SOCIAL PROTECTION STRATEGIES AND HEALTH FINANCING TO SAFEGUARD REPRODUCTIVE HEALTH FOR THE POOR: MAKING A CASE FOR PAKISTAN
Abstract
Globally, a billion people cannot seek appropriate and timely healthcare because they are not coveredunder any social protection and health insurance system. Countries where government financing forhealth care is meagre, the situation is even worse. Pakistan with its slowly improving indicators ofmaternal and child health makes a classical case for instigating a social protection mechanism for thepoor segments of population. The Government safety nets are unable to cater the large proportion ofpoor population. NGOs partially cover the rural areas where majority of the vulnerable population livesbut need to expand their scope of work. Donors have presented variety of models and frameworkswhich were seldom considered in the concerned quarters. All stakeholders ought to strategise theirplans to adopt and scale up the successful interventions (vouchers, cash transfers, micro-credits,community based insurance etc) which have been operating but on a very small scale or for other typesof health services, but none for reproductive health care per se. Adoption of risk pooling mechanismsand provision of accessible and quality reproductive health services seems feasible through ameaningful and integrated public private partnership in the times to come.Keywords: Social protection, Health financing, Reproductive health, Health SystemReferences
GTZ-ILO-WHO. Consortium on Social Health Protection in
Developing Countries. Eschborn: 2007.
http://www.socialhealthprotection.org/social_protection_health.php
(accessed on 18th December 2011)
Wieczorek-Zeul H. Social health insurance in development
cooperation. Extending social protection in health; developing
countries experiences, lessons learnt and recommendations.
GTZ-ILO-WHO, Berlin: 2005.
J Ayub Med Coll Abbottabad 2011;23(4)
http://www.ayubmed.edu.pk/JAMC/23-4/Babar.pdf
World Health Organization. World Health Report 2010. Health
Systems Financing: The path to universal coverage. Geneva:
United Nations Development Programme. Human Development
Report 2010. The real wealth of the nations: Pathways to human
development. New York: 2010.
Rasheeda G, Shah ZH, Fikree F. Unwanted Pregnancy and Post
Abortion Complications: Report from Health Care Professionals
and Health Facilities. Population Council, Islamabad: 2004.
Jan R, Mohammed YJ, McIntyre H. Implementing midwifery led
care in Pakistan. Pract Midwife 2011;14(6):32–4.
Shaikh BT, Hatcher J. Health seeking behavior and health
services utilization in Pakistan: challenging the policy makers. J
Public Health (Oxford) 2005;27(1):49–54.
Shaikh BT. Health care system in Pakistan In: Health care
systems: A global survey. Rout HS (Eds.): New Delhi, India:
New Century Publications; 2011.pp
Nishtar S. Choked pipes. Reforming Pakistan’s mixed health
system. Karachi: Oxford University Press; 2010.
Doetinchem O, Schramm B, Schmidt JO. The benefits and
challenges of social health insurance for developing and
transitional Countries. In: Laaser U, Radermacher R (Eds.):
Financing health care —A dialogue between South Eastern
Europe and Germany, Lage. Series International Public Health;
Vol 18: 2006.
Nishtar S. The Gateway Paper. Financing health in Pakistan and its
linkage with health reforms. J Pak Med Assoc 2006;56(4):25–42.
Government of Pakistan. Pakistan Bait-ul-Mal. Prime Minister
Secretariat, Islamabad. http://www.pbm.gov.pk/new/
MDs_Message.html (accessed 12th Dec 2011)
National Rural Support Programme. Social protection.
Islamabad. http://nrsp.org.pk (accessed 12th Dec 2011)
Government of Pakistan. Benazir Income Support Programme.
Islamabad. http://www.bisp.gov.pk (accessed 12th Dec 2011)
Government of Punjab. Punjab Health Sector Reform Programme.
