Our TA has helped to strengthen the health systems building blocks that are necessary to increasing access to essential care – from policy development to health service planning, the health workforce and financial management, procurement and monitoring and evaluation. We have also helped to strengthen government systems for managing and procuring technical expertise.

 

During its lifespan TRF worked on 136 TA assignments. These included TA approved by an Executive Committee (comprising government and donor counterparts) and TA provided on special requests by provincial governments.

 

A systems approach in a changing context

 

In 2009 TRF was tasked with supporting a federal vertical programme (the National NMCH Programme) in order to improve the country’s progress towards MDGs 4 and 5. However improving the health of mothers, newborns and children has required a broader, whole-of-system approach. 

 

TRF started working at the federal level, but this changed after the enactment of the 18th Constitutional Amendment in 2010, which transferred to provincial governments many of the functions and resources of the federal Ministry of Health. We assisted provincial health departments in the immediate pre-and post-devolution period. Since then our focus has been at the sub-national, provincial level. Our TA has been dynamic, addressing the evolving political context and emerging priorities.

 

At-a-glance: how TRF helped to strengthen the six ‘building blocks’ of the health system 

 

How do we know whether our TA has been successful? 

 

A key sign of success is whether recommendations from our TA have been adopted, meaning that progress is being made in the cycle of health sector reform. TA recommendations have guided Pakistan’s health departments in improving public sector systems and services as well as prospects for future health financing. 

 

For more detailed examples of our TA use the links on the right pane.