‘Strengthening of Healthcare Delivery System of Pakistan’
Universal healthcare program creating enabling environment for HSPs in Pakistan
The government has created an enabling environment for health services providers (HSPs) through Sehat Sahulat Program that has resulted in secondary and tertiary healthcare becoming a win-win proposition for the stakeholders and is providing much-needed relief to millions of patients in need of hospitalization across the country. A number of new hospitals are being built by the private sector to provide for the needs of the patients who can afford their treatment to a large extent in the shape of the health card. The result has been not only increased universal healthcare facilities in Khyber Pakhtunkhwa, Azad Jammu & Kashmir, Gilgit-Baltistan, and Punjab but also a beneficial impact on the overall economy. However, there is a long way to go in terms of the improvement of quality in healthcare services and their standardization for the benefit of the patients.
This was observed by health professionals and experts during a seminar, titled ‘Strengthening of Healthcare Delivery System of Pakistan’, jointly organized by the IPS, Rawalpindi Medical University (RMU), and Qmentum Consulting on October 12, 2022.
The seminar was chaired by Prof. Muhammad Umar, vice chancellor RMU, and co-chaired by Khalid Rahman, chairman IPS, while Muhammad Arshad Muqarib, CEO, Prime Minister’s Health Program, joined as the chief guest.
The discussion, revolving around the country’s health delivery system landscape, was addressed by Muhammad Nasrullah, advisor and program lead IPSTECH (an IPS initiative for technology-based governance solutions), Manzoor Ahmad, eHR consultant, Dr. Asif Maqsood Butt, public health specialist, and Dr. Khizar Pervaiz, palliative care specialist.
Arshad Muqarib highlighted that even though the Sehat Sahulat program is in its early phase, it has already started creating an enabling environment for both the public and private sector hospitals; new hospitals and facilities are being established, jobs being created and certain medical devices are being manufactured domestically, which has helped reduce their prices.
He gave the examples of the erstwhile FATA that now boasts some 30% new hospitals after the program was universalized two years ago, 13 cardiac cath labs have been set up in KP after healthcare was universalized one year ago, and an oncology hospital has been set up in Gilgit-Baltistan region that will become operational soon. Now even angioplasty facility is available in a far-flung area like D.I. Khan, he added.
He informed the participants that Tharparkar was the first area to be included in the universal healthcare program in 2019. Since then it has been introduced in FATA after its merger into KP, AJ&K, Punjab, Gilgit-Baltistan and Islamabad. Sindh and Balochistan are expected to be included in the program within one year. This will make Pakistan the world’s first country to offer state-funded universal health coverage to the public.
Muqarib said currently, 170 million people are benefiting from the program at 1,082 hospitals, out of which 30% are public and 70% are private. This is because the government cannot deliver universal healthcare without the support of the private sector. He conceded that improvements are still needed in developing a systematic approach that integrates institutions, leadership, health professionals, and the public at the center of healthcare.
Regarding viability of the program, he said the whole country can be provided healthcare by using just 23% of the total mainstream health budget of Pakistan for financial year 2022-23.
Muqarib said in the coming days the government plans to introduce an act in parliament in order to institutionalize this program so that no future government would be able to make any changes without consent of parliament.
Khalid Rahman pointed out that the narrative propagation and extreme polarization within the country could threaten the continuity of Sehat Sahulat Program, which is a major leap toward social welfare reforms. To counter these threats and strengthen healthcare delivery, everyone needs to address the polarization and propaganda in their own capacity by maintaining a common minimum agenda.
Moreover, institutions need to utilize resources to ensure the availability of data and push R&D, he stressed. He further underscored the necessity of generating, utilizing, and pooling data in a way that other sectors also move towards social welfare by developing a people-friendly environment and initiatives that benefit society.
Muhammad Nasrullah identified standardization of operations, maintaining quality of service and patient safety as the basic requirements to run health facilities.
While highlighting the significance of applicable standards in healthcare delivery systems, Manzoor Ahmad presented a research study covering challenges faced in implementing and monitoring these criteria. He stated that the country’s healthcare system needs to be sustainable and predictable and organizations need to implement both international and national standards in an integrated manner, along with an integrated management system, considering both cost and quality.
While advocating a public health corridor, Dr. Asif Maqsood pointed out several challenges in the public health sector that compromise the quality of health deliverance. These include the imprudent role of health professionals, the attitude, behavior, and practices of professionals as well as the community, the non-implementation of healthcare development plans, the absence of integration and coordination between professionals, low research at the physician level, and low social mobilization.
Dr. Khizar Pervaiz stressed the implementation of healthcare system standardization. He pointed out that even though health professionals and organizations are dealing with several common challenges, there is no platform where they can address these common challenges and develop policies and solutions. He upheld that discussing common issues is necessary to bring effective and sustainable solutions.
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