Health Department, Lahore. http://www.phsrp.punjab.gov.pk/
index.html (accessed 12th Dec 2011)
Marie Stopes Society. Safe Motherhood.
http://mariestopespk.org/projects/safe-motherhood. (accessed 12th
Dec 2011)
Greenstar Social Marketing. Family Planning and Reproductive
Health. http://www.greenstar.org.pk/FPRH.htm (accessed 12th
Dec 2011)
Health and Nutrition Development Society. Marginalized Areas
RH & FP Viable Initiatives (MARVI). Mid-term Review Report;
http://www.hands.org.pk/beta1/images/stories/pdf/
ResearchReports/MidTermReview/MARVI.pdf (accessed 12th Dec
Aga Khan Development Network. Microfinance for Women in
Northern Pakistan. AKDN Publications; 2007.
http://www.akdn.org/publications/case_study_akam_women_pa
kistan.pdf (accessed 12th Dec 2011)
Heartfile. Health Financing. http://www.heartfilefinancing.org
(accessed 12th Dec 2011)
Government of Pakistan. Health: New Growth Framework.
Planning Commission Newsletter. Planning and Development
Division, Islamabad 2011;12.
Asian Development Bank. Impact of Maternal and Child Health
Private Expenditure on Poverty and Inequity those constraints.
Technical Assistance Report, Research and Development
Technical Assistance; 2008. Project Number: 41252.
http://www.adb.org/Documents/TARs/REG/41252-REGTAR.pdf (accessed 25th Dec 2011)
World Health Organization. Marginal Budgeting for
Bottlenecks: Costing tool. The Partnership for Maternal,
Newborn and Child Health. Research and Development
Technical Assistance; 2011. http://www.who.int/pmnch/topics/
economics/costing_tools/en/index12.html (accessed 25th Dec
Binnendijk E, Koren R, Dror DM. Hardship financing of
healthcare among rural poor in Orissa, India. BMC Health Serv
Res 2012;12(1):23.
Ministry of Health & Population and GIZ. Assessment of the
Government health financing system in Nepal: Suggestions for
reform. Kathmandu: 2011.
Abrejo FG, Shaikh BT. Social Health Insurance: can we ever
make a case for Pakistan? J Pak Med Assoc 2008;58(5):267–70.
Kruk ME, Galea S, Prescott M, Freedman LP. Health care
financing and utilization of maternal health services in
developing countries. Health Policy Plann 2007;22:303–10.
Mohammad KB, Hafeez A, Nishtar S. Public sector health
financing in Pakistan: A retrospective study. J Pak Med Assoc
;57(6):311–6.
Asian Development Bank. Specific Pro-Poor Activities in PPPs.
Public Private Partnership Hand Book, Philippines; 2008:81–4.
http://www.adb.org/Documents/Handbooks/Public-PrivatePartnership/Public-Private-Partnership.pdf (accessed 15th Dec
Huntington D, Zaky HH, Shawky S, Fattah FA, El-Hadary E.
Impact of a service provider incentive payment scheme on
quality of reproductive and child-health services in Egypt. J
Health Popul Nutr 2010;28(3):273–80.
Ir P, Horemans D, Souk N, Van Damme W. Using targeted
vouchers and health equity funds to improve access to skilled
birth attendants for poor women: a case study in three rural health
districts in Cambodia. BMC Preg Childbirth 2010;10:1.
Rob U, Rahman M, Bellows B. Using vouchers to increase
access to maternal healthcare in Bangladesh. Int Q Community
Health Educ 2010;30(4):293–309.
Van Rossem R, Meekers D. The reach and impact of social
marketing and reproductive health communication campaigns in
Zambia. BMC Public Health 2007;7:352.
Kabir N, Huda K, Kaur S, Lamhauge N. Productive safety nets
for women in extreme poverty: lessons from pilot projects in
India and Pakistan. Institute of Development Studies, Sussex:
Government of Pakistan. National Programme for Family
Planning and Primary Health Care. Ministry of Health,
Islamabad: 2009. http://www.phc.gov.pk (accessed 20th Dec
Government of Pakistan. National Maternal Newborn & Child
health Programme. Program Overview.
http://www.mnch.gov.pk/overview.php (accessed 2nd Dec 2011)
Shah NM, Wang W, Bishai DM. Comparing private sector
family planning services to government and NGO services in
Ethiopia and Pakistan: how do social franchises compare across
quality, equity and cost? Health Policy Plan 2011; 26 Suppl
:i63–71.
Ejaz I, Shaikh BT, Rizvi N. NGOs and government partnership
for health systems strengthening: a qualitative study presenting
viewpoints of government, NGOs and donors in Pakistan. BMC
Health Serv Res 2011;11:122.
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