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SP4PHC in Pakistan

Strengthening primary health care (PHC) in Pakistan, the world’s fifth most populous nation, is integral to making progress toward universal health coverage (UHC) and global health goals. Despite the country’s health outcomes trailing behind regional peers, innovative provincial governments are making strides: under Pakistan’s devolved system of government, several provinces are striving to maximize the impact of limited budgets to provide free, universal PHC services. ThinkWell’s work focuses on building strategic partnerships with local partners who share our goal of improving PHC delivery through innovative analysis and approaches. Our efforts aim to address various health system challenges, including strengthening the role and sustainability of Lady Health Workers in PHC delivery and ensuring that an essential package of PHC services is rapidly and sustainably scaled up. Leveraging local expertise and insights, our goal is to contribute to the development of sustainable, high-quality health care solutions that meet the needs of Pakistan’s diverse population.

Current workstreams and activities

Workstream One: Strengthen PHC facility outsourcing and Sehat Sahulat coordination in Khyber Pakhtunkhwa (KP) province

  • Support the KP Health Foundation in the entire process of PHC outsourcing
  • Bolster the role of Primary Care Management Committees (PCMCs) in PHC governance

Workstream Two: Foster effective governance and community-based services in Sindh province

  • Help improve the governance around outsourcing of primary health care in Sindh
  • Support the expansion and strengthening of the Lady Health Worker Program
  • Support the universal health coverage pilot implementation in Tando Allah Yar district

Workstream Three: Support innovative family planning initiatives in Punjab province

  • Support the mainstreaming of social marketing and voucher schemes in the context of family planning in Punjab

There is more information about the Pakistan program in this presentation and this one-pager.

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Strategic Purchasing for Primary Health Care in Pakistan: Challenges and Opportunities

Pakistan is committed to driving health sector reform toward Universal Health Coverage (UHC). Accelerating progress toward UHC in Pakistan, the world’s fifth most populous country, is crucial for meeting global goals. Weak outcomes result from low coverage of PHC services, driven by Pakistan’s low government expenditure on health. Therefore, the government aims to provide free, universal, public PHC services from this limited budget envelope, which leads to low service availability, readiness, quality, and utilization. SP4PHC aims to improve how governments purchase primary health care (PHC) services, with a focus on family planning (FP) and maternal, newborn, and child health (MNCH). ThinkWell commissioned this study, published in July 2021, to understand the current landscape for PHC, health financing, and policy reform in Pakistan through desk review and key informant interviews. This report describes our findings and sets the stage for a concept note outlining potential.

SP4PHC aims to improve how governments purchase primary health care services, with a focus on family planning and maternal, newborn, and child health. SP4PHC is supported by a grant from the Bill & Melinda Gates Foundation.