Political Determinants of Health: Lessons for Pakistan

Abstract

There is much concern about the capacity of the health system of Pakistan to meet its goals and obligations. Historically, the political thrust has been absent from the health policy formulation and this is reflected in the low and stagnant public allocations to health. Successive political leaderships have averred from considering healthcare is a common good rather than a market commodity and health has not been recognized as a constitutional right. Over 120 of world’s nation states have accepted health as a constitutional right but the 1973 Constitution of Pakistan does not mandate health or education as a fundamental right and the recently adopted 18th constitutional amendment missed the opportunity to extend access to primary health care as an obligation of the State. It is argued in this communication that missing from the calculations of policy formulation and agenda setting is the political benefits of providing health and other social services to underserved populations. Across the developing world, many examples are presented of governments undertaking progressive health reforms that bring services where none existed and subsequently reaping electoral benefit. The political determinant of healthcare will be realized when the political leaders of poorly performing countries can be convinced that embracing distributive policies and successfully bringing healthcare to the poor can be major factors in their re-elections.

Sehat Sahulat Program Effect on Patients Presenting to Secondary Level Hospital in Mardan

“…The 1973 constitution of Pakistan does not give health as a fundamental right while article -38 gives it as social protection. 14,15 This program covers all Khyber Pakhtunkhwa citizens according to Universal Health Coverage (UHC) with Beneciaries bearing no copayment, premium or coinsurance. 16,17 According to the census, 2017 data Khyber Pakhtunkhwa's population is 35.55 promote public health, especially for the poor.…”

Geriatric Care in Pakistan: Current Realities and Way Forward

“…In Pakistan, historically, the political thrust has been absent from the formulation of health policy, reflected in the low public allocations to health over time resulting in 90% of out-of-pocket expenditure for health among people in Pakistan. This figure is among the highest in the world and is considered a major contributor to poverty (21). Successive political leadership remains to put less priority on health and education resulting in further disparities and suffering among the people of Pakistan.…”

How conflicts of interest hinder effective regulation of healthcare: an analysis of antimicrobial use regulation in Cambodia, Indonesia and Pakistan

“… 50 Since the early 1990s, funding for public services has been severely cut, meanwhile the availability of financing for private providers has increased and health policies have prioritised curative over preventive care, paving the way for exponential and unregulated growth of a for-profit healthcare market. 51 The value of the pharmaceutical industry in Pakistan has doubled over the past decade, with more than 700 pharmaceutical companies operating, of which the vast majority are domestic. 52 Pharmaceutical sales per annum are over US$2 billion.…”