Some government officials say that enhancing health and nutrition of the population is the priority agenda of the present government of Pakistan with increased focus on revamping and strengthening primary and secondary healthcare facilities. Fundamental health indicators to some extent are enhancing but the pace of progress is slow. The spending on health has been less than one percent of GDP since decades. This is one of the key structural challenges. In terms of HDI, statistics showed that Pakistan’ position is 150 out of 189 countries in 2017. Some slight improvement has been recorded, as during 2012-13, 45 percent of children were underdeveloped which dropped to 38 percent during 2017-18. Childhood wasting fell slightly from 11 percent to 7 percent, while the prevalence of underweight children fell from 30 percent to 23 percent. Childhood mortality rates have fallen since 1990.
The officials also recorded that infant mortality has fallen from 86 deaths per 1,000 live births in 1990 to 61.2 in 2017. During the same time period, under-5 mortality has markedly decreased from 112 to 74 deaths per 1,000 live births. Neonatal mortality decreased from 55 in 2012 to 42 deaths per 1,000 live births.
Government of Sindh
The Government of Sindh allocated Rs 96.38 billion for health sector in the budget for FY2019. The government has allocated Rs. 12.50 billion for 2018-19 for development of health sector. It envisaged new schemes of health sector under the provision of Rs 50 billion earmarked separately as block allocation in ADP 2018-19. Sindh Government has completed 68 new uplift schemes of Rs 5.12 billion, including RHCs, Trauma-cum-Emergency Centres and construction of warehouses at all divisional head quarters for cold storage facility; four schemes of up-gradation of RHC, to THQ Hospitals and establishment of Cancer Ward at Nuclear Institute of Medicine & Radiotherapy (NIMRA), Jamshoro at the cost of Rs 1.086 billion.
Government of Punjab
The economic survey of Pakistan showed that the Government of Punjab has aggressively working on strengthening the primary and secondary level of healthcare. The priority of the Government of Punjab has moved to the strengthening preventive and promotive pillars of primary health care to enhance the healthcare service delivery. There is a drastic surge of health budget on strengthening of primary and secondary healthcare which is increased by 81 percent i.e. from Rs. 62 billion in 2015-16 to Rs. 112 billion in 2018-19. Statistics showed that the government envisaged benefiting 30 million people and 3.7 million families from launch of health insurance scheme the Sehat Sahulat cards. The launch of Sehat Sahulat cards in January 2019, envisaged distributing the cards among 50 percent population of the province in its initial phase. By the end of March 2019, 0.8 million cards will be distributed in four districts of the province. The government will complete the distribution of cards across the province by the end of year 2019. By that time, 7.2 million Sehat Sahulat cards will be offered to 35 million individuals of Punjab. Through this card scheme the cardholders are entitled to free medical treatment worth Rs. 720,000.
Furthermore, patients are also offered an additional Rs.1000 by the card so that they can travel to the hospital. Government of Punjab has presently recruited doctors through public service commission and deployed 2,717 women medical officers across Punjab and 3,620 male medical officers. The government has also enhanced the physical infrastructure of healthcare services by revamping nine districts and tehsil hospitals counting hospitals of Okara, Nanka Sahab, Sheikhupura, Kasur, Hafizabad, Narowal, Jhelum, Kamonki and Daska.
Government of Khyber Pakhtunkhwa
The survey also recorded that the Government of Khyber Pakhtunkhwa (KPK) has enhanced the health insurance scheme Sehat Sahulat cards through increasing service delivery of health insurance scheme to 2.4 million households with provision of free treatment to 70 percent of the population of KPK. Statistics also showed that the Government of KPK granted empanelment to 106 public and private hospitals by health insurance scheme and about Rs. 2.64 billion spent so far for free treatment through this scheme. KPK has enhanced healthcare service delivery by increasing number of healthcare service providers.
The provincial government rose recruitment many fold as compared to existing situation during 2013. Recently, during the 2018-19 KPK recruited 8,801 medical officers that is 142 percent greater than it was in 2013. 931 doctors in district specialist cadre have been recruited in 2018 which is increased by 232 percent of 2013. 488 managers about 50 percent increase and 397 dental surgeons about 56 percent have been recruited in 2018.
Government of Balochistan
The health sector of Government of Balochistan is struggling to offer adequate healthcare services because of shortage of healthcare service providers who prefer to work in provincial capital Quetta and unwilling to stay in rural regions which has largely affected health status of rural population. The provincial health department has made robust arrangements to address this issue and developed Health Sector Strategy (2013-2018) which is ongoing in its last phase of implementation. In August 2018, the provincial government planned to take strategic initiatives to address the issues of healthcare service delivery, quality of care, lack of skilled health workforce and to ensure adequate health coverage for the poor and vulnerable population in Balochistan.