The 18th Amendment to Pakistan's constitution devolved several powers from the federal to provincial governments, including in the health and education sectors. In health, this led to loss of national leadership and coordination, but also greater provincial ownership. Problems included tensions over federal roles and insufficient provincial capacity. In education, it transferred curriculum setting and other powers to provinces, but raised concerns over harm to national cohesion and provincial capacity to implement. Both sectors faced challenges in transitioning responsibilities and ensuring provincial ability to handle new mandates.

1. Challenges in Implementation and
Management of Provincial
Autonomy in the Context of 18th
Amendment

2. Sequence of presentation
• Introduction
• Provincial Autonomy
(18th Constitutional Amendment)
• Financial Devolution
• Council of Common Interests (CCI)
• National Economic Common (NEC)
• Health Sector after 18th Amendment
• Education after 18th Amendment
• Challenges

3. Introduction
• Pakistan's history is replete with efforts to grapple with
federalism and balance power between the centre and its
provinces.
• Right from the inception of the state, an inequality in income
and service distribution amongst provinces—suspicion with
regard to the federation and larger provinces.
• With the transition to democracy in 2008, a political
consensus on re-allocating several federal-level functions to
the provinces emerged.
• Encapsulated in the 18 Amendment to the Constitution, this
consensus resulted in the abolition of the Concurrent List

4. Introduction
• The 18 Amendment included 102 amendments to various sections of the
Constitution including the deletion of the Concurrent Legislative List and
the addition of subjects to Part II of the Federal Legislative List.
• The Implementation Commission, set-up to ensure the devolution of
powers to the provinces, was given a deadline of August 2011 to complete
the process.

5. Provincial Autonomy
(18th Constitutional Amendment)
• Article 27.- Areas not represented in the service of Pakistan
may be adequately compensated in such manner as may be
determined by an Act of Parliament.
• Article 61.- The days of the Senate from 90 increased to 110.
• Article 70.- Deletion of the Concurrent List.
• Article 89.- Ordinance not to be issued when Senate in Session.
• Article 101.–
i)Appointment of the Governor to be on the advice of the Prime
Minister.
ii) That he shall belong to the same Province and shall be a
registered voter.

6. Provincial Autonomy
(18th Constitutional Amendment)
• Article 104.- Speaker Provincial Assembly to act as Governor.
• Article 105.- Governor to act on advice of Chief Minister and date
of election of Provincial Assembly.
• Article 116.- In case the Governor fails to give assent to a Bill
within ten days it shall be deemed that he has assented to the
same.
• Article 127.- The days of the Provincial Assemblies from 70
increased to 100.
• Article 129.- The executive authority of the Province be to exercised
by the Chief Minister and the Provincial Ministers.

7. Provincial Autonomy
(18th Constitutional Amendment)
• Article 130.-
– Size of Provincial Cabinet to be not more than 11% of the Assembly
and Chief Minister not to appoint more than five Advisors.
– Mode of election of Chief Minister changed.
• Article 131.- Functions of Chief Minister with relation to the
Governor original 1973 Constitution restored.
• Article 139.- All executive actions shall be taken in the name of the
Provincial Government and not the Governor.
• Article 142.- Clause(d) amended to restrict powers of Majlis-e-
Shoora of making laws falling within the ambit of Province.

8. Provincial Autonomy
(18th Constitutional Amendment)
• Article 147.- Entrustment of functions by the Provincial Government to
the Federal Government, to be ratified by the Provincial Assembly within
sixty days.
• Article 232 of the Constitution – Emergency Provisions.-
i. For the imposition of Emergency, due to internal distributions
beyond the powers of the Provincial Government to control, a
Resolution from the Provincial Assembly of the said Provincial will be
required.
ii. Should the President act on his own the Proclamation will be placed
before both the Houses to be approved by each House within 10 days.
• Article 233 - Suspension of fundamental rights during emergency: An
Order made in this respect by the President shall be laid before both
Houses separately rather than before a Joint Sitting of Parliament.

