignment aims to establish clear functional boundaries for PHC delivery to transition from fragmented, project-based systems to a sustainable, institutionalized model within the national health structure.

The Ministry of Health and Family Welfare (MoHFW) is implementing a range of reform measures to strengthen the resilience, efficiency, and equity of the health system in line with the recommendations of the Health Reform Commission (2025). These reforms aim to align Bangladesh’s health system with the principles of equity, participation, and accountability ensuring that health is realized as both a constitutional right and a public good. In this regard, the Ministry has prepared a comprehensive proposal titled “Health Sector Transformation in Bangladesh”, outlining the strategic priorities, implementation modalities, and expected outcomes of the reform agenda. The proposal emphasizes eight key strategic areas including governance and institutional reform, primary healthcare restructuring, workforce planning, financial sustainability, digital transformation, medicine regulation, documentation of transition strategies, and stakeholder communication.

The Ministry seeks the technical and strategic partnership of the World Health Organization (WHO) to support the implementation of these reform initiatives. WHO will provide technical assistance, policy advice, and coordination support to ensure that the reform measures are effectively implemented and aligned with global best practices in health system strengthening.

The consultant will develop an integrated Primary Health Care (PHC) Boundary Framework and Urban PHC Transition Model that define and institutionalize the PHC service package across Bangladesh. The framework will ensure a standardized package of essential services, medicines, diagnostics, and a skilled workforce embedded within existing rural and urban facility tiers.

This assignment aims to establish clear functional boundaries for PHC delivery to transition from fragmented, project-based systems to a sustainable, institutionalized model within the national health structure.

Objectives of the Assignment

• Review and map existing PHC service packages, delivery mechanisms, and integration points in both rural and urban contexts.
• Define the PHC boundary encompassing essential promotive, preventive, curative, rehabilitative, and palliative services suitable for existing facility tiers (community clinics, union sub-centres, upazila health complexes, and urban primary health centers).
• Develop a list of essential medicines, diagnostics, and supplies required for the PHC package.
• Recommend an appropriate mix and distribution of multidisciplinary health workers for PHC delivery.
• Align the PHC boundary with existing delivery platforms, referral systems, and national standards.
• Propose implementation and monitoring mechanisms for sustaining the PHC boundary within health sector reform initiatives.

The consultant/team will address the entire PHC continuum across rural and urban contexts, covering public, NGO, and private providers.

Situational Review and Mapping

• Conduct literature and policy reviews, key informant interviews, and focus group discussions.
• Map PHC facilities and workforce across rural and urban areas.
• Identify overlaps, fragmentation, and integration gaps between DGHS, DGFP, and LGD-managed facilities.
• Analyze best practices from comparable low- and middle-income countries (LMICs).

Drafting of PHC Boundary Framework

• Define PHC service packages by level of care (rural and urban) encompassing promotive, preventive, curative, rehabilitative, and palliative services.
• Develop service delivery standards including staffing structure, skills mix, essential medicines, diagnostics, and equipment norms.
• Ensure inclusion of MNCAH, NCDs, mental health, and health promotion interventions.
• Integrate gender, equity, and community engagement dimensions.
  

Integration within Existing Facility Network

• Map public and NGO-managed facilities to align PHC package with service capacity and infrastructure.
• Recommend adaptation measures for union and urban primary health centers to deliver standardized PHC packages.
  

Referral and Coordination Systems

• Design structured referral and back-referral pathways between PHC, secondary, and tertiary levels.
• Integrate ICT-based referral tracking and patient follow-up systems with unique health IDs.
  

Stakeholder Consultation and Validation

• Conduct consultations with MoHFW divisions, LGD, City Corporations, NGOs, and development partners.
• Incorporate technical and policy feedback through workshops and validation meetings.

Finalization and Reporting

• Prepare final Integrated PHC Service Package and Urban PHC Transition Framework with operational guidelines.
• Present findings and recommendations to MoHFW, WHO, and other stakeholders.

Expected Deliverables:

Sl No.

Activities

Deliverables

Timeline

1

Situational Analysis & Mapping

Situational Review Report – including PHC facility/service mapping, analysis, and gap assessment

Day 1-10

2

Development of PHC Boundary Framework

Draft PHC Boundary Framework – encompassing essential services, medicines, diagnostics, and team composition

Day 11-20

3

Design of Urban PHC Transition Model

Urban PHC Transition Framework – outlining institutionalization roadmap, governance, and financing structure including PPP mechanism

Day 21-28

4

Stakeholder Engagement & Validation

Stakeholder Consultation Report – synthesis of inputs and validation findings

Day 29-33

5

Knowledge Sharing & Capacity Building

Technical Presentation / Workshop Materials – for MoHFW and WHO

Day 34-36

6

Finalization & Submission

Final PHC Boundary Report – incorporating feedback, recommendations, and implementation roadmap

Day 37-40

About the Organization

United Nations Office for Project Services