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Experts stress universal health coverage to improve health indicators

Public-private partnerships have played an instrumental role in providing high quality free of cost healthcare in the poorest areas of Sindh and SIUT and Gambat Institute of Medical Sciences are models which must be scaled up at the federal level, said Dr Shazia Sobia Aslam Somroo, Parliamentary Secretary for Ministry of National Health Services, Regulations and Coordination. She was speaking at a webinar on Sehat Sahulat Program, organized by Sustainable Development Policy Institute here today. She said that during her professional career, she experienced issues of poor coordination between public bodies and dated administrative and bureaucratic systems which serve as hinderance in effective service delivery.

Dr Shahzad Ali, Vice Chancellor, Health Services Academy, highlighted that successful social protection programs globally took various decades to reach a substantial coverage level while Pakistan has achieved profound success in less time. He said that social protection in Pakistan has been hindered by lack of public infrastructure and finance which force already vulnerable segments to bear health expenses out of pocket and exacerbates poverty. He suggested pooling finances from public funds and development partners to address the issue of out of pocket expenditures for health.

Dr Arshad, CEO, Sehat Sahulat Program, informed that the program covers 80% of inpatient health coverage across Pakistan excluding Sindh and Baluchistan. He further informed that the process to include 5 districts from Sindh is also underway while coverage to Balochistan will be initiated next month. He further said that health financing strategy is in discussion between government, development partners and other stakeholders and will be formulated soon. To reduce financial over or misspending he stressed on eradicating duplication of social services which is experienced in every country and Pakistan will be no exception.

He emphasized that customer centric service provision and maintenance of public hospitals is a key to build back public trust and suggested directing financing through health levy. He informed that health levy on fizzy drinks due to bureaucratic challenges was not directed towards the program which prevents overcoming financial challenges in the program. He further identified outdated management style in public hospitals and lack of/poor infrastructure to work in a cashless mechanism as key challenges. He also elucidated that process to include 1.6million NADRA registered Afghan refugees in the program is in pipeline and discussion for financing are being carried out at the moment with UNHCR.

Dr Aliya Khan, former Dean Faculty of Social Sciences, Quaid-i-Azam University said highlighted that government financing by mobilizing cross-subsidized tax revenues and redirecting these towards health financing can be instrumental in lifting the burden of out-of-pocket health expenditures from the vulnerable public. She said that Mexico has used VAT on sugary drinks to cross subsidize health coverage expenditures and urged the government to explore best practices as well.

Dr Razia Safdar, Advisor, Centre for Health Policy and Initiatives, said that the Sehat Sahulat Program is unique due to covering the 100% premium in 2 provinces and is being extended to rest of the country as well. She stressed that the program must be extended to the entire population with particular focus on out-patient expenses to improve the country’s health indicators.

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