In Pakistan, the health sector has been badly neglected and the policy makers have shown a callous lack of concern for educating the people and providing them with health care. People living in rural and remote areas mainly depend on primary health care facilities, like basic health unit and dispensary provided by the public sector. However, due to poor governance, lack of access and unequal resources, poor quality of health information management system, corruption in health system, lack of monitoring in health policy and health planning and lack of trained staff, the quality of life of the people has remained low and the nation has not been able to achieve higher levels of economic progress due to underdeveloped human resources.
The under-development of the health sector is manifested in Pakistan’s poor health-related key indicators. According to UNICEF, despite significant improvements over the past two decades, Pakistan ranks towards the bottom among other countries when it comes to infant and neonatal mortality.
With the contribution of human capital in total wealth growing globally, the creation of a skilled labor force that is more productive and better able to adopt and adapt to new technologies is at the core of a long-term growth path for Pakistan. To this end, improvements in education and learning need to go hand in hand with improvements in health and well-being to maximize the cognitive potential of both men and women in the population. Pakistan has made progress on these fronts, but it is uneven and slow. If Pakistan is to grow in an inclusive manner, the government must prioritize and invest equitably in the development of its human capital.
Perhaps, the only thing that works in favor of Pakistan is its demographic youth bulge (63% of our population comprising of youth, 69 million aged below 15) and an increase in the working- age population as a share of the total population. To reap the “demographic dividend” of this change, the economy needs to provide education and create productive and remunerative employment for young workforce entrants. In this connection, providing free or subsidized education and healthcare could be a common welfare state goal.
One of the major difficulties faced by the healthcare policy makers, is the provision of health facilities to approx. 220 plus million population in Pakistan out of which majority do not have enough funds to buy the health care facilities they deserve. In order to assign expenditure on health care services, the need for an impartial financing system was felt. It was in this backdrop that Ehsaas Program and Sehat Sahulat cards were launched.
While the common man expects initiatives for job creation and social uplift and businesses would like to put the economy on fast track, the reality is that the government is presently cash-starved.
In order to motivate the private sector to come forward for public-private partnership, the government needs to incentivize them heavily which in the current scenario appears to be an uphill task. An ideal model would be a unique mix of free market capitalization and social benefits where citizens have high trust in the government because it delivers top quality social services, including free education and free health for all.
In order to achieve overall improvement in health, fairness in risk distribution and financing and responsiveness to the non-medical needs of the clientele by the health system in Pakistan, it is imperative to create strong inter-sector agencies, norms and standard setting for health care delivery, quality assurance in the pharmaceutical industry and more collaboration with the private health care sector. To provide direction and proper oversight a strong stewardship function is necessary. Public private partnership may strengthen the stewardship role of the government in terms of bringing good governance and promote more responsiveness in Pakistan health system.