Challenges for a Public Private Partnership in Pakistani Healthcare

By Motoki Aoki

Pakistan’s Punjab Province, home to more than 101 million people, has the potential to become one of the world’s largest economies in the twenty-first century. However, a strong economy requires a healthy populace. Despite robust economic growth over the last decade, the Punjab government allocates as low as 0.7 percent of its spending to healthcare, compared to the OECD average of 8.9 percent. Infant mortality in Punjab is 77 deaths per 1,000 live births, and mortality for children under five is 112 in 1,000, compared to the OECD averages of 2.9 and 4.2 respectively. Although Punjab has made a gradual progress on these two health indicators in the last decade, both are still short of the MDG targets of 52 deaths per 1,000 live births for under-five mortality, and 40 deaths per 1,000 live births for infant mortality.

The major issues in Punjab’s health services run the gamut from financial mismanagement to insufficient resources to absenteeism of doctors and other staff. In light of its failure to achieve MDG targets, the government of Punjab announced in June that it will outsource day-to-day operations and management of all public health facilities in 10 districts to private parties starting in November 2015. These locations span from the smallest healthcare facilities to district hospitals, totaling 669 health facilities. The government will continue to own the physical facilities and remain accountable for overseeing the quality of healthcare delivered. Continue reading