Making Sehat Sahulat Programme Sustainable

Abstract

Today, millions of people in low-income countries lack access to health services due to accessibility and affordability issues. Health financing refers to the “function of a health system concerned with mobilizing and allocating money to cover health needs. There are various healthcare financing models around the globe; the two broader ones are;

1. The supply-side models provide free-of-cost health services in public hospitals, i.e., Canada, Taiwan, South Korea, etc.
2. The demand-driven models encourage citizens to purchase health insurance, the government only partly finances the premium for marginalized segments, i.e., USA, UK, and many others.
   

The Sustainability Issues of Sehat Sahulat Program (SSP)

Pakistan has a mixed health financing system where the private sector dominates. Before the SSP’s emergence, the country faced a twofold burden: only 0.6% of the health budget as percentage of GDP, and more than two-thirds of the financing by households themselves.

The federal government took a major initiative in 2015 by launching the Sehat Sahulat Program (SSP) in a few districts (excluding the KP province) to provide free in-door health services to poor and vulnerable segments having poverty scores up to 32.5 in the BISP database. At the same time, the Khyber Pakhtunkhwa (KP) government independently started it in four districts. Until 2020, the program served only marginalized segments by using the BISP data. However, the KP government declared it universal in 2020, and the same approach was followed by the federal government in 2021. There are settled package rates against each sickness; however, the federal and KP vary over premium rates and treatment packages.

There are five stakeholders to run the program; the primary stakeholder is the State Life Insurance Company (SLIC), which is responsible for all operational activities, including; onboard empanel hospitals, providing free-of-cost in-door health services, and addressing all service-related grievances. So far the program has enrolled 43 million families by covering 190 million population of country. More than 14.6 million individuals have used in-door health facility in empanel hospitals (till November 2023).