En­sure healthy lives and pro­mote well-be­ing for all at all ages

The Financial Daily - - NATIONAL -

im­mense health is­sues. The health-re­lated Sus­tain­able De­vel­op­ment Goals (SDGs) are ex­ten­sive in na­ture in a way that they cover all as­pects rang­ing from health ser­vice pro­vi­sion to the preva­lence of health is­sues.

Health plays the key role in de­ter­min­ing the hu­man cap­i­tal. Bet­ter health im­proves the ef­fi­ciency and the pro­duc­tiv­ity of the labour force, ul­ti­mately con­trib­utes the eco­nomic growth and leads to hu­man wel­fare. To at­tain bet­ter, more skill­ful, ef­fi­cient and pro­duc­tive hu­man cap­i­tal re­sources, gov­ern­ments sub­si­dize the health care fa­cil­i­ties for its peo­ple. In this re­gard, the pub­lic sec­tor pays whole or some part of the cost of uti­liz­ing health care ser­vices. The size and dis­tri­bu­tion of th­ese in-kind trans­fers to health sec­tor dif­fers from coun­try to coun­try but the fun­da­men­tal ques­tion is how much th­ese ex­pen­di­tures are pro­duc­tive and ef­fec­tive? It very much de­pends on the vol­ume and the dis­tri­bu­tion of th­ese ex­pen­di­tures among the peo­ple of dif­fer­ent ar­eas of the coun­try. Be­sides the na­ture of the ex­ist­ing cir­cum­stances of the hu­man re­source, any mar­ginal change in pub­lic sec­tor spend­ing on health ser­vices may have pos­i­tive im­pact on the hu­man cap­i­tal and eco­nomic growth.

Health gen­er­ates pos­i­tive ex­ter­nal­i­ties for the so­ci­ety as a whole, as well as the eq­uity con­cerns that with­out pub­lic sec­tor fi­nan­cial sup­port only the wealthy seg­ment of the pop­u­la­tion would be able to af­ford rea­son­able health care ser­vices. So­cial health pro­tec­tion is an im­por­tant in­stru­ment aim­ing at fair bur­den shar­ing and re­duc­ing bar­rier un­der­lin­ing ac­cess to health care ser­vices. An­other good rea­son for the gov­ern­ment spend­ing in de­liv­er­ing ba­sic health care ser­vices is to re­duce bur­den of the dis­eases (BOD) in the pro­duc­tive years of the life. The so­cial rate of re­turn and the BOD force the pol­icy-mak­ers to trans­fer the pub­lic re­sources to­wards ba­sic health care fa­cil­i­ties.

Some pol­icy im­pli­ca­tions are pro­posed for en­sur­ing good health: First, In­equal­i­ties in the shares of dif­fer­ent quin­tiles, the ben­e­fits of gov­ern­ment ex­pen­di­tures on health in Pak­istan are widely ac­cepted. In­equal­ity pre­vails at pro­vin­cial and re­gional level. Hor­i­zon­tal and ver­ti­cal eq­uity in al­lo­ca­tion of re­sources to the health sec­tor both at pro­vin­cial and re­gional level can make the health sec­tor ser­vice de­liv­ery more ef­fec­tive. Se­condly, health is the ne­glected sec­tor in Pak­istan. Real­lo­ca­tion of re­sources and re­for­mu­la­tion of the health strat­egy that tar­get to ben­e­fit the dis­ad­van­taged groups more and im­prove the low in­come peo­ple ac­cess to med­i­cal ser­vices is the de­sired need of the time. Through bet­ter health pol­icy with em­pha­sis on the im­pli­ca­tion side can make a huge dif­fer­ence in the liv­ing stan­dards of the poor. Thirdly, health poli­cies mea­sures as fee waiver, cash trans­fers and inkind trans­fer or any other pub­lic sup­port may re­sult in­crease of sub­sidy to poor and will en­hance the share of lower quin­tiles. Fourthly, cur­rent fig­ures on to­tal and pro­vin­cial pub­lic sec­tor health ex­pen­di­ture present the poor pic­ture of the gov­ern­ment com­mit­ment on cost-ef­fec­tive and reach­able health pro­vi­sion. The sharp in­crease in the ex­pen­di­tures as per­cent­age of GDP on health be­sides other so­cial sec­tor ex­pen­di­tures is em­pha­sized. Fifthly, the gov­ern­ment should in­vest in nurs­ing col­leges to over­come the lim­ited hu­man cap­i­tal in the health sec­tor. Pri­vate sec­tor can play a vi­tal role in this re­gard as well. The gov­ern­ment should en­cour­age the pri­vate sec­tor to train and pro­duce nurses in Pak­istan. In­deed Lady Health Worker (LHW) pro­gramme can be ef­fec­tive for preg­nant fe­males, but lim­ited knowl­edge through short train­ing can­not cover the place of a pro­fes­sion­ally trained nurses. Last but not least the pri­vate sec­tor is play­ing a vi­tal role in the health care ser­vice de­liv­ery in Pak­istan. How­ever, this sec­tor needs to be reg­u­lated and mon­i­tored.

Riaz Ahmed Rai

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