Punjab Development Forum

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(No Transcript)
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Strategic Reforms in Health Sector in
PunjabIssues Prospects

• Sohail Ahmad
• Secretary Health

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Mission

• To provide quality healthcare services to the
  community through efficient and effective service
  delivery system that is accessible, equitable,
  culturally acceptable, affordable and sustainable

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HEALTH CARE DELIVERY SYSTEM IN PUNJAB
Secretariat
Directorate
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HEALTH FACILITES

• Number Beds
• TEACHING HOSPITALS 19 11,964
• DHQ HOSPITALS 34 5,799
• THQ HOSPITALS 71 3,338
• RHCs 295 5,986
• BHUs 2456 4,866
• Other Hospitals 59 3,463
• Dispensaries 213 318
• TB Clinics 37 36
• MCH Centres 188 ----
• Sub-Health Centres 574
  -----
• Total 3,946 35,810

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TEACHING/TRAINING INSTITUTIONS

• University of Health Sciences 1
• Post Graduate Medical Institute 1
• Institute of Public Health 1
• Medical Colleges 9
• Dental Colleges 2
• College of Nursing 2
• College of Paramedics 1
• Nursing Schools 46
• Public Health Nursing Schools 11
• Paramedical Schools 5
• Tibbia College 1
• Dental Paramedical Schools 2
• Other Institutions (PIC, CH) 3
• PHDC DHDCs 31
• Total 116

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Cadre-wise Strength of Health Deptt.
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PROVINCIAL BUDGET FOR HEALTH Present and Past
(Rs. in Million)
Note Allocations for the districts not included
after devolution.
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POLICY FRAMEWORK

• Health expenditure part of Poverty Focused
  Investments Strategy (PFIS)
• Priority to primary and secondary levels of
  health care
• Good governance as the basis of health sector
  reforms
• Willingness to innovate and experiment

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Key Initiatives in Health Sector
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Strengthening Emergency Medical Services (SEMS)

• Revamping of Emergency Departments
• Emergency services free of cost 24 hours a day
• Phase-I 14 Tertiary teaching hospitals
• DHQ THQ Hospitals in Phase II Phase III
• Dedicated staff on specifically created posts
• Guidelines issued to the institutions for
• Mandatory training (ATLS BLS) of staff
• Adoption of Standard Operating Procedures
• Upgraded equipment/services
• 50 additional basic pay
• Total cost Rs 1.5 billion

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PUNJAB EMERGENCY AMBULANCE SERVICES (PEAS)

• Launched as a pilot project in Lahore
• Cost Rs. 100 million
• One Central Station 5 sub-stations established
• 4 purpose built ambulances at central station 2
  at each sub-stations
• Recovery vehicles and equipment
• Telephone links through unified Code Service
• Wireless linkage between ambulances and stations
• Dedicated and trained staff for emergency
  handling
• One Additional basic pay per month for PEAS staff

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MULTAN INSTITUTE OF CARDIOLOGY

• 250 beds specialized institution on the pattern
  of Punjab Institute of Cardiology at Lahore
• Project cost estimates over Rs. 1 billion
• Implementation period One year

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Targets
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Strengthening of Preventive Promotive Services

• Reduction of communicable diseases focusing on
  rural poor
• Expanded Program for Immunization
• Malaria Control Program
• T.B Control Program
• Hepatitis Control Program
• AIDS Control Program
• Health Education
• National Program for PHC FP
• Introduction of School Health Service

Cont
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Strengthening of Preventive Promotive Services

• Strengthening EPI through GAVI at a cost of Rs.
  940 million (2003-08)
• Vaccination for Hepatitis B for under 1 year
• Polio Eradication Campaigns regularly conducted
  to eliminate Polio by 2005
• Immunization activities for reduction of Maternal
  and Neonatal Tetanus

Cont
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. PREVENTIVE HEALTH CARE

• Enhanced HIV/AIDS Control Project at a cost of
  Rs. 632 Million (2003-08)
• Malaria Control through Roll Back Malaria
  Strategy at a cost of Rs. 93 million (2003-08)
• TB Control through DOTS Strategy at Rs. 1026
  million (2004 07) including JICA assistance

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Mother Child Health

• Women Health Project at a cost of Rs 1260 million
  in 8 districts (2000-06) ADB, UNICEF
• Reproductive Health Project at a cost of Rs. 240
  million for 10 districts (2003-09) ADB
• Mothers Newborn Health (MNH) initiatives
  programs supported by DFID and USAID

Cont
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Mother Child Health
Cont

• Punjab Safe Motherhood Initiative Rs.20 million
  (2004-06) UNICEF
• Optimal Birth Spacing Initiative (OBSI) USAID
• Operational Research POP Council
• System Oriented Health Investment (SOHIP) CIDA

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Human Resource Development

• Appraise the option of replacing / augmenting
  medics at the Basic Health Units with a cadre of
  specially trained paramedics
• Launch new cadres, including community midwives
  (Skilled Birth Attendants- SBAs)
• Increase number of nurses and specialized nurses

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Improvement of Secondary and Tertiary Care

• Plan initiatives to strengthen autonomy and
  provision of pro-poor services in tertiary care
  institutions
• Improvements in infrastructure of DHQ/ THQ
  hospitals and provision of additional facilities
• Plan for addition of new specialties in district
  and tehsil hospitals

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Punjab Devolved Social Services Program PDSSP

• DFID / ADB funded 200 million program with
  primary focus on health also includes female
  higher secondary school education, special
  education, and water supply sanitation
• Unprecedented size of Technical Assistance ( 25
  million) made available primarily for building /
  sustaining capacity of DGs to plan, implement
  evaluate social sector programs

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Health Sector Reforms Program

• Initial thrust over 2 years is to provide missing
  facilities for RHCs and BHUs at a cost of Rs 6
  billion
• Make available additional funds to DGs for
  increased availability of medicines
• Adopt innovative means to facilitate presence of
  healthcare providers (doctors paramedics)

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Institutionalization of Health Sector Reforms

• Establishment of Health Policy and Strategy
  Support Unit to
• Adopt a holistic approach towards Health Sector
  Reforms
• Provide constant intellectual/ analytical support
  to decision makers
• Manage, coordinate and assimilate TA and research
  funds
• Transform policy statements into implementation
  plans
• Provide continuity / sustainability to
  interventions and policies

Cont
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Guiding Principles

• Emphasis on Primary Health Care and preventive
  services
• Targeting health services to poor, women and
  children
• Introduction of legislative and regulatory
  amendments
• Designing implementation of organizational
  system modifications

Cont
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Guiding Principles
Cont

• Rationalization of human resource planning and
  production
• Quality of services increase demand for
  services and build confidence of the people
• Foster culture of information based decision
  making
• Building partnerships (PRSP NCHD)

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THANK YOU