Terms of Reference – Long Term Agreement (LTA)

Software and Digital Solutions Development and Maintenance Services

1. IDENTIFICATION

2. BACKGROUND AND OBJECTIVES

The World Health Organization (WHO) is committed to leveraging innovative digital health technologies to strengthen health systems and advance its mission of promoting health, keeping the world safe, and serving the vulnerable. To achieve this, WHO Pakistan requires robust, scalable, and interoperable digital health solutions that can address the increasing demand for digital health initiatives and Health Information Systems (HIS).

Given the dynamic nature of health emergencies, disease surveillance, and health system strengthening projects, WHO is seeking to establish a Long-Term Agreements (LTA) with qualified and experienced service providers for comprehensive digital health services. This LTA will enable WHO to engage with top-tier service providers as needed, ensuring that projects are executed with the highest standards of quality, security, and efficiency while adhering to global health data standards.

The TORs will cover development and maintenance of digital systems/ applications supported by WHO Pakistan including Integrated Disease Information System, Disease Surveillance Systems, Mobile Applications, Emergency Response Platforms, Immunization Information Systems, Maternal and Child Health platforms, and other health-related digital solutions.

Objectives of the TORs:

1. Development Services:

• Engage a qualified firm to design, develop, and implement digital health solutions that align with WHO's strategic health objectives
• Ensure that all software development adheres to the highest standards of health data security, interoperability, scalability, and user-centric design
• Comply with WHO Digital Health Guidelines and health data governance frameworks

1. Maintenance/ Enhancement Services:

• Ensure continuous operation and optimization of existing WHO's digital health systems through proactive maintenance and support services
• Address technical issues or system upgrades promptly to minimize disruptions and maintain critical health service delivery
• Ensure compliance with health data protection standards and regulations considering information security protocols

1. Research, Assessment and Analytical Services:

• Conduct research on emerging digital health technologies including artificial intelligence and machine learning applications.
• Leverage specialized technological research and data analytics services to support evidence-based health decision-making.
• Conduct information systems audit, review or assessment and provide support in improving systems architecture.
• Support field research operations through mobile data collection platforms.

3. SCOPE OF WORK

The selected service provider(s) will be responsible for delivering comprehensive digital health services across various WHO programs. The scope includes:

A. DEVELOPMENT SERVICES

Project Management:

• Oversee all phases of digital health solution development lifecycle
• Develop detailed project plans with health-specific milestones and deliverables
• Ensure compliance with WHO project management standards and health data governance requirements
• Provide regular progress reports

Requirements Analysis:

• Conduct comprehensive health system analysis to gather user requirements from the WHO technical focal person
• Translate health program needs into functional and technical specifications
• Prepare detailed documentation including health data flow diagrams, interoperability requirements, and integration strategies with existing health systems

Software Development:

• Develop health applications using modern programming languages and frameworks (Java, .NET, Python, React, Angular, Node.js)
• Implement health data standards (HL7 FHIR, ICD-11, SNOMED CT) and interoperability frameworks
• Ensure software is scalable, secure, and adheres to WHO's digital health guidelines
• Implement proper development, testing, and production environments following health software lifecycle requirements

Data Management and Analytics:

• Design and implement health data warehouses and analytics platforms
• Develop health indicators dashboards and reporting systems
• Implement real-time health data monitoring and alert systems
• Ensure compliance with health data privacy and security regulations
• Develop comprehensive user management and geography management modules for cross platform support.

Mobile Application Development:

• Develop cross-platform mobile health applications using Swift, Kotlin, Flutter, or React Native
• Optimize applications for the field users in health and immunization programs
• Ensure offline functionality for resource-limited settings
• Implement health data synchronization and security protocols

Health Information System Integration:

• Design and develop APIs for health system interoperability
• Integrations with existing health information systems (IDIMS, Surveillance, Dashboards and other required systems)
• Ensure seamless data exchange between health platforms
• Implement health data governance and audit trails

Cloud-based Health Solutions:

• Design secure cloud architectures for health applications using custom/self-hosted
• Implement health-specific security measures and data encryption
• Ensure compliance with health data residency requirements
• Design disaster recovery and business continuity plans for critical health systems

