Chair and Discussant: Dr. Nabila Ali, Chief of Party, Pakistan Initiative for Mothers and Newborns (PAIMAN), Islamabad, Pakistan
Panel Organizer: Dr. Shafqat Shehzad, Research Fellow, SDPI, Islamabad, Pakistan
Dr. Talib Lashari, Executive Coordinator of The Network for Consumer Protection, Pakistan, gave his presentation on “Health Policy Implementation: A Prerequisite for Sustainable Solution”. The objectives of his study were to review Provincial Operational Plans for the National Health Policy 2001; assess how these Plans are translated into action at each tier and issues being faced in achieving policy objectives as well as to suggest a policy implementation framework and recommend ways and means as sustainable solutions. The study areas included Departments of Health; P&D; DoF and Devolved Social Services Projects in four provinces; Sheikhupura (Punjab); Charsadda (NWFP); Quetta (Balochistan); Hyderabad and Noshehro Feroze (Sindh); and EDOs (Health); MS DHQs; MO RHCs and BHUs (one DHQ, one RHC and one BHU in each district). His study found that there was lack of required preparedness to implement the Health Policy and that it is difficult to attribute enhanced health status as an outcome of the policy due to many factors involved. Implementation of the policy is also too weak to moderate, he pointed out. In the end he recommended that: the policy formulation process should be revisited and restructured at the federal and provincial level; Implementation Framework should be thoroughly discussed and incorporated in the future policy which should then be annually reviewed and widely disseminated; a viable district health system should be developed including studies on health expenditures, procurement at the district level; finally the ban on recruitments should be lifted so as to fill the gap in paramedical staff.
Mr. Fayyaz Ahmad Khan, Behavior Change Communication Team Leader from PAIMAN Project Johns Hopkins University, Center for Communications Programs, Islamabad, Pakistan, presented his paper on “Learning from the Past: Family Planning Communication Strategies in Pakistan from 1965-2003 and 2004-08.” The main objective of the paper was to provide a comprehensive overview of Pakistan’s family planning communication strategies. Pakistan has seen little success in its effort to control the high population growth rate despite her long history of family planning communication campaigns. Mr. Khan’s presentation was simple and effective. It highlighted the problems and shortfalls of effective communication and information dissemination in family planning. It was suggested that communication should be linked with the supply side and different media strategies need to be devised for each province, as ‘one size doesn’t fit all’. Role of civil servants, policy makers, and religious leaders is crucial for family planning media strategy. The key to success to MoPW Communication Programs is not increasing financial resources but training and posting appropriate people capable of devising need based plans and implementing them to encourage couples to opt for informed choices about their family and health, he stressed.
Mr. Muhammad Sabir, Senior Principal Economist from the Social Policy and Development Center (SPDC), Karachi, Pakistan, gave his presentation on “Gender and Public Spending on Health in Pakistan: A Case Study for Sustainable Solution.” The main concern of his paper was to analyze issues in access to health services in general, and for the poor segment of the society and women in particular. The study also suggested measures for sustainable solutions in access to health services. The presentation was quantitative and micro data from Pakistan Social and Living Standards Measurement Survey (Round – 1) 2004-05; province-wise sex disaggregated utilization of public health facilities by quintiles, regions and gender; Poverty Reduction Strategy Paper (PRSP) progress report for the year 2005-06, Demand for Grant and Appropriations 2005-06; and public spending on health services (general hospital and clinics) were used in the analysis. Policy recommendations included the following:
Discussion
Discussant and Chair of the session Dr. Nabila Ali, Chief of Party, Pakistan Initiative for Mothers and Newborns (PAIMAN), Islamabad, Pakistan, stressed the importance of implementation. Dr. Lashari’s presentation was appreciated along with some comments on the interviews at the federal level, linkage of parameters with recommendations and reflections of MDTF, MDGs in the development of the Health Policy. It was stressed that the study should be published and shared with all tiers of government and social sector. About Mr. Khan’s paper it was pointed out that his paper needed some inputs on the implications of the policy and program and training of counselors. For Mr. Sabir’s paper, it was suggested that more in-depth analysis of indoor and outdoor patients was required in research. Effective health reforms need to balance increased devolution of responsibility and resources with enhanced market competition and regulatory frameworks that ensure accountability for results.
Reported by Ayesha Abdul Razzaq and Aneel Salman
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