Microinsurance in Pakistan is still in its nascent stages. More than half of the current microinsurance policies in effect in Pakistan are offered through the Benazir Income Support Program (BISP), with the remainder provided in conjunction with microcredit services offered by various microfinance institutions (MFIs), microfinance banks, nongovernment organizations, and rural support programs (RSPs). The policies offered by the microcredit sector are mainly creditlife policies, which cover loan balances in the event of the borrower's death. In addition, some lenders-principally the RSPs-offer small health insurance policies covering the hospitalization of the borrower and (sometimes) their spouse. As catastrophic health expenses and deaths in the family are among the most important economic stressors that households face, it makes sense that microinsurance should first make inroads in these areas.It is difficult to say what impact microinsurance has had in Pakistan, since few rigorous evaluations have been undertaken to date. What we do know is that utilization has been low, explained by providers as limited client awareness of the benefits and coverage. In the short to medium term, microinsurance outreach can be expanded by offering health microinsurance (HMI) coverage to microcredit borrowers' entire households, and by offering HMI to all community members within an RSP, rather than only microloan borrowers and their spouses. Partnering with mobile phone operators for automated, digital payments can also significantly expand potential customer volume while reducing transaction costs. HMIs might also be combined with health savings accounts that households can use to pay for medications and outpatient services not covered by HMI plans. Provinces could also leverage the existing database of poverty scorecards implemented by BISP to channel partially government-subsidized microinsurance policies toward poor households just above the BISP threshold.

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Fostering co-ordinated management of a transboundary basin can benefit from an understanding of the internal, often multilevel governance mechanisms in each country sharing it. This chapter delves into the legal and institutional architecture of water governance in basins shared between Afghanistan and Pakistan. Drawing on a careful document analysis as well as expert interviews, the chapter analyses the national laws and institutions in Afghanistan, as well as the legal and institutional provisions for water governance at the federal, provincial and local levels in Pakistan. A review of the existing design of internal water governance in both Afghanistan and Pakistan reveals that despite the existence of well-meaning and well-structured legal provisions, implementation is a key challenge for effective water governance to be addressed on both sides of the Durand Line. The chapter concludes that strengthening internal institutions for better implementation and engaging multilevel stakeholders for improved co-ordination of water policies between riparian countries can pave the path towards successful transboundary basin management in the Kabul, Kurram and Gomal river basins. Fig. 8.1. Gathering of informal institution in the Gomal river basin.