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Pakistan’s Step Towards Universal Healthcare
A pre-launch of the Naya Pakistan Qaumi Sehat Card scheme, which would provide an annual healthcare insurance cover of approximately one million rupees for every family residing in Punjab, was held on December 13, 2021, by Prime Minister Imran Khan. As a first step towards reforming social welfare, the Sehat Sahulat Program, through its Sehat Cards, ensures the underprivileged residents of the country would have access to medical health care in a timely and properly formulated manner, without financial constraints.
The Sehat Sahulat Program aims to make quality medical care more readily available to the impoverished by implementing a micro health insurance program. Prime Minister Imran Khan took the Sehat Card initiative as a milestone for the welfare of the state. With the implementation of its full scope, the Naya Pakistan Qaumi Sehat Card has the potential to be a transformative facility for the millions of Pakistani nationals living below the poverty line or barely making enough to survive, or for the regular income employees, having a difficult time affording the uneconomical costs of high-quality medical treatment.
Initiation of the Sehat Sahulat Program & Sehat Cards
The healthcare costs are pushing millions of people into extreme poverty worldwide, especially in developing countries. Providing universal health coverage (UHC) is a top aim for the Pakistani government in its health sector reforms. To fulfill its universal health coverage (UHC) objectives, the federal government and the partnering provincial and regional governments launched the Sehat Sahulat Program (SSP) – a groundbreaking social health protection project.
The program will provide no-cost health insurance to families living below the poverty line first, followed by the rest of the population to achieve the maximum results. The vulnerable and marginalized groups, such as people with disabilities and the transgender community, are included in the coverage population, which health policymakers have hitherto overlooked.
Since its inception in October 2015, the Sehat Card has served as a healthcare project in Khyber Pakhtunkhwa, emphasizing individuals living below the poverty line. At that time, card distribution accounted for approximately 35-40% of the population. After the success of the scheme in Khyber Pakhtunkhwa (KPK), it was later adopted in central Punjab by the Nawaz Sharif government in 2015 and further expanded by Shehbaz Sharif in different districts of Punjab in 2016.
Under Imran Khan’s governance, the Sehat Sahulat Program further expanded to launch health cards to the entire population of KPK and later to Punjab in December 2020. The Government of Punjab pledged to provide universal healthcare insurance to the whole population of the province. The card will be available to every family’s head, regardless of their material circumstances.
According to sources, due to this success, the Sehat Sahulat Program expanded to encompass 69% of KPK’s population, or 2.48 million families, from its initial 51% coverage. Moreover, Sehat Insaf Cards were handed to families in KPK under the initiative, which allowed them to receive treatment worth up to Rs 540,000 per family at the approved facilities.
In KPK alone, the PTI-led government had released approximately Rs 4.5 billion to benefit 125,000 people. A task force was also established that would seek help from the KP health department for the statewide launch and implementation of the Sehat Sahulat Program.
Mechanism of the Sehat Sahulat Program
The SSP is subjected to rigorous monitoring and assessment processes, which have been put in place. Among the most critical components is the Central Management Information System (CMIS), which allows the program’s management to keep track of the program’s progress in real-time. This comprises all of the patients’ admission to discharge activities from a service delivery perspective. Through the CMIS, all registration operations are being recorded and tracked.
The Sehat Sahulat Program has also set up a call center through a third party, namely NADRA (National Database and Registration Authority), to get feedback on service delivery and to call each discharged patient to get their feedback on the quality of service and treatment they received while they were admitted and to check their level of happiness.
After investigating all concerns, an acceptable resolution has been reached for all parties involved. The initiative also assures adequate gatekeeping through patient facilitation counters to eliminate superfluous or ineligible services at all panel hospitals.
Distribution & Availability of Sehat Insaf Cards
The Naya Pakistan Qaumi Sehat Card will be accepted in 43 public and private panel hospitals in Islamabad and Rawalpindi, providing access to a wide range of medical services. A total of PKR 1 million in free therapy is available every year for cancer, kidney transplantation, chronic diseases, thalassemia, complications of diabetes, heart disease, nervous system surgery, organ failure, and accident-related treatment.
All of Khyber Pakhtunkhwa’s residents now have access to free medical care through the Naya Pakistan Qaumi Sehat Card, and the model is being replicated in Punjab, Islamabad, Azad Jammu and Kashmir, Gilgit-Baltistan, Sindh, and Tharparkar. By March 2022, the facility will be operational in Punjab.
Difficulties in Achieving Targets of SSP
Despite official assertions to the contrary, Punjab’s Sehat Sahulat Program (SSP) has fallen short of expectations. Five million families, in 36 districts of the province, received Sehat Insaf Cards as part of this health facility program. Yet, only 93,000 people could take advantage of this service in the first year, resulting in a success rate of only 2%.
According to the sources, the administration set a target of issuing Sehat Insaf Cards to 7.2 million people in Punjab, with 2.2 million families unable to register. It was impossible to complete registration because 2.2 million families could not be located, according to the information from NADRA. Apart from failing to meet specified aims, the Punjab Health Insurance Initiative Management Company has had internal difficulties. Furthermore, this initiative has been mainly ineffective to the general public because of the lack of emergency and outpatient services.
The Government’s Hope
The losses suffered from the COVID-19 pandemic have been enormous, resulting in inflation and joblessness. As a result, the government needed to establish a social assistance system for the people in need. The current government is comfortable with the devised policies to support the Sehat Insaf Cards.
Due to this analysis, the finance department thoroughly evaluated the program’s sustainability for several months and confidently assessed its capacity to raise the necessary cash over three years. Achieving universal health coverage, and financial protection against catastrophic expenditure related to healthcare is a crucial aim and the most effective method to alleviate poverty or prevent families from sliding into it.
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