Naya Pakistan Sehat Card: A Giant Step Toward Universal Healthcare

[Riaz Haq]

Prime Minister Imran Khan launched Sehat Card in Punjab, Pakistan 's largest province, on International Universal Healthcare Day 2021. This is essentially a government-funded health insurance program run by insurance companies to cover up to one million rupees worth of care each year at government certified public and private clinics and hospitals.  It represents a major expansion of this program which was first introduced in Khyber-Pakhtunkhwa province.  It is now available to residents of Khyber Pakhtunkhwa, Punjab, Balochistan, Gilgit Baltistan, Azad Kashmir, and Tharparkar district in Sindh under the Sehat Sahulat Program. 

Universal Healthcare Map. Source: World Population Review

Health Card: 

Speaking at the launch event in Lahore, Prime Minister Imran Khan said, “This is a landmark. This is a defining moment towards our course to make Pakistan a welfare state.” “This is not (just) a health insurance (but) rather a health system. Now (the) private sector will build hospitals even in villages where the basic health units remain vacant as no doctor desires to be posted there. Now (the) private sector will come and (the) poorest of the poor will get free treatment,” he added.   

Pakistan Sehat Card

Sehat card was first introduced in Khyber Pakhtunkhwa (KP) by Taimur Jhagra, a former McKinsey consultant who now holds both the health and finance ministry portfolios in the province. Talking with The Telegraph newspaper reporters, he said: “It shows us we can do big things in this country in a short amount of time". He went on: “It's giving quality access to those that tend to be viewed by many as second class citizens and deserving of only second class facilities.” 

The Sehat Card program will fund both public and private healthcare, Mr. Jhagra said. “We are not funding the private sector, we are funding health care for our citizens, wherever they want.,” he said. The Telegraph has spoken with patients using the program in KP. They say it has delivered them from the worry of medical debt, where serious illness often means having to sell land or livestock, or take out loans, to pay medical bills.  

Monthly Usage of Sehat Card in KP. Source: Government of KP

Sehat card is being widely used in Khyber Pakhtunkhwa province with a population of over 30 million. There is data available to understand how the program is being funded. Here's an excerpt of The Telegraph story on it: "Treatment is provided through approved public or private hospitals and the comparatively low cost of healthcare in Pakistan has meant the state-owned insurance provider has been able to provide cover at around £3 ($3.97) per head. The card is currently costing 22bn rupees (£93m  or $123m) out of a total health budget in the province of 146bn rupees (£620m or $820m)"

The final hold-out in Pakistan is Sindh province with its nearly 50 million people. Prime Minister Imran Khan has urged Sindh's ruling party, the Pakistan Peoples Party (PPP), to launch Sehat Card and other social sector programs in Sindh as well. 

Ehsaas Satisfaction Survey. Source: Gallup

Ehsaas Social Welfare Program:

Ehsaas Program was established by Prime Minister Imran Khan in 2019. Aimed at helping the poor and the needy, it has several elements ranging from cash hand-outs and education to health and nutrition. 

A recent survey conducted by Gallup Pakistan confirms that the program is very popular among the people. Nearly 3 out of 4 Pakistanis (76%) have a good opinion about the Ehsaas program.  Nearly 9 in 10 (89%) Pakistanis who have received assistance from the program are satisfied with the amount of money received.  90% of Pakistanis believe that the program should be expanded to include more people, according to the survey.     

Related Links:

Haq's Musings

South Asia Investor Review

Pakistan's Expected Demographic Dividend

Can Imran Khan Lead Pakistan to the Next Level?

