Pakistan Health Financing System Assessment
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Washington, DC: World Bank
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Accelerated progress towards and
achievement of universal health coverage (UHC) has become a
central goal of the Government of Pakistan’s (GoP) policy
agenda in health in recent years. Both at the center and in
the provinces, Pakistan’s domestic governments have now
consistently reiterated, through the National Health Vision
2016–2025 and other essential agenda setting documents,
their joint commitments to making UHC and primary care
access a priority across the country. The federal and
provincial governments have initiated critical UHC and
primary health care (PHC) related interventions. First,
Pakistan has become an early adopter of the Disease Control
Priority 3 (DCP3) framework and, in collaboration with the
DCP3 Secretariat and the World Health Organization (WHO),
has begun implementing for the first time a prioritized
Essential Package of Health Services (EPHS). Another major
program led by the federal government and now adopted by the
provincial governments is the social health protection
initiative, the Sehat Sahulat Program (SSP). The program, a
tax-financed scheme, provides cash-free coverage to
inpatient hospital services at empaneled public and private
hospitals for eligible low-income populations (households
earning less than US2 dollar per day). The EPHS and the
public health insurance scheme are two promising
developments that together hold the potential to expand
health coverage, grow existing health finance resource
pools, and improve efficiency of public health expenditures.
Each would in turn help achieve broader objectives in a
health financing system that has to date produced
concerningly lagging health and human development outcomes.
However, faced with resource needs significantly higher than
current health expenditures, and a particularly turbulent
near-term macro-fiscal environment, the GoP’s ability to
sustainably fund crucial UHC priorities has become decidedly uncertain.
Palabras clave
GOOD HEALTH, GOVERNANCE AND HEALTH, UNIVERSAL HEALTH COVERAGE, HEALTH FINANCE