Health System Integration Support:

• Facilitate integration between various health information systems
• Ensure secure data exchange protocols
• Implement health data interoperability standards
• Provide technical support for system integrations

B. MAINTENANCE/ ENHANCEMENT SERVICES

Web and Mobile Application Support:

• Provide 24/7 technical support for critical health applications
• Monitor information system performance and implement necessary updates
• Ensure minimal downtime for applications including Integrated Disease Information Management System
• Provide user support for field offices at different levels

System Monitoring and Optimization:

• Continuously monitor health information systems for performance issues
• Implement performance tuning and optimization for health databases
• Monitor health data quality and implement corrective measures
• Provide proactive maintenance to prevent system failures

Data Security Management:

• Conduct regular security audits of health information systems
• Implement health data protection measures and access controls
• Apply security patches promptly to protect sensitive health data
• Ensure compliance with health data governance frameworks

Data Backup and Recovery:

• Implement robust backup procedures for critical health data
• Ensure rapid recovery capabilities for health service continuity
• Test disaster recovery procedures regularly
• Maintain health data integrity and availability

Change Request Management

• Process and Implementation of Approved Change Requests.
• Handle functional enhancements, UI/UX improvements, and integration of new modules based on stakeholder-approved change requests.
• Ensure proper documentation, version control, and testing before deployment.

C. RESEARCH, ASSESSMENT AND ANALYTICAL SERVICES

Data Analysis and Reporting:

• Analyze health data to generate insights for program decision-making
• Develop automated health reporting systems and dashboards
• Create data visualizations for health indicators and outcomes
• Prepare evidence-based reports

Data Management and Archiving:

• Implement secure health data archiving solutions
• Ensure long-term preservation of health research data
• Maintain health data catalogs and metadata management
• Ensure compliance with health data retention policies

Innovation and R&D Support:

• Conduct research on emerging digital health technologies including artificial intelligence and machine learning applications
• Provide recommendations for innovative health solutions leveraging AI powered systems
• Develop prototypes for digital health interventions
• Support implementation research for information systems

To ensure continuity and availability of skilled personnel under the maintenance and enhancement services scope, bidders are required to propose a monthly resource retention rate for each designated role. This retention cost will apply only in cases where a resource, as agreed upon in the SLA, is engaged for less than or equal to five (5) working days within a given month. The intent is to maintain readiness and minimize onboarding delays, while providing fair compensation for resource availability during low-activity periods. Vendors must clearly specify retention rates in their financial proposal, which will be considered in the overall cost evaluation.

4. WORKING LOCATIONS

The assigned projects under the LTA will mostly be carried out within Islamabad.  However, in few situations where it is required, WHO may ask to visit field offices to perform certain roles like UI/UX studies, assessments and user training etc.  Below will be the potential project locations.

• WHO Country Office, Islamabad, Pakistan
• WHO Field Offices and project locations across Pakistan

• • Lahore
  • Multan
  • Karachi
  • Sukkur
  • Quetta
  • Peshawar
  • D.I.Khan
  • Bannue
  • Muzaffarabad
  • Gilgit

• Remote work capabilities for certain deliverables as agreed.

5. DELIVERABLES AND REQUIRED SERVICES

To support the WHO’s digital transformation initiatives and strengthen the technical capacity of public health information systems, bidders are requested to propose qualified personnel across a comprehensive range of IT roles. These positions reflect the diverse technical needs of public health sector projects in Pakistan, particularly those implemented in collaboration with government departments and other partner organizations.  Each role is defined with relevant qualifications and responsibilities tailored to the local IT landscape, ensuring alignment with international standards and contextual relevance. Bidders must demonstrate access to professionals with the listed expertise to support both short-term assignments and long-term engagements under the LTA framework.

