Pakistan has made big leaps in healthcare in the last few years, particularly for the most vulnerable. Political skill will be needed to sustain the momentum.
As the world’s sixth most populous country, Pakistan’s National Health Vision (2016-2025) recognises UHC as a top priority. The country has also aligned UHC with its Poverty Reduction Strategy and pro-poor social protection initiatives. Particular attention has been paid to the most vulnerable sections of the population, as the country’s Sehat Sahulat Program (SSP) illustrates.
An initiative of the federal government and province of Khyber Pakhtunkhwa, SSP currently provides secondary healthcare for all admissions for 5.7 million vulnerable households in more than 100 districts. Limited tertiary care is also included. In the coming years, the plan is to expand coverage to around 11 million families across Pakistan, providing access to healthcare for nearly 50 million people in total.
However, to achieve UHC, the various schemes run by the federal and provincial governments will need to broaden their membership bases, increase disease coverage, and be underpinned by institutional reform. All this will require political skill to find solutions to the political, financial and legal constraints, and to enable healthcare to be the effective and properly financed responsibility of the provinces, in line with the 18th Amendment.
UHC service coverage index: 44.8%
Physicians per 1,000 population: 1.0
Catastrophic expenditure: 4.5%
2019 – 2023
Type of Support
- L4UHC Modules
- Collective Action Initiatives
- National coach
- Social Health Protection Initiative, Khyber Pakhtunkhwa province
- Sehat Sahulat Program, Ministry of Health Services Regulations and Coordination
- Specialized Healthcare & Medical Eduction Department, Government of Punjab
- Social Health Protection, Gilgit Baltistan Province
- State Life Insurance Corporation of Pakistan
- Health System Reform Unit, Department of Health of Khyber Pakhtunkhwa province
- Punjab Health Initiative Management Company
- Dr Akbar Niazi Teaching Hospital
- Ministry of Health Services Regulations and Coordination
- German Development Cooperation
- World Health Organization
- World Bank
- Uzair Afzal (GIZ)
Ongoing Collective Action Initiatives
1. Develop a UHC financing strategy
The strategy, currently under development, is addressing three key issues: how to categorize the target population; how to pool resources; and how to use those resources as effectively as possible.
Completed Collective Action Initiatives
Increase UHC enrolment via civil society organisations, NGOs and local government structures
- A strategy and action were developed for a district of Khyper Pakhtunkhwa to enable CSOs to increase enrolment by 10% by April 2020, including training for the CSOs.
- Local government actors and NGOs in Rawalpindi District worked together to create reporting and coordinating structures that will help them enrol poor families and other targeted groups in the national health insurance program, more efficiently and effectively. The goal is to increase enrolment from 40% to 60% across the district.
Identify barriers to private and philanthropic hospitals joining the national insurance scheme
- Barriers were evaluated, and solutions identified. The aim is to sign a Memorandum of Understanding (MoU) with at least one hospital network, including a roadmap for its participation in the national insurance scheme. This roadmap could provide a template for other private hospitals and networks.