Pakistanis spend 2.5 % of their public expenditure on health. Whilst the government aims to provide