The Financial and Administrative Issues in Public Sector Health Programs: A Case Study of Sehat Salulat Program in Pakistan
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Abstract
Catastrophic health expenditure is one of the significant causes to push the people under the poverty line. As per Household Integrated Economic Survey (HIES) (2018-19), around 22% population of Pakistan is living below poverty line. Moreover
Background:
The Sehat Sahulat Program (SSP), initiated by the Government of Pakistan, is a public health initiative designed to address catastrophic health expenditures that are a major cause of poverty. The program, aimed at enhancing healthcare accessibility, aligns with the global movement towards Universal Health Coverage (UHC). The SSP, in partnership with the State Life Insurance Corporation of Pakistan, targets families living below the poverty line, providing a range of healthcare services, including secondary and certain tertiary services. Initially focusing on 34 districts, SSP is part of a broader effort to mitigate healthcare costs and extend coverage to over 230 million people across Pakistan.
Objective:
This study evaluates the SSP’s effectiveness in expanding healthcare coverage and reducing catastrophic healthcare expenditures among targeted population groups in Pakistan. It also documents the financial and administrative challenges within the program, offering policy recommendations for improvement.
Methods:
A retrospective case study design was utilized, combining both quantitative and qualitative data analysis. This study, focusing on SSP's strategic framework and operational efficiency, primarily used a qualitative approach. Secondary data from government publications, program reports, and financial records were analyzed to assess the program’s effectiveness and its contribution to reducing catastrophic health expenditures, thereby aiding in the attainment of Universal Health Coverage in Pakistan.
Results:
Quantitative findings showed an annual increase in hospital admissions by 8% and outpatient visits by 10%. The average cost per treatment episode decreased by 15% over three years. There was a 40% reduction in catastrophic health expenditure for enrolled families. Qualitative insights revealed a 20% improvement in claim processing times after implementing a centralized digital system. However, service uptake in rural areas remained lower compared to urban centers.
Conclusion:
The SSP has significantly contributed to advancing UHC in Pakistan, with notable improvements in healthcare access and financial protection against health costs. While the program has achieved some success, it faces ongoing challenges in policy innovation and administrative efficiency. Continued efforts are necessary to enhance the program’s effectiveness and scalability.
, World Bank and World Health Organization claimed that around half of the world’s population is still not getting essential health coverage, therefore, a significant portion of the population forced towards poverty because of expensive healthcare services. The ultimate solution to this problem is the implementation of Universal Health Insurance. UHC will support the people to get the required healthcare services at the right time without facing financial crises. The Government of Pakistan launched a social health protection initiative named as Sehat Sahulat Program (previously known as Prime Minister’s National Health Program). Sehat Sahulat Program is a public sector funded initiative of Federal and participating Provincial Governments working to provide financial health protection to targeted families against catastrophic (extra-ordinary) health care expenditure. Sehat Sahulat Program is being implemented in a phased manner, starting from below poverty families and eventually targeting universal families and providing coverage eventually to more than two hundred thirty (230) million population across Pakistan. This case study seeks to document the financial and administrative issues in the Sehat Salulat Program and accordingly policy recommendations are made to improve the structure and working of the program.
Article Details
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