6. QUALIFICATIONS AND EXPERIENCE REQUIRED

Company Experience:

• Minimum 10+ years of proven experience in digital health solutions development
• Demonstrated experience with health information systems for international organizations, NGOs, or government health departments
• Experience with IDIMS system and other UN health agency platforms preferred
• Track record of delivering health projects adhering to international health data standards
• Experience with health data governance and compliance frameworks

Technical Expertise:

• Extensive experience in health information system development methodologies
• Proficiency in health data standards
• Experience with health system interoperability and data exchange protocols
• Strong background in health database management and health analytics
• Demonstrated expertise in health data security and privacy protection
• Experience with WHO-endorsed digital health tools and platforms
• Knowledge of health system workflows and healthcare professional requirements

Public Health Domain Knowledge:

• Understanding of public health principles and health system strengthening
• Knowledge of disease surveillance and health emergency response systems
• Experience with health program monitoring and evaluation
• Familiarity with WHO health strategies and guidelines
• Understanding of health data governance and ethics frameworks

Certifications and Compliance:

• Relevant certifications in health informatics or digital health
• Internationally recognized frameworks (ISO standards) that help ensure quality, security, and resilience in IT and organizational operations.
• Compliance with health data protection regulations
• WHO supplier registration and compliance certifications preferred.

7. ADDITIONAL REQUIREMENTS

Health Data Governance:

• All solutions must comply with WHO Data Governance framework
• Implementation of health data protection measures and access controls
• Compliance with national health data regulations and international standards
• Regular security audits and vulnerability assessments for health systems

Interoperability Requirements:

• All health applications must implement standard health data exchange protocols
• Compliance with WHO Digital Health Guidelines for interoperability
• Integration capabilities with existing health information systems
• Implementation of health data standards and terminologies

Open Source and Digital Public Goods:

• Preference for open source health solutions and Digital Public Goods
• Contribution to health-focused open source communities
• Sharing of health application code repositories with WHO
• Support for WHO's commitment to digital health equity

Capacity Building:

• Provide training and capacity building for WHO staff and government partners
• Transfer of technical knowledge for health system sustainability
• Documentation and knowledge management for health solutions
• Support for local health IT capacity development

8. CONTRACT TERMS AND CONDITIONS

Duration:

• Initial Long-Term Agreement (LTA) for 2 years
• Renewal of LTA is subject to satisfactory performance and mutual agreement.

Payment Terms:

• If the number of working days is equivalent to a full month (i.e., 22-23 days), the monthly rate will be applicable.                                    
• If the number of working days is less than 22, the daily rate will apply—provided the total payment does not exceed the monthly rate.                               
• The hourly rate shall be applied in accordance with WHO requirements and subject to mutual agreement.                                         
• Milestone-based payments linked to deliverable acceptance
• Performance guarantees for critical health system components
• Penalty clauses for delays affecting health service delivery

Intellectual Property:

• WHO retains ownership of all health applications and data developed under the contract
• Vendor cannot reuse health-specific code without WHO permission
• Git repositories for all health software to be provided to WHO

Performance Standards:

• 99.5% uptime for critical health information systems
• Maximum 2-hour response time for critical health system issues
• Regular performance reporting and service level agreement compliance

Warranty (for new developments)

• To ensure the reliability, maintainability, and long-term usability of the newly developed software/ research, assessment projects, the vendor shall provide an irrevocable and unconditional bank guarantee valid for 6 months from the final completion and acceptance of services with 5% of the total value of that project as a warranty to cover the defect liability period.
• Any changes made to the software during the warranty period must be reflected in updated user manuals and technical documentation.

Travel (Field Visits)

• The contractor may be required to visit often the provincial/ field offices of WHO in order to conduct user experience or other related assessments and user trainings etc.   Please indicate lumpsum cost per resource/ day for such required visits including travel/ logistic costs by each location. The list of locations/cities are listed above and in Appendix 2 (travel sheet)

9. Submission Requirements:

• Technical proposal addressing all evaluation criteria
• Financial proposal with detailed cost breakdown (separate costing per Month, per Day and per Hour against each resource) to be considered for new development or enhancement projects. Travel costs for field visits
• Company registration documents and certifications
• CVs and qualifications of key personnel
• Portfolio of health sector projects with client references
• Proof of health sector experience and WHO/UN agency work