9. Provincial Autonomy
(18th Constitutional Amendment)
• Article 234– Power to issue proclamation of emergency in case of failure
of Constitution machinery in a Province.-
– The words “otherwise” in Clause-1 have been deleted.
– At a Joint Sitting shall be substituted by the words “each House
separately”.
• Chapter of Election Commission:
i. Chief Election Commissioner and Election Commission to be
confirmed by Joint Parliament Committee.
ii. Each Province to be represented in the Members of the
Commission.

10. Financial Devolution
• Certain items have been omitted from the Federal Legislative list Part I
and have not been included in any other list.:-
– Item 33. State Lotteries.
– Items 45. Duties in respect of succession to property.
– Items 46. Estate duty in respect of property.
– Items 50. Taxes on Capital value of immovable property.
• A few items have been moved from the Federal Legislative List Part I to
Federal Legislative List Part II:-
– Item 21. Major Ports.
– Item 32. National Planning and national economic coordination
including planning and coordination of scientific and technological
research.
– Item 38. Census.
– Item 39. Establishment of standard of weights and measures.

11. Financial Devolution
• Important items in the Concurrent List
– Drugs and medicines.
– Environment.
– Population planning and social welfare.
– Labour welfare, trade unions, labour exchanges, unemployment
insurance.
– Zakat.
– Tourism.
• Article 161(a).- Federal Excise Duty collected on gas “shall not form
part of the Federal Consolidated Fund and shall be paid to the
province in which the well-head is situated”.
• Article 161 (b) stipulates the same for the Federal Excise Duty
collected on oil well-heads.

12. Financial Devolution
• Article 167 (4) “A province may raise domestic or
International loan, or give guarantees on the security of the
Provincial Consolidated Fund within such limits as may be
specified by the National Economic Council”.
• Article 172 (2).-
– ‘lands, minerals and other things of value’ underlying the
ocean in the territorial waters of Pakistan will be owned by
the Provinces instead of the Federal Government.
– ‘mineral oil and natural gas within the Province or the
territorial waters adjacent thereto shall vest jointly and
equally in that Province and the Federal Government’.

13. MECHANISMS

14. Council of Common Interests (CCI)
• The change in CCI is oriented towards greater provincial
autonomy and greater say of the provinces in supervision of
Federal resources and dispute management.
• Article 153 was amended to provide –
(i) The Council shall consist of, the Prime Minister, as
the Chairman of the Council;
(ii) the Chief Ministers of the Provinces
(iii) three (3) Members from the Federal Government
to be nominated by the Prime Minister from time to time.
(iv) The CCI shall submit an Annual Report to both the
Houses of Majlis-e-Shoora

15. Council of Common Interests (CCI)
• Article 154 was amended to provide,
(i) the Council shall be constituted within 30 days of
the Prime Minister taking oath of office;
(ii) the Council shall have a permanent secretariat and
shall meet at least once in 90 days.
(iii)Prime Minister may convene the meeting on the
request of the Province on an urgent matter.
• Formulate and regulate policies in relation to part II of the Federal
Legislative List and shall exercise supervision and control over
related institutions.

16. National Economic Common (NEC)
• The National Economic Council (Article 156) attains enhanced importance in the
18th amendment.
• Its size, procedures and functions have been enhanced to make it a truly
representative and independent forum to undertake national economic planning.
• Besides the Prime Minister who shall be the Chairman of NEC and four other
members nominated by him from time to time it shall include Chief Minister of the
provinces and one member each from every province to be nominated by its Chief
Minist
• Heavily tilted towards the provinces; the total representation of the Federal
Government including the Prime Minister is restricted to five members and that of
the Provinces stands at eight members.
• Major issues of economic planning have to be discussed and decided.er.

