Asia Foundation roundtable in Islamabad
Dialogue between government and practitioners from the private sector on regulation and collaboration
The Asia Foundation convened a Round Table on Health Market Innovations in Pakistan on April 21, 2011 in Islamabad, Pakistan. Given that health sector policy making and execution is expected to be largely devolved from the federal government to the provincial governments, necessitating re-configuration of policy formulation structures regarding private health service delivery in Pakistan, the event was very timely.
The platform provided by the round table was perhaps the first one where government and practitioners from the private sector came together to discuss the policy issues concerning the private health sector. Similarly, the round table also followed the ongoing deliberations on private health regulation and market-led innovations which are being hotly debated at various levels in at least two of the provincial governments. The forum provided a neutral platform to frankly debate the whole range of allied issues in the sector.
Implementers and policymakers active in Pakistan’s health sector came to the meeting to share their experiences and learn from each other regarding innovative health programs being implemented in Pakistan. It also provided an opportunity for this group of key stakeholders to discuss private health sector policy issues. Participants learned about the work in Pakistan of the Center for Health Market Innovations (CHMI), and had an excellent opportunity to network with each other.
The varied challenges and opportunities participants face in their work will inform the project team’s selection of topic for the policy brief which is planned for later in the project, as well as the selection of activities for year two.
Contech International, Heartfile Health Financing, and The Aga Khan University presented on their health programs. Contech implements a Mobile Health Clinic and created the Sehat Sahulat Card (SSC), or Health Facilities Card, which is a voucher scheme to expand access for maternal, newborn and child health to disadvantaged mothers, with the district governments of Kasur and Rawalpindi. Heartfile has created an IT-supported, automated demand side health financing instrument that can be accessed by local health care workers to seek urgent financial support for patients running the risk of spending catastrophically. Aga Khan University runs several e-health programs that improve care in remote areas with few trained health workers.
Following the presentations, participants discussed ‘Regulation and Enforcement Issues in the Private Health Sector in Pakistan’ or ‘Health Market Innovations in Pakistan: Implementation Challenges and Opportunities.’ Participants highlighted the importance of coming up with a private healthcare model that is appropriately regulated for quality control, yet decently priced for low income populations. They also felt that creating a policy framework was important to address the private healthcare financing issues–especially at the provincial level--from the perspective of the users as well as the practitioners.
There is a broader consensus that government needs to devise a system of public financing for, at least, the weaker sections of society. There are several pilots, by state institutions of state-funded organizations, whereby specific health services--especially of the less affluent--provided by private sector are partly or completely covered.
Participants showed a great deal of interest in the opportunities made available through CHMI. Some had already made relevant contacts internationally through CHMI and one participant commented that the peer-to-peer interaction enabled by CHMI was its most valuable function (for example, the ability to send messages to people running other innovative programs through the website). In addition to many positive aspects, some participants were concerned with how information about programs was validated. Several participants highlighted the importance of field visits for substantiating claims.
Participants felt that one key challenge was to derive policy lessons for the private health service delivery in Pakistan. Participants suggested several next steps:
A conference for the purpose of connecting donors and implementers.
Another meeting with all relevant implementers with a larger group of practitioners and implementers so they could present their work in detail.
Continued communication and cooperation with an aim to identify a shared agenda among stakeholders in Pakistan.
Seeking meaningful participation of private practitioners and innovators in on-going deliberations within government for developing quality assurance and regulation framework in health service delivery in Pakistan.