The State of the Social Sector in Pakistan

Pakistan Child Health Indicators

Pakistan's Balance of Payments Crisis

Panama Leaks in Pakistan

Conspiracy Theories About Pakistan Elections"

PTI Triumphs Over Corrupt Dynastic Political Parties

Strikingly Similar Narratives of Donald Trump and Nawaz Sharif

Nawaz Sharif's Report Card

Riaz Haq's Youtube Channel

PakAlumni Social Network

[Riaz Haq]

Faseeh Mangi
@FaseehMangi
Pakistan's subsidized house finance scheme data
-260b rupees ($1.5 billion) requested by people
-109b rupees ($600 million) approved for small houses
- 32b rupees disbursed

https://twitter.com/FaseehMangi/status/1474358251068313601?s=20

-------------------

Prime Minister Imran Khan on Wednesday formally launched the Naya Pakistan Card initiative, bringing mega welfare programmes of the Pakistan Tehreek-i-Insaf (PTI) government covering health, education, food and agriculture sectors under one umbrella.

https://www.dawn.com/news/1662707

With the launch of Naya Pakistan Card, which covers Ehsaas Ration Programme based on a food subsidy package for low-income families, Kisan Card, Sehat Card and scholarships for students, beneficiaries of various initiatives can avail all services on the same card.

Addressing the ceremony held at the Governor House, Prime Minister Khan said that Kamyab Pakistan scheme was also in the pipeline under which two million eligible families would receive Rs400,000 interest-free loans for self-employment, free technical education to one member of each registered family, Rs2.7 million loan for house construction and free health insurance.

He said the proposed Kamyab Pakistan programme to be launched in the KP province would be extended to other provinces later.

Says a project promising interest-free loan for 2m eligible families is on the anvil

Besides, the government was awarding 6.3m scholarships to students to encourage them to pursue higher education as Rs47bn had been allocated in this regard, he said.

In order to ensure award of scholarships on merit, a special cell was being set up at the PM secretariat to collect students’ data, he announced

[Riaz Haq]

Pakistan women fight gender norms to build online health business
by Zofeen T. Ebrahim |

https://news.trust.org/item/20220427154524-2hs38

Growing number of Pakistani women jump into health tech

Women founders face multiple barriers in conservative Pakistan

Mental health care not considered legitimate

Pakistan, April 28 (Thomson Reuters Foundation) - After surviving a car crash that left her hospital-bound and unable to walk for months, Saira Siddique embarked on a mission: making health care accessible to Pakistanis.

The 45-year-old left her high-profile job in government health to pitch her app linking doctors and patients by video to investors.

Months later, with COVID-19 hurting businesses across Pakistan, Siddique's firm, MedIQ, burst on to the scene as the country's first "virtual hospital".

"(The pandemic) really gave a boost to my company," said Siddique.

With face-to-face doctors' appointments restricted due to contagion risks, Siddique's company, connecting patients across Pakistan with doctors and pharmacies, was suddenly in demand.

MedIQ served 16,000 patients in its first six months. Almost two years on, the number has increased by nearly 20 times.

Siddique is one of a growing number of women in Pakistan who are defying conservative gender norms by jumping into the health tech industry.


"Running a startup business is like riding a bull," she told the Thomson Reuters Foundation by phone from the capital Islamabad.

"You never know which way or how hard it's going to buck."

Siddique's company raised $1.8 million in an early stage of financing last week after receiving mentoring in the World Bank-backed WeRaise programme, which helps women-led ventures in Pakistan raise capital.

'DOCTOR BRIDES'
Others are blazing a similar path.

Two entrepreneurs in Karachi wanted to use the untapped potential of tens of thousands of so-called "doctor brides" - women doctors who quit their medical practise after marriage in a country where millions have no access to medical care.

Iffat Zafar Aga and Sara Saeed Khurram's platform allows female medics to provide e-consultations from their homes to patients in mostly rural communities.

In the country of some 210 million the doctor-patient ratio stands at just a little over one for every 1,000 patients, according to the World Bank.

Countries such as the United States, Japan and Brazil have more than two doctors for every 1,000 patients, while Britain has nearly four.

The pair has set up dozens of 'e-health clinics' in low-income communities where, for as little as 80 rupees ($0.43), a patient visits a nurse who uses the online platform to reach a doctor.

Khurram said they provided free consultations during COVID-19 after the government sought their help - a task made possible by their team of 7,000 doctors, many of whom are former doctor brides.

The phenomenon of doctor brides remains pervasive with many families encouraging their daughters to study medicine not for a career, but to bolster marriage prospects.