17. National Economic Common (NEC)
• It shall “review the overall economy”, shall advise “the Federal
Government and Provincial Governments” and “make, formulate plans in
respect of financial, commercial, social and economic policies” [Article 156
(2)].
• What is most progressive in this new article is the binding that “in
formulating such plans it shall among other factors, ensure balanced
development and regional equity”.
• The NEC “shall also be guided by the Principle of Policy set out in Chapter
2 of Part II” of the Constitution.
• The working procedure outlined for the NEC binds it to meet “at least
twice in a year” [Article 156 (4)] and shall “submit an annual report to
both Houses of the Parliament.”

18. CASESTUDY

19. Health Sector after 18th
Amendment
• The constitutional changes implemented under the 18th Amendment
redefined health-related mandates at the federal, inter-provincial and
provincial levels but clearly carved out a space for a strong federal role in
the healthcare sector.
• A number of problems arose due to the re-structuring required after the
of the 18th Amendment and stemmed principally from the sudden
abolition of some Ministries, and the abrupt transfer of responsibilities to
the provinces without a transitional period.
• As a result, the federal role in sectors such as health was undermined and
there was a loss of leadership in the healthcare sector at the national
level.
• With the loss of leadership and ownership at federal level the vital link to
world global health cooperation was also undermined.

20. Health Sector after 18th
Amendment
• With the loss of leadership and ownership at federal level the vital link to
world global health cooperation was also undermined.
• An additional number of risks also emerged. Accurate information from
the healthcare sector is needed to drive decisions, particularly in the areas
of disease security, trade in health, and domestic and external resource
mobilization.
• Each of these in turn has a bearing on provincial and district-level service
delivery, health financing, human resource management and health
governance.
• Fragmentation is most evident in, and detrimental for, health information,
there are many gaps in the flow and consolidation of information which
makes it very difficult to synthesize information for decision making.

21. Health Sector after 18th
Amendment
• Tensions arose between the federal entities over the control of
federal functions in health.
• A case in point is the battle between the Planning Commission and
the Ministry of Inter-Provincial Coordination over the control of the
National Public Health Programmes.
• After an initial round of devolution, the project management units
of all programmes where international agreements were involved
were 'returned' to the federal government and placed under the
Ministry of Inter-Provincial coordination in view of donor
coordination considerations.

22. Health Sector after 18th
Amendment
• Some irregularities are also evident at the provincial level.
• The centralization of power in the provinces along with the lack of tangible plans
to decentralize responsibilities to the districts is an issue to be addressed.
• In addition, recent analysis has pointed out that large devolved programs are
facing problems — the Lady Health Worker Programme being a key example.
• It's weaknesses notwithstanding; the former Ministry of Health had some
processes in place to deal with these problems. These processes were either not
fully transferred, or the provinces did not have the capacity to deal with them.
• The provinces have not paid sufficient attention to health promotion and despite
adequate resources the focus has remained on tertiary care and medical schools.
Lack of attention to glaring problems such as the prevailing doctor-nurse ratio,
does not inspire confidence in provincial governments' capabilities.

23. Health Sector after 18th
Amendment
• The provinces are also having difficulty implementing some of the
decisions that the federal government took immediately before the
18thAmendment that now have significant resource implications at the
provincial level.
• The remuneration of health professionals as in the case of doubling the
salary of women health workers', following the orders of the Supreme
Court, is one instance where the resource allocation situation of the
provinces was considerably affected.
• Revenue distribution has been a key bone of contention in federal-
provincial relations. Provinces consistently state that given their new
responsibilities, the allocation of funds is insufficient, especially since the
Rs. 23 billion for vertical programmes was based on 2010 estimates and
did not take into account the impact of decisions such as the doubling of
female health worker remuneration.
• These tensions have surfaced because of the fundamental mistake of
deciding the National Finance Commission (NFC) Award before the
passage of the 18 Amendment.

