2. Background
• Punjab comprising of more than 95
million populations is more than 50% of
Pakistan
• Health inequities and inequalities exist
within and between the districts
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3. Broad Health Policy Objectives
• “Provision of affordable, accessible
and quality health/RMNCH to the
people of Punjab in an equitable
manner”
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4. Punjab Health Department
The Provincial Health Department operates under
the administrative control of Secretary Health,
Punjab who is the head of provincial Health
Department. The Health Department has two main
functions;
1. Policy-making
2. Regulatory function.
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5. Punjab Health Profile
• Punjab constitutes more than half the population
of Pakistan. In spite of extensive network of
health care facilities, health status of the people
of the province as a whole is below the desired
level.
• Infant mortality rate is 77 per 1000 live births.
• Under 5 mortality rate is 112 per 1000 live births.
• Maternal mortality ratio is estimated to be 300
per 100,000 live births, lower than the national
figure 350.
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6. Malnourished children in Punjab
• Four million malnourished children in Punjab,
• A third of all pregnant women are estimated to
have iron deficiency anemia.
• Over 34 percent of children under the age of five
years are short for their age;
• over 10 percent are under weight for their age
and over half anemic.
Malnutrition is a major contributor to infant and
maternal deaths.
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7. Health Services
• The services for Punjab are provided through a
well designed infrastructure. Health Department
across the province is divided into:
• 2,461 Basic Health Units (BHUs)
• 293 Rural Health Centers (RHCs)
• 88 Tehsil Headquarters Hospitals (THQs)
• 34 District Headquarter Hospitals (DHQs)
• 23 Teaching/ tertiary Care Hospitals
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8. Health Departments Punjab
• Department of Health
• MNCH Program
• Punjab Nutrition Program
• EPI Program
• CDC Department
• PSPU-Punjab
• PHSRP
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9. Major Barriers to MDGs 4 & 5
Availability of Health Care Providers
Accessibility of MNCH services in terms of physical,
social and economic access
Issues regarding availability of MNCH related
medicines, supplies and equipments
Capacity of HCPs
Governance and accountability
Women empowerment
Evidence based advocacy to raise community
awareness
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10. Management Reforms
Strengthening the role of Punjab Health
Foundation underway for the development of
private sector
In pursuance of LGO 2013 and take devolution
further to districts establishment of “District Health
Authorities” under process
Establishment of Punjab Health Care Commission to
regulate Public & Private health care delivery system
Multi-sectoral Nutrition Initiative
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11. Service Delivery Reforms
• Development of EPHS & MSDS for PHC and
Secondary level
• An integrated RMNCH and Nutrition Program-
PC-1 approved
• Strengthening of referral services by provision of
rural ambulances. PC-1 has been approved.
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12. Health Care Programs in Punjab
• Epidemics Prevention and Control Program
• Extended Program on Immunization (EPI)
• National Maternal and Child Health Program
• National Programme For Family Planning & Primary Health Care
• Nutrition Program
• Prevention and Control of Hepatitis
• Punjab AIDS Control Program (PACP)
• Punjab Health Sector Reforms Programme (PHSRP)
• Rollback-Malaria Program
• TB Control Program
• District Health Information System (DHIS) Program
• Health Education Program
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13. Influencing departments
• Planning & Development
– Chief Health/Emergency under Member Social
Services in P&D Board
– Public Private Partnership Cell (Assistant Chief Social
Sectors, Health & Education)
– Punjab Resource Management Program
– Policy and Strategic Planning Unit
– Punjab Information and Technology Board
• Women Development, Population Welfare, Law and
Parliamentary Affairs, Social Welfare and Baitul Mal
• Institutional Reform Group (IRG)
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15. Policy and Strategic Planning Unit
• The need of Policy and Strategic Planning Unit
(PSPU) was identified mutually by Health
Department and donors. Therefore, the need to
have a body working closely with the
Department of Health on policy analysis,
strategic planning, data analysis, identifying
issues and challenges was acknowledged.
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16. Objectives of PSPU Punjab
• The main objectives of PSPU are:
• Public-Private mix of human resource
• Steering committee to approve policies
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17. PSPU Punjab Projects
• School Health and Nutrition Program
• Punjab Millennium Development Goals Program
• Knowledge Management
• e-Monitoring
• Chief Minister's Initiative for Health Care
• Punjab Health Sector Strategy
•
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18. Conclusion
• Despite devolution of powers at the local level,
the health system remains centralized and not
able to respond to the organizational and
governance challenges resulting in ineffective
use of already scarce resources and its ability to
deliver.
• Devolution remains incomplete with weak
accountability mechanisms and management
capacity at the district level.
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19. Recommendations
• The public health system needs re-organization
based on management principles, with the
federal and provincial governments focusing on
its core stewardship functions of policy,
regulation, monitoring and evaluation, standard
setting and moving towards quality service
delivery both by the public and private sector.
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