PHC-SP Newsletter: Joint Mission on PHC for UHC in Pakistan

The government of Pakistan places ‘health’ at the center of its human development agenda. Pakistan had signed the UHC2030 Global Compact in 2018, committing itself to advancing Universal Health Coverage (UHC) as part of the country’s efforts to achieve the health-related SDGs. The government has set a target to increase Pakistan’s Service Coverage Index (SCI) from 45 out of 100 (in 2017) to 65 out of 100 (by 2030).


Formulating a UHC vision and a strategy towards its realization, requires taking into account the devolved nature of the health system. In 2020, Pakistan endorsed a UHC Benefit Package (UHC BP), detailing a set of entitlements to be assured for all Pakistanis under a National UHC agenda. The UHC BP includes interventions to be delivered at community level, Primary Health Care (PHC) facilities including first-level hospitals as well as an intersectoral package of population level interventions. An UHC Investment Case has been drafted to assess gaps in the health system and to provide options for improving its performance.


It is with this background that a mission grouping eight GAP partners (WHO, UNICEF, UNFPA, UNAIDS, Global Financing Facility, Gavi the vaccine alliance, the World Bank and the Global Fund ) visited Pakistan, 1-5 Mar 2021, to: review the status of PHC and health financing and advise on a ‘Model of Care’ to ensure the effective implementation of the UHC BP.


The mission was preceded by intensive preparatory work amongst the mission members and included a series of in-county visits by representatives from most of the partner agencies to meet and interact with policymakers, mid-level managers and health practitioners. The mission visited three of the four provinces and organized a virtual meeting with the fourth province.


The mission examined six Key Priority Areas: Model of care, primary care workforce, sustainable financing for PHC, strengthening coordination mechanisms, monitoring and evaluation, as well community and civil society engagement. The mission identified key finding for each of these key areas and selected Ten Selected Actional Recommendations for the Medium Term, related to stewardship, skill mix of health workers, make (domestic) resources available for the implementation of the UHC BP in the frame of “Sahat Sehulat Program”, quality of care, inclusion of actors in the policy dialogue, to name a few.


The mission was concluded with a high-level national ‘PHC for UHC’ Forum, where representatives from Federal and Provincial levels as well as the eight development partners signed a Joint Statement in support of enhancing PHC towards UHC in Pakistan.


The partners in the mission shall work jointly with the government to finalize an ‘action plan’ to implement the various recommendations with budget and funding sources. This shall be followed with a process to develop a national ‘PHC for UHC Compact’ in connection with the UHC2030 Global Compact. There is a need to establish joint regular monitoring routines, e.g., stock takes, to track progress, solve problems, learn, and make course corrections in the process.