Supporting better access to social protection including social health protection in Pakistan

Project description

Title: Support to Social Protection, including Social Health Protection (SP-SHP)
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Pakistan
Lead executing agencies: Economic Affairs Division (EAD), Ministry of Finance and Revenue, Government of Pakistan
Overall term: 2016 to 2023

SP-SHP 1

Context

The majority of people in Pakistan still make a living with no protection against life-cycle risks such as illness, inability to work, poverty in old age or property loss. Seventy per cent of economic shocks experienced by poor households are related to out-of-pocket expenses for health services. This is one of the highest rates in the region. Expenses of this kind place a dual burden on many households. On the one hand they reduce employability and productivity, while diminishing disposable income on the other. The Government of Pakistan gives high priority to social protection. Under the Ehsaas programme, announced in March 2019, the government is seeking to reduce poverty and inequality, improve the provision of social security, further develop human capital and improve jobs and livelihoods. Universally accessible social protection mitigates existing poverty and prevents poverty that results from shocks. It positively impacts the level of education, promotes good health, and therefore acts as a strong foundation for the country’s sustainable social and economic development.

Objective

The Government of Pakistan is now able to provide better access to social protection services targeted towards people living in or at immediate risk of falling into poverty.  

SP-SHP 2

Approach

The project supports national and provincial partners in the area of strategy development. It offers assistance in the implementation of the Pakistani government’s social protection initiatives at the Federal level and in the provinces of Punjab and Khyber Pakhtunkhwa. It also supports other government-led reforms. These include capacity development among the implementing organisations as well as structural improvements that contribute towards sustainable solutions for social protection. To create an enabling environment for the more effective implementation of social protection programmes, the project operates in three fields of work:

  • Improving evidence-based decision-making by relevant stakeholders in the area of social protection.
  • Building better capacities for improving the coordination of social-protection programmes in partner provinces. 
  • Institutionalising approaches for developing implementation capacity among social health protection stakeholders.

Results

Access to medical services for vulnerable people and those living in poverty has been improved through the Government’s introduction of the Sehat Sahulat Program. Since their launch in 2015, these reforms now cover over 50 million people across Pakistan, giving them access to free in-patient services. The project has facilitated significant improvement in the domains of health management, design and insurance for policymakers and managers of district, provincial and federal health departments, hospitals and insurance companies. Data driven decision-making and awareness of risk management to ensure the financial sustainability of initiatives have increased. With support from the project, national training institutes such as the Health Services Academy have developed short courses on health insurance and contract management. 

Since March 2019, two One Window Operation’s have been piloted in the districts of Lower Dir and Nowshera, Khyber Pakhtunkhwa and two Single Window Service centres have been integrated within the existing Citizen Facilitation Service Centres in Sargodha and Bahawalpur districts of Punjab. A digitalised beneficiary registration system provides district and provincial authorities with a unified database of existing social protection services and beneficiaries, enabling them to better coordinate their efforts. In collaboration with Punjab’s Social Protection Authority, an assessment of the provincial social protection system using internationally developed assessment tools has fostered multisectoral coordination for better harmonisation and reflection on the effectiveness of existing schemes.

National-level exchange between provinces has led to mutual trust and learning from country-specific implementation experiences, including on translating international and regional lessons into solutions for the country context.

Last update: April 2021