Six months, no pay, health paralysed

Over 4,500 K-P IHP staff unpaid, crippling services for mothers, infants, and vulnerable groups

PESHAWAR:

More than 4,500 employees of the Integrated Health Programme (IHP) in Khyber-Pakhtunkhwa, including Lady Health Workers, Lady Health Visitors, nutrition assistants, drivers and support staff, have not received their salaries for the past six months. The non-payment has left employees in deep financial distress while also crippling health services for pregnant women, newborns, and vulnerable communities across the province.

According to insiders, the affected employees are shuttling between the Health Directorate and the provincial Secretariat in a desperate bid to secure their pending salaries, but their efforts remain fruitless. The financial crisis has virtually paralyzed the programme, suspending its field activities and leaving Lady Health Workers without basic medicines to provide to mothers and infants. Payments for POL (petrol, oil, lubricants), essential for outreach activities, have also been discontinued.

The Integrated Health Programme was launched in 2013-14 with federal funding and foreign donor assistance. Initially, it combined several vertical programmes, including the Expanded Programme on Immunization (EPI), Nutrition, Maternal, Neonatal and Child Health (MNCH), and the Lady Health Worker Programme. Over 4,500 employees were recruited to run the initiative, which received financial support from the World Bank, USAID, DFID, and Australian Aid, among other international partners.

However, following the 18th Constitutional Amendment, the programme was devolved to the provincial government. Sources disclosed that foreign funding was excluded from the scheme's PC-1 in 2017, leaving the programme increasingly dependent on provincial finances. The project was extended multiple times, most recently until 2025, but its financial stability has steadily eroded.

Significant changes were introduced during the tenure of former provincial health minister Taimur Jhagra in 2020. Consultants were brought in from Punjab, the EPI component was removed, and the services of 1,370 community midwives were terminated. Despite these measures, the programme continued on paper, with extensions granted year after year.

Currently, employees report that their last salaries were paid in March, after which all payments stopped. Without financial resources, Lady Health Workers are unable to carry out household visits, screenings, or provide even basic medicines for pregnant women. Similarly, no resources are available to conduct awareness sessions, supply nutritional supplements, or provide logistical support through vehicles and motorbikes purchased under the programme.

Insiders further point out that the programme is now being overseen directly by the provincial health secretary instead of a qualified medical professional, raising questions about its management. With its activities at a standstill, the programme has effectively ceased to function, despite having thousands of staff members still on the government's payroll, at least in theory.