More than 70% of the country's doctors are women, but only half will ever practise, according to the Pakistan Medical Commission.

'LATE-NIGHT DEALS'
From domestic violence to anxiety over job losses and grief of losing family members to Covid-19, requests for virtual appointments on ReliveNow, an online mental health care platform, surged during lockdowns.

Amna Asif, its founder and CEO, said most of the clients were women, including single mothers, struggling to juggle children while working from home.

"This put us on the radar, and helped increase our sales," said Asif by phone.

Founded in 2018, ReliveNow has clients - 80% of whom are women - in dozens of countries including Pakistan, Britain, Canada and Australia.

But the road to success for firms like MediIQ and Sehat Kahani has been paved with misogyny, stereotypes and discouragement.

[Riaz Haq]

Sindh to Finally Get #Rescue 1122 After Almost Two Decades. #PPP gov't in #Sindh has procured 288 new #ambulances and a loan of $70 million from the #WorldBank to launch the service. #Punjab launched it in 2004 in #Musharraf era. #Pakistan #emergency https://propakistani.pk/2022/05/10/sindh-to-finally-get-rescue-1122...

After noticing its effectiveness in Punjab, the Sindh government has decided to launch the Rescue 1122 emergency response service. The Punjab government launched this service in 2004, giving it an 18-year-headstart over Sindh.

According to a media report, the government has procured 288 new ambulances and a loan of $70 million from the World Bank to launch the service.

Sources say that authorities will deliver new ambulances to the health department soon. They added that Provincial Disaster Management Authority (PDMA) will begin work on the mobilization of Rescue 1122 next week.

Sources further stated that the ambulance service will work under Aman Foundation, while the fire brigade will operate under the Local Government and Community Development (LG&CD) department of Sindh.

The government will set up Rescue 1122’s regional offices in all divisional headquarters and will continue to use PDMA’s machinery and staff to diffuse emergency situations.


Rescue 1122 will have five offices in Karachi. Also, the Sindh government will likely integrate the service with 10,000 cameras at 2,000 locations across the mega-city as a part of its latest Safe City project.

[Riaz Haq]

World Bank approves $258m to support healthcare in Pakistan

https://www.dawn.com/news/1693770/world-bank-approves-258m-to-suppo...

The World Bank has approved $258 million to strengthen primary health care systems and accelerate national efforts towards universal health coverage in Pakistan, a press release issued by the international financial institution said on Wednesday.

The National Health Support Programme "complements ongoing investments in human capital and builds on health reforms that aim to improve quality and equitable access to healthcare services, especially in communities lagging behind national and regional-level health outcomes".

It identified three areas of focus for healthcare reforms under the initiative: healthcare coverage and quality of essential services, governance and accountability and healthcare financing.

Elaborating on these areas, the statement said the programme focused on healthcare coverage and quality of essential services to ensure availability of adequate staffing, supplies and medicines and to enhance patient referral systems for expediting emergency and higher-level care.


Similarly, the focus on governance and accountability was intended to strengthen oversight and management of primary healthcare services through real-time monitoring of available supplies and essential medicines.

The statement further explained that initiatives in this area included setting up a central information platform for provincial authorities to assess gaps in service delivery across public and private healthcare facilities.

Moreover, the focus on healthcare financing was to improve the financial management of primary healthcare centres for better expenditure tracking and budget forecasting to sustain quality healthcare services and delivery.

"The programme will benefit all communities through improvements to provincial primary healthcare systems, particularly [those] in approximately 20 districts that suffer from having the least access to health and nutrition services," the press release read.

According to the press release, the NHSP is co-financed by the International Development Association ($258 million) and two grants ($82 million) from the Global Financing Facility (GEF) for Women, Children and Adolescents (GFF), including a $40 million grant for protecting essential health services amid multiple global crises.

“The partnership between the GFF and the government of Pakistan focuses on building sustainable health systems while ensuring that all women, children and adolescents, especially in the most vulnerable communities can access the services they need amid multiple crises,” the statement quoted Monique Vledder, head of secretariat at GFF as saying.

