ANAM SHAHID

Mobilization of funds for health care.

Allocation of funds to the regions and population groups and for specific types of health care.

Mechanisms for paying health care

(Hsaio, W and Liu, Y, 2001)

The Overall need and Available funds

How money flows to ensure the system reaches its objectives

Creating incentives to enhance health care delivery

Provide social protection against routine and catastrophic health care expenses.

The Current Government Setup

Federal

Provincial

District

Fun

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Fun

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PolicyBudget

SurveillanceM&E

Direct OversightM&E

Direct ImplementationM&E

Public expenditure

Private expenditure

General revenue or earmarked taxes

Social insurance contributions

Private insurance premiums

Community financing

Direct out of pocket payments

Financial protection

Total: Rs 152 billion (2% of GDP)

Or about USD 17 per capita

Government contribution is about a quarter

Reflects only about a 50% increase over the past 15 years (when adjusted for inflation and population growth)

Government: prevention, curative care and infrastructure

Private sector and NGOs: mostly curative care and social awareness

An analysis of districts of Pakistan reveals 83.7% are poor

16.1% are rich

More tax revenue in these areas to ensure equitable access to health; Community financing to enable poor to get care.

All rural areas are backward as compared to urban areas. Numbering sequence is rural areas of Punjab, NWFP, Balochistan and Sindh More tax revenue targeted as per the sequence.

50% of the total wealth is held by 20% riches quintile and 7% is held by 20% poorest quintile Tax revenue targeted at poorest.

Limited revenue collection (<15% of GDP) Limited revenue collection by provincial or district governments Under utilization of allocated funds.

YES…..!!

An analysis of the population should be conducted to find out how the population is divided into income and employment segments.

After establishing these groupings, we shall apply different financing methods as appropriate for the group concerned in the context of strengths and weaknesses of the methods as discussed

Economic survey must be conducted of it.

Increased donor support to finance the provision of public goods and to ensure access for the poor to essential services.

Conversion of out-of-pocket expenditures into pre-payment schemes, including community financing programs supported by public funding, where feasible efforts to address existing inefficiencies in the way in which government resources are presently allocated and used in the health sector.

Social sector programs focused on the poor.