Health spending less than one percent of GDP for decades


KARACHI: The spending on health has been less than one percent of GDP for decades. Improving the health and nutrition of the population is the priority agenda of the present government with an increased focus on revamping and strengthening primary and secondary healthcare facilities. Fundamental health indicators to some extent are improving but the pace of progress is slow. The spending on health has been less than one percent of GDP since decades, PPI learnt on Monday.

According to the federal ministry of finance’s new report, this is one of the key structural challenge. In terms of HDI, Pakistan’ position is 150 out of 189 countries in 2017. Some slight improvement has been witnessed, as in 2012-13, 45 percent of children were stunted which dropped to 38 percent in 2017-18. Childhood wasting declined slightly from 11 percent to 7 percent, while the prevalence of underweight children declined from 30 percent to 23 percent. Childhood mortality rates have declined since 1990. Infant mortality has decreased from 86 deaths per 1,000 live births in 1990 to 61.2 in 2017.

The health sector of the country faces tough challenges and there is a dire need to enhance the budget allocation for health aggressively by federal and all provincial governments, especially development expenditure so that increased and better quality health facilities may be available across the country. The present government is committed to increasing the health coverage for the growing demand of the increasing population. A number of efforts are underway to provide health facilities, increasing health expenditure and to meet goals under SDGs like Sehat Sahulat Program, Civil Registration & Vital Statistics, Deworm Islamabad Insensitive, etc. and taking expenses at health as an investment rather considering it cost.

During the same time period, under-5 mortality has markedly declined from 112 to 74 deaths per 1,000 live births. Neonatal mortality declined from 55 in 2012 to 42 deaths per 1,000 live births. Socio-economic factors like health, education, environment, etc., are closely interlinked with Human Development Indicator. Living standard and life showed improvement but this is not uniform across the regional countries.

Cumulative health expenditures by federal and provincial governments during 2018-19 (Jul-Mar) increased to Rs 203.74 billion which is 3.29 percent higher than the corresponding period of the previous year, which was recorded at Rs 197.25 billion. The current expenditure increased by 19.84 percent from Rs 149.97 billion to Rs. 179.72 billion while of development expenditure decreased by 49.19 percent from Rs 47.28 billion to Rs 24.03 billion.

However, the break-up of expenditures among federal and provinces demonstrate that during JulyMarch FY2019, Federal and Punjab health expenditures decreased by 10.0 and 8.2 percent, respectively, over the same period last year. On the other hand, Sindh, Balochistan, and Khyber Pakhtunkhwa health expenditures increased by 22.2, 18.4 and 10.5 percent, respectively. As percentage of GDP, health expenditure has improved from 0.91 percent in 2016-17 to 0.97 percent in 2017-18 and during FY 2018-19(Jul-Mar) it increased by 0.53 percent compared to 0.49 percent during the corresponding period last year.

A series of programs and projects are on track in Pakistan to improve the health status of the people and to reduce the burden of communicable and non-communicable diseases while vertical programs have been devolved to the provinces. By the year 2018, the number of public sector hospitals has increased to 1,279, Basic Health Units (BHUs) improved to 5,527, Rural Health Centers (RHCs) were increased to 686 and dispensaries to 5,671. These facilities together with 220,829 registered doctors, 22,595 registered dentists, and 108,474 registered nurses bring the current ratio of one doctor for 963 persons, 9,413 persons per dentist and availability of one hospital bed for 1,608 people during the corresponding period last year.

The ‘Action Plan’ sets out the prioritized strategic actions of the new government to transform the health sector of Pakistan by addressing the challenges, health sector reforms and thus improving the health outcomes of people of Pakistan. This action plan will augment current health sectoral and sub-sectoral strategies and plans in the country and will support the progress towards achieving Sustainable Development Goals (SDGs), Universal Health Coverage (UHC) and International Health Regulations (IHR) agenda in the country.