"By investing in primary health care, strengthening the health workforce and equipping community health centres to both respond to emergencies and deliver quality services, Pakistan can drive a more equitable and resilient recovery,” she added.

World Bank Country Director for Pakistan, Najy Benhassine explained that “by strengthening provincial health systems, this programme is foundational to building the country’s human capital and improving health and nutrition outcomes for its citizens".

“Pakistan continues to make strides in health reforms toward ensuring access to primary healthcare services, especially for children and women during pregnancy and childbirth,” he said.

Hnin Hnin Pyne, task team leader for the programme, said: “NHSP creates a national forum for the federal and provincial governments to exchange lessons and collaborate on achieving sustainable health financing and high quality and coverage of essential services. It also helps strengthen engagement between public and private facilities and better coordination among development partners on future investments in health.”

[Riaz Haq]

Lancet Study: Non-infectious diseases cause early death in Pakistan
BY MUNIR AHMED, ASSOCIATED PRESS - 01/19/23 4:04 AM ET

https://thehill.com/homenews/ap/ap-health/ap-study-non-infectious-d...

Pakistan has considerable control over infectious diseases but now struggles against cardiovascular diseases, diabetes and cancer as causes of early deaths, according to a new study published Thursday.

The Lancet Global Health, a prestigious British-based medical journal, reported that five non-communicable diseases — ischaemic heart disease, stroke, congenital defects, cirrhosis, and chronic kidney disease — were among the 10 leading causes of early deaths in the impoverished Islamic nation.

However, the journal said some of Pakistan’s work has resulted in an increase in life expectancy from 61.1 years to 65.9 over the past three decades. The change is due, it said, “to the reduction in communicable, maternal, neonatal, and nutritional diseases.” That’s still 7.6 years lower than the global average life expectancy, which increased over 30 years by 8% in women and 7% in men.

The study says “despite periods of political and economic turbulence since 1990, Pakistan has made positive strides in improving overall health outcomes at the population level and continues to seek innovative solutions to challenging health and health policy problems.”

The study, which was based on Pakistan’s health data from 1990 to 2019, has warned that non-communicable diseases will be the leading causes of death in Pakistan by 2040.

It said Pakistan will also continue to face infectious diseases.

“Pakistan urgently needs a single national nutrition policy, especially as climate change and the increased severity of drought, flood, and pestilence threatens food security,” said Dr. Zainab Samad, Professor and Chair of the Department of Medicine at Aga Khan University, one of the authors of the report.

“What these findings tell us is that Pakistan’s baseline before being hit by extreme flooding was already at some of the lowest levels around the globe,” said Dr. Ali Mokdad, Professor of Health Metrics Sciences at IHME. “Pakistan is in critical need of a more equitable investment in its health system and policy interventions to save lives and improve people’s health.”

The study said with a population approaching 225 million, “Pakistan is prone to the calamitous effects of climate change and natural disasters, including the 2005 Kashmir earthquake and catastrophic floods in 2010 and 2022, all of which have impacted major health policies and reform.”

It said the country’s major health challenges were compounded by the ongoing COVID-19 pandemic and last summer’s devastating flooding that killed 1,739 people and affected 33 million.

Researchers ask Pakistan to “address the burden of infectious disease and curb rising rates of non-communicable diseases.” Such priorities, they wrote, will help Pakistan move toward universal health coverage.”

The journal, considered one of the most prestigious scientific publications in the world, reported on Pakistan’s fragile healthcare system with the Institute for Health Metrics and Evaluation at the University of Washington’s School of Medicine. The study was a collaboration with a Karachi-based prestigious Aga Khan University and Pakistan’s health ministry.

The study also mentioned increasing pollution as one of the leading contributors to the overall disease burden in recent years. Pakistan’s cultural capital of Lahore was in the grip of smog on Thursday, causing respiratory diseases and infection in the eyes. Usually in winter, a thick cloud of smog envelops Lahore, which in 2021 earned it the title of the world’s most polluted city.

