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