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Healthcare sector of Pakistan

Historically, Pakistan has spent low in the healthcare sector. To put things into perspective, according
to estimates done in 2017-18, Pakistan spent $45 per person on health, while Iran spent $484 and Qatar
spent $1,716 per capita. According to the High-Level Taskforce on Innovative International Financing
for Health Systems (2012), the minimum spending per capita on health is an average of $86 per person.
A more recent estimate from 2017, including investments in the health system, sets the bar at $271 per
person.

This figure of $86 is recommended as minimum public-sector spending whereas the above-mentioned
$45 per capita in Pakistan is the total health expenditure. A breakdown of the total healthcare spending
reveals that only $14 is spend by the public sector while the rest ($31) comes from private spending and
external sources. Because of this, there are high out-of-pocket expenditures i.e. around 60% owing to
healthcare.

The state of the healthcare system of Pakistan can be explained by the following graph which denotes
the beds available per 1000 people:

From the graph it can be seen that the beds/1000 have remained fairly constant over the past 2 decades
owing to the reduced spending in the sector and high setup costs for the private sector. Additionally,
other factors that contribute to the meager state of the sector are brain drain (people moving oversees
for better opportunities), less involvement by females in the sector (although 30% of medical school
graduates are females) and inconsistent public spending / government support of the sector.

However, not all hope is lost. Covid has have a positive impact on the state of the industry with the
government investing heavily in the sector. New tertiary health centers have been set up to reduce load
from the hospitals. Additionally, the federal budget 2021-22 has seen an increase of 11% compared to
last year. The health budget has gone up from around Rs. 25.5 billion to Rs. 28.3 billion (still only 0.4pc
of the total budget). The federal development budget (PSDP) has seen an increase of 49.6% i.e. from
Rs.14.5 billion in 2020-21 to Rs21.7 billion, including Rs5.6bn for the Sehat Sahulat Programme. One
of the government priorities for the current fiscal year is impact mitigation of Covid-19. Rs100bn is
dedicated only for Covid-19 related expenditures i.e. almost four times the budget for routine healthcare.

I am hopeful that the healthcare sector witnesses a turn-around to become an asset for the country and
its citizens.