[Riaz Haq]

Pakistan ID boss to head UNDP digital transformation committee as World Bank mulls funding | Biometric Updat

https://www.biometricupdate.com/202302/pakistan-id-boss-to-head-und...

World Bank considers $78M project for digital public services
Malik has previously worked on identity projects with both the World Bank and UNDP. ProPakistani reports that the World Bank will consider the US$78 million ‘Pakistan: Digital Economy Enhancement Project’ that seeks a more holistic approach to digital government services for citizens and businesses.

While Pakistan has relatively robust national ID and payment systems (with links to improve service and inclusion), a lack of interoperability frameworks has limited public and private efforts for secure data exchange.

The country lacks certain elements of digital infrastructure and digital government, notes the report, though acknowledges that nearly four million citizens have been a smartphone app called the Pakistan Citizen’s Portal for accessing services or submitting grievances.

A data protection bill is still in draft form and requires more work, finds the World Bank documentation. Together these issues mean a lack of implementation support for digital projects, despite policy instruments at the federal and provincial levels. World Bank analysis therefore finds opportunities are being missed in the country’s digital transformation.

A recent opinion piece in Pakistan Today also covered elements of progress in the digital economy in the country.

Property registrars go biometric in Sindh province
All offices of the Sub-Registrar Property in Sindh province will be equipped with biometric identity verification systems to prevent impersonation in property registration, reports The Express Tribune.

NADRA Technologies Limited (NTL), a subsidiary of NADRA, signed an agreement with the Board of Revenue Sindh in Karachi, the province’s largest city. The system will be linked to the NADRA database and used to check the identity of property buyers and sellers.

The development of such systems was reported on in July 2022, with a similar biometric verification system slated for the Capital Development Authority.

[Riaz Haq]

1,800 TCF schools: Jazz digitally enabling TCF to implement tech-enabled learning - Pakistan - Business Recorder

https://www.brecorder.com/news/40227050


KARACHI: Jazz, Pakistan’s leading digital operator and a part of VEON Group, is digitally enabling The Citizens Foundation (TCF) to implement tech-enabled learning across 1,800 TCF schools and ensuring an advanced learning experience for over 250,000 students nationwide.

As part of this initiative, 23 computer labs have already been revamped, and a school management app has been introduced in all TCF schools, offering efficiency, transparency, and accuracy of data collection and management for all students, faculty, and non-faculty employees.

The blended learning solution for primary students is an innovative approach that combines online and offline education to provide a more interactive and engaging learning experience, while the computer curriculum under DLP (Digital Literacy Program) for grades 6-8 is specifically designed to equip students with digital-age skills.

The digitization initiative also facilitated the translation of books and learning materials for grades 6 and 7 into Urdu, creating a bilingual curriculum, along with a scripted bilingual lesson plan. In addition, 700 Android phones were delivered to schools across the entire TCF network, which aided in implementation of blended learning program.

Commenting on the initiative, Jazz CEO Aamir Ibrahim said, "We are proud to have collaborated with TCF on this important initiative to digitize schools and provide students with access to the latest technology. Driven by the impetus to digitally empower youth and to assist the Government of Pakistan in realizing its Digital Pakistan vision, Jazz continues to club its resources and expertise in creating long-term, sustainable solutions and partnerships that uplift individuals and the larger community."

Additionally, the female teacher training program is a crucial part of the grant as it will digitally empower women to take on more leadership roles and optimize their performance, which has been a key focus area for Jazz toward building an integrated and equitable society.

[Riaz Haq]