24. Health Sector after 18th
Amendment
• These 'problems' were largely process-related and could have been
avoided if decision making had been more participatory and open; if
technical advice had been sought and taken into consideration, and if a
carefully designed planning phase had guided a transition period wherein
these changes could have been incrementally made.
• Limitations and problems notwithstanding, there are some positive
developments, particularly in ownership.
• Some provinces are moving forward with the creation of strategic plans
and provincial policies while efforts are also underway to initiate greater
integration of the vertical programmes.
• Its initial issues notwithstanding, the establishment of the Drug Regulatory
Authority at the federal level is also an indication that collaborative
federalism can be established.

25. Health Sector after 18th
Amendment
• The government launched the Prime Minister's Health Insurance
Programme to provide free-of-cost medical treatment facilities to
as many as 118,585 families, up until early April 2016.
• Balochistan also started the programme in March 2016, and the
plan would benefit 242,000 people in the province according to the
provincial government estimates. The plan would cover diseases
such as diabetes and cancer.
• Sindh and KPK have refused to participate in the insurance scheme.
• An allocation of Rs. 2 billion for the scheme under PSDP for the
fiscal year 2016-17. Furthermore, Rs24.951 billion has been given to
the National Health Services, Regulations and Coordination Division
for 15 ongoing and three new schemes under PSDP.

26. Health Sector after 18th
Amendment
• The government launched the Prime Minister's Health Insurance
Programme to provide free-of-cost medical treatment facilities to
as many as 118,585 families, up until early April 2016.
• Balochistan also started the programme in March 2016, and the
plan would benefit 242,000 people in the province according to the
provincial government estimates. The plan would cover diseases
such as diabetes and cancer.
• Sindh and KPK have refused to participate in the insurance scheme.
• An allocation of Rs. 2 billion for the scheme under PSDP for the
fiscal year 2016-17. Furthermore, Rs24.951 billion has been given to
the National Health Services, Regulations and Coordination Division
for 15 ongoing and three new schemes under PSDP.

27. Education after 18th Amendment
• The Eighteenth constitutional amendment has some drastic effects on Education sector in
Pakistan.
• There are two distinctive changes in 18th amendment. First the inclusion of article 25A that
ensures the right to education to the children from five to 16 years, and second the exclusion
of concurrent list which implies that the curriculum, syllabus, planning, policy, Centre of
excellence and standards of education would be devolved and comes under provincial
jurisdiction.
• The implications of 25A can only be significant if the government really exhibit the will to
implement the clause in its true essence. Nevertheless the article 25A provides an
opportunity to develop a legislative framework for Education sector that would provide the
basis of accountability of responsible authorities who maybe involve in denying this basic
right to education.
• The second and the most significant effect of 18th amendment is the abolishment of
concurrent list. As stated above it has implications on all those educational areas which were
part of federal jurisdiction. In fact apart from Higher education, everything related to
education is now devolved to the provinces.

28. Education after 18th Amendment
• Under the 18th Amendment to the Constitution, the functions of formulating education
policy and determining curricula have been devolved to the provinces, but conflict still
persists over the question of which aspects of education need to be devolved.
• Parliamentarians and Senate members have argued that allowing the provinces to have their
own syllabi and curricula is a retrograde step that will harm national integration and
cohesion. Meanwhile, the capacity of provincial education departments to design, plan,
manage and implement programmes and projects is also an area of concern.
• Legislating on the required constitutional amendment, however, was just half the task. The
real challenge since then has been to ensure that provincial governance structures have
sufficient capacity to handle their increased responsibilities.
• Ensuring this has been a challenge, with obvious implications for the country's already lacking
public sector performance. Despite binding itself to a constitutionally mandated devolution
of power, there is evidence that the centre is still sceptical about the ability of provincial
governments to shoulder their new responsibilities.

