CONSTITUTIONAL REFORMS IN PAKISTAN: TURNING AROUND THE PICTURE OF HEALTH SECTOR IN PUNJAB PROVINCE
Abstract
The 18th constitutional amendment in Pakistan requires an independent and objective analysis of consequences of 2011 reforms on the future roles demarcation between the federation and provinces for steering the health sector. The objective of this assessment study was to conduct an institutional appraisal of the provincial health department in Punjab to mark the achievements, problem areas and issues, as well as to formulate the recommendations in the post-devolution scenario. It was an in-depth literature review comprising papers found on PubMed/Medline, Google Scholar, reports published by the government departments, independent research works, academic papers, and documents produced by the development agencies in Pakistan, covering 18th constitutional amendment and its implications on health sector. Following 18th amendment, the Punjab Government formulated health sector strategy (2012–2017) which is being implemented in a phased approach. All districts have developed their three years rolling out plans. An integrated strategic and operational plan of MNCH, Nutrition and Family Planning is under review for approval. Punjab Health Care Commission has been established and is functional to regulate the health sector. Development agencies have in principle committed to support health sector strategy till 2017. Fair investments in improving governance, service delivery structure, human resource, health information, and medical products are expected more than ever in the post 18th amendment scenario. This is the chance for the health system of Punjab to serve the vulnerable people of the provinces, saving them from health shocks.Keywords: Reforms, Health system, Devolution, PakistanReferences
Cabinet Division. The 18th Amendment to the Constitution of the Islamic Republic of Pakistan. Islamabad: Government of Pakistan; 2011. [Internet] [cited 2014 Jun 10]. Available from URL:http://pakistanconstitution-law.org/18thamendment
Nishtar S. Health and the 18th Amendment: Need for a national structure. Islamabad. Heartfile; 2011. [Internet]. [cited 2014 May 24]. Available from: http:www.heartfile.org
Nishtar S, Mehboob AB. Pakistan prepares to abolish Ministry of Health. Lancet 2011;378(9792):648–9.
National School of Public Policy. Strategic appraisal of 18th amendment: Federal/Provincial roles and impact on service delivery. Senior Management Wing. National Management College, Islamabad: NSPP; 2012. [Internet] [cited 2014 Jun 10]. Available from: http://www.nspp.gov.pk/guideline/strategic-appraisal-of-18th-amendment.pdf
Mazhar A, Shaikh BT. Reforms in Pakistan: Decisive times for improving maternal and child health. Healthc Policy 2012;8(1):24–32.
Pakistan Institute of Legislative Development and Transparency. Health and the 18th Amendment: An analysis. Islamabad: PILDAT; 2011.
Carr-Hill RA. Efficiency and equity implications of the health care reforms. Soc Sci Med 1994;39(9):189–201.
Callen M, Gulzar S, Hasnain A, Khan AR, Khan Y, Mehmood MZ. Improving public health delivery in Punjab, Pakistan: Issues and opportunities. Lahore J Econ 2013;18:249–69.
Multiple indicator cluster survey Punjab 2011. Bureau of Statistics, Punjab [Internet]. [cited 2014 Jun 10]. Available from: http://www.bos.gop.pk/mics2011
Shaikh BT. Health care system in Pakistan. In Rout HS ed. Health care systems: A global survey, New Century Publications, New Delhi; 2011: p.434–54.
Technical Resource Facility. 18th constitutional amendment and national health programs: Options and way forward. Islamabad: 2012.
Government of Pakistan. An act to provide for the establishment of Drug Regulatory Authority of Pakistan: The Gazette of Pakistan. Act no. XXI of 2012. Islamabad: Government Printing Bureau; 2012. [Internet]. [cited 2014 Sep 20]. Available from: http://drap.org.pk/DRAP%20ACT.htm
Shaikh BT, Rabbani F. The district health system: a challenge that remains. East Mediterr Health J 2004;10(1-2):208–14.
Malik AU, Hill PS, Ahmad AM, Ulikpan A. Reforms of 2001 in Pakistan: opportunities lost in strengthening health service delivery. Pak J Public Health 2012;2(1):10–6.
Technical Resource Facility. Punjab Health Sector Strategy 2012-2020. Islamabad: 2012. [Internet]. [cited 2014 Jun 15] Available from: http://www.trfpakistan.org/LinkClick.aspx?fileticket=FNQ9lLlJ4jA%3D&tabid=2403
Pakistan - Punjab Health Sector Reform Project (English). The World Bank. [Internet]. [cited 2014 May 20]. Available from: http://documents.worldbank.org/curated/en/2013/05/17847026/pakistan-punjab-health-sector-reform-project
Punjab Health Sector Reforms Programme (PHSRP) [Internet]. [cited 2014 Aug 12]. Available from: http://www.phsrp.punjab.gov.pk/3yrp.asp
Nishtar S. Health and the 18th amendment: Retaining national functions in devolution. Islamabad: Heartfile; 2013.
Ministry of Finance. Federal Budget 2014-15: Budget in brief. Islamabad: Government of Pakistan; 2014. [Internet]. [cited 2014 Jun 17]. Available from: http://www.finance.gov.pk/budget/Budget_in_Brief_2014_15.pdf
Pakistan Institute of Legislative Development and Transparency. Understanding Punjab health budget 2012-13: A brief for standing committee on health provincial assembly of Punjab. Islamabad: PILDAT; 2012.
Shaikh BT. Devolution in health sector: Challenges & opportunities for evidence based policies. Occasional paper series Islamabad: LEAD Pakistan; 2013.
Shafiq Y, Shaikh BT, Kumar R. Availability and affordability of essential medicines: exploring the health seeking behaviours and health service utilisation for children under-5 years living in squatter settlement of Karachi, Pakistan. J Ayub Med Coll Abbottabad 2011;23(1):132–8.
Abbasi ASK, Mazhar A, Khan SA, Rehman R. Assessment of logistic mechanisms of anti- tuberculosis drugs in district Bagh, Azad and Jammu & Kashmir. Pak J Public Health 2012;2(1):30–5.
Nishtar S, Bile KM, Ahmed A, Amjad S, Iqbal A. Integrated population-based surveillance of non-communicable diseases: the Pakistan model. Am J Prev Med 2005;29(5 Suppl 1):102–6.
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