Healthcare Startups in Pakistan
(Showing 1-5 of 47)
With 31 funding rounds

https://magnitt.com/en-pk/startups/healthcare


Selected filters - headquartered: Pakistan, primary industry: Healthcare

Name Description Primary Industry Startup HQ Date Founded Number of Rounds
Dawaai
See Funding
Dawaai is Pakistan’s no.1 digital health platform. Starting as the only technology enabled digital pharmacy in the country, we are now on to disrupting healthcare in a big way and making it accessible to consumers
Healthcare
Pakistan
Dec 2012
6
MEDZnMORE
See Funding
We're digital healthcare innovators, dedicated towards improving your access to healthcare by solving problems associated with modern day pharmacies.
Healthcare
Pakistan
Sep 2020
2
medIQ Smart Healthcare
See Funding
medIQ Smart Healthcare is ‘Pakistan’s First Integrated Virtual Care Platform’ which provides on-demand healthcare services at the point of need. medIQ is connecting customers, health services providers and companies to put great care within everyone’s reach. medIQ through its holistic virtual care platform is making healthcare services ‘patient centred’ instead of hospital centred’. We are revolutionizing healthcare by moving away from brick and mortar health facilities and bringing healthcare to doorstep with convenience, customization and cost reduction.
Healthcare
Pakistan
Jul 2020
1
F
Find my Doctor
See Funding
-
Healthcare
Pakistan
Dec 2015
2
Healthwire
See Funding
Healthwire is on a mission to use technology to empower patients and improve healthcare outcomes.
Healthcare
Pakistan
Mar 2015
2
Want more data?

[Riaz Haq]

Pakistan’s New Middle Class
Neo Pei En, Phedra, Amit Ranjan

15 December 2022


https://www.isas.nus.edu.sg/papers/pakistans-new-middle-class/

New Middle Class



The new middle class is distinct from the old middle class. Its members work in mid-level positions, often in the private sector or have families making money through semi-skilled jobs in the Middle East or North America.[33] They rose mainly during Musharraf’s rule, whose economic reforms allowed many to join the middle class though his subsequent actions disillusioned them.[34] In 2008, more than 50 per cent of Pakistanis lived in towns of more than 5,000 people or more – this increasing urbanisation indicates most of the middle class could be found in urban areas.[35]

-----------------

This new middle class is also evolving as it uses social media to interact with the outside world more. It is “a global pioneer in digitally fuelled amplification of protests” and has the power to take down governments.[46] Currently, its identity is diversifying with the additional mix of freelancers and gig workers. The ease of accessing information with the rise of the internet contributed to the middle class’ increased connectivity with the world through digital means. This would, therefore, continue to have an effect on the Pakistani middle class. It may lead to new developments as protests are now initiated online and can reach more people instantaneously, which is a great way to swiftly gather a large following.



As is seen in many countries, including Pakistan, there is a global consensus that the rise of new information and technologies has changed the political arena.[47] With heightened access to the internet and unrestricted information, the middle class, particularly the youths, are likely to receive more information and be mobilised from such online platforms that would influence their political views. This can be seen from the throngs of middle-class youths that support Imran Khan’s Pakistan Tehreek-e-Insaf (PTI), who have been mobilised by the PTI through digital media both in the past and in the present.[48] The PTI’s ability to use social media platforms, broadcast videos and initiate blog postings have led them to successfully attract the viewership of the youths and the middle class. The evolution of the new middle class, which has also included increased access to the internet, combined with the political parties’ deft use of digital media, will change how political parties function in Pakistan in the long run.



Further, other factors, such as Imran’s populist politics, may have a part to play in galvanising apolitical youths.[49] With their contempt for politicians of the past and their corrupt ways, the new middle class and youths threw their support behind Imran for his promises to implement large-scale political change and his stand against status quo politics.[50] The effects of this support in pushing Imran back to being the leader of Pakistan remain to be seen. Given their fervent support for Imran and his politics, the middle class is likely to have a role to play if that happens.



Conclusion



Over the course of Pakistan’s history, the middle class has seen itself morphing, transiting from the old to one that now includes the new middle class. The new middle class appears to subscribe to a slightly different set of religious values and leadership compared to the old middle class. The identities and aspirations of the new middle class, along with their engagement in Pakistani civil society, may continue to change as they grow in size and influence. In the contemporary times, many in this new middle class viewed the old leaders as corrupt politicians who have damaged the country. In this regard, Imran’s pledge to fight corruption and his vow to create a Naya Pakistan (new Pakistan) are directly responding to the imperatives of the new middle class. As a result, a sizeable portion of the middle class supports him, which could trigger political changes and restore Imran to power.