Sindh unveils ambitious health strategy for the next eight years

The post-devolution plan will focus on the rural areas and standardisation of private care.

KARACHI: For Sindh’s health sector and doctors, Thursday, was an important day. After it was torn away from the centre last year, the governor and ministers finally decided on a strategy for the next eight years. This plan includes what the health sector intends to do and how it will do it till 2020.

According to the chief of the Health Sector Reforms Support Unit, Kiran Noman, their strategy is to focus on seven main areas, including the district health system, human resources, regulation and financing. Investment in the health sector needs to be increased by Rs318 billion. They plan on increasing the inflow of money towards innovative financing systems to reduce out-of-pocket expenditure by the poor. This will be carried out by harnessing funding from the private sector and international organisations.

In the district health system, special emphasis will be given to under-developed districts and urban Primary Health Care. The under-developed districts will be given Minimum Delivery Service Packages in each taluka as well as Essential Service of Health Packages in district headquarters for secondary care.

In comparison to other parts of the country, Sindh is not doing so well when it comes to infant mortality, maternal mortality, nourishment of children, child and maternal anaemia, food insecurity and utilisation of the government health resources. The rate of infant mortality in Sindh is 81 as compared to 78/100,000 in the rest of the country.

The government also plans on making sure that remote and disadvantaged talukas have access to facilities such as the provision of support and outreach measures like transport vouchers, district-based pilots on nutrition and social development via the Benazir Income Support Programme.

The new health plan will streamline human resources, production and capacity to support priority health needs, including employment of female health staff in rural areas, enhancing coverage and the technical supervision of lady health workers, sending male and female volunteers to districts, filling vacancies of specialists in rural areas and civil hospitals, develop a trained administrative cadre, a hospital pharmacy cadre and strengthening the management of human resource.

In this eight-year plan, special areas of focus will also cover polio through the community based Polio Plus programme, under nutrition health packages, aiming at birth spacing in young couples, controlling non-communicable diseases and establishing links between communicable diseases for integrated control.

They also plan to set up permanent structures at the provincial and district levels for disaster management, have medico-legal units at the provincial level and incorporate an integrated health response to gender-based violence.

One of the other aims is to increase sector-wide access to drugs through improvement in quality assurance, affordability, supply management and description. This will be carried out through enhancing technical and budget support by market surveillance, training pharmacists and creating a central body for pharmacists.

By setting up a regulatory body for licencing, the health sector aims to monitor the extensive private sector, standardisation of care, minimal reporting requirements and address medical negligence. This will increase and provide incentive for self-accreditation and accountability for medical negligence. In the long run, the government also plans to establish a multi-stakeholder provincial health commission on non-communicable diseases along with a framework for the Peoples Primary Healthcare Initiative. They also want to set up hospital autonomy pilots for major tertiary hospitals and improve accountability in service delivery by increasing internal control at district and provincial levels.

The governor hopes that this plan will improve the healthcare for those who need it.

Published in The Express Tribune, October 5^th, 2012.