29. Education after 18th Amendment
• The tussle over the extent of devolution in the education sector is
illustrated by the controversy that came to surround the dissolution of the
Higher Education Commission (HEC) in Pakistan.
• The move to dissolve the HEC evoked broader fears concerning provincial
capacity to manage tertiary education. Some experts advised that the
process of handing over the HEC's functions be undertaken gradually,
based on an unbundling of HEC mandates and functions and their
sequential transfer.
• This would have enabled the process to move smoothly and without
disrupting the functioning of universities and the fate of scholars and
students in advanced stages of research. Instead, a turf war ensued.

30. Education after 18th Amendment
• HEC officials began insisting that the status of the entity as an
autonomous body was protected under the 18th Amendment's Fourth
Schedule, which allowed for it to continue supervising standards in
institutions of higher education and ensure inter-provincial coordination.
• However, those in favour of disbanding the HEC insisted on the need for a
separate commission constituted under the Cabinet Division to look after
degree verifications – one of the key functions of the HEC.
• The federal government's attempt to place the HEC under the Ministry of
Professional and Technical Training was promptly suspended by the Sindh
High Court in July 2012, albeit temporarily. The authority's fate still hangs
in balance, and it currently comes under the supervision of the ministry.

31. Education after 18th Amendment
• Following the implementation of the 18 Amendment, a United Nations Educational, Scientific
and Cultural Organization (UNESCO) report noted varying provincial priorities to education.
• While Sindh still lacks a formal policy document that can be considered the province's
authoritative policy on education, there are ongoing discussions within the education
department on this issue.
• Balochistan is in the process of developing an education sector plan with assistance from the
UN. To that end, UNESCO set up a Policy Planning and Implementation Unit in 2010 to design,
coordinate and oversee educational reforms.
• The unit drafted laws on compulsory education and curriculum development and initiated a
donor coordination process. The Department of Elementary and Secondary Education in
Khyber-Pakhtunkhwa has prepared the Khyber-Pakhtunkhwa Education Sector Plan to be
implemented by 2015. Punjab, meanwhile, has developed the Punjab School Roadmap aimed
at achieving the enrolment of all children of school-going age and attaining universal literacy
in the province.

32. Education after 18th Amendment
• While these plans should have been put into place before responsibilities were devolved,
they are steps in the right direction. However, further attention and a commitment to
providing resources is needed if significant education sector improvements are to be
implemented.
• Coordinating the distribution of donor funded projects in the education sector also remains
weak and fragmented and the passage of the 18 Amendment has not helped in this regard.
• Since devolution, the ensuing confusion is feared to have caused a duplication of efforts with
more than one donor implementing projects in the same geographical area.
• While most donors are involved in primary education, very few are interested in providing
support for vocational training or improving general literacy efforts, despite the fact that half
of Pakistan's adult population is unable to read or write.

33. Education after 18th Amendment
• Another major challenge that education specialists have begun drawing attention to is the
need for provincial governments to set up special arrangements to address the needs of the
education sector during times of emergency.
• Based on experiences from the post-disaster efforts after the 2005 earthquake and the three
years of flooding since 2010, special arrangements need to be put in place within the
provincial education departments to expediently oversee the reconstruction of damaged
schools and the rehabilitation of displaced students. This is an area that donor agencies and
relief organizations could also assist in.
• The process of devolution in Pakistan was long anticipated but inadequately prepared for.
Nowhere is this more apparent than in the education sector. The provinces have prioritized
education in varying ways and it has become apparent that the provinces do not yet have
sufficient capacity to handle their increased responsibilities.
• Moreover, there is still conflict and confusion over basic issues including which aspects of
education, previously handled by the Federal Ministry of Education, need to be devolved.

34. Education after 18th Amendment
• The government has earmarked Rs. 84.19 billion for Education Affairs and Services in the
federal budget for 2016-17 against Rs. 75.57 billion it had allocated for last fiscal year,
showing an increase of 11 percent.
• According to the budget documents Rs. 79.5 billion has also been earmarked for Higher
Education Commission (HEC) including Rs. 21.5 billion under the Public Sector Development
Program (PSDP) and Rs. 58 billion on account of current expenditure, showing an increase of
13 percent as compared to Rs. 51 billion earmarked for 2015-16. Overall this is 11 percent
higher than last year and highest ever in Pakistan’s history.
• The government has earmarked Rs. 8.19 billion for pre-Primary & Primary Education Affairs
for 2016-17 against Rs. 7.24 billion for 2015-16 which was later revised to Rs 7.24 billion, Rs
10 billion earmarked for Secondary Education Affairs & Services for 2016-17 against Rs 8.99
billion for 2015-16, Rs 63.59 billion for Tertiary Education Affairs and Services against Rs
56.67 billion earmarked for 2015-16 which was later revised to Rs 56.84 billion.

35. Education after 18th Amendment
• According to budgetary document Rs 5.4 billion earmarked for the new schemes of
the HEC, while Rs 16.05 billion earmarked for the ongoing schemes.
• The allocated amount for the new important schemes included Ph.D Scholarship
Program under Pak-Us Knowledge Corridor phase-1, with total funding of Rs. 300
million while Rs297.981 million has been earmarked for Strengthening & Up
gradation of the Universities of Less Developed Areas. An amount of Rs. 200
million has been allocated for the Women University Campuses at Pashin and
Khuzdar.
• The ongoing schemes of the HEC included Establishment of FATA University with
total funding of Rs250.000 million, while Rs 350.000million for Establishment of
University of Loralai, Rs 50.000 million for Establishment of University at Sibi,
Balochistan has been allocated.

36. Education after 18th Amendment
• A total amount of Rs. 500 million has been earmarked for the Fulbright
Scholarships Support Program of HEC-USAID Phase-2, while Rs. 900 million would
be utilized for Indigenous PhD fellowship for 5000 scholars, HEC phase-2.
• With an amount of Rs105 million, the FATA, Balochistan students would be
facilitated of higher education. An amount of Rs. 70 million would be utilized for
the Up-gradation of the Federal Government College for Women F-7/2 to Federal
Women University Islamabad.
• The federal government on the initiative of the Prime Minister of Pakistan has
launched a scheme to support the students from less developed areas. The
scheme is focused on enhancing the access to higher education especially to
talented but financially constrained students belonging to remote and far flung
areas of the country who despite possessing academic merit, are unable to finance
their education.

37. Education after 18th Amendment
• Under this innovative and special scheme, along-with tuition fee, the federal government has
paid other academic, incidental, or mandatory fees charged by educational institutions as
one-off or on a per semester basis for Masters, MS/ M.Phil & Ph.D students of selected areas.
• A cumulative Rs. 5.0 billion have been released for this scheme since its inception. HEC has
successfully paid around Rs. 3.896 billion on account of fee to a total number of 134,926
deserving students studying in Masters /MS, M.Phil & PhD programmes.
• The Prime Minister’s Youth Skill Development Program was launched under the directives of
Prime Minister for unemployed and less educated youth.
• National Vocational Technical Training Commission (NAVTTC) in collaboration with Provincial
TEVTAs including Azad Jammu & Kashmir, Gilgit-Baltistan, FATA and other
Government/Private Sector Skill Training Institutes executed the phase-I of this program, in
which 24,834 individuals were equipped with hand-on skills. After the successful execution of
PMYSDP (Phase-II), NAVTTC launched PMYSDP (Phase-II) for more 25,000 trainees and
catered 195 demand driven trades.

38. CHALLENGES

39. Challenges
• Political will
• Operationalization of mechanisms
• Socio cultural diversities
• Linkages between the federation and provinces
• Lack of expertise
• long term planning
• Legislation

40. Challenges
• Sustained increase in Sectoral allocation in health, education
and agriculture sectors both for development as well as
current budget
• Sustained political ownership of spirit of eighteenth
amendment.
• Trickled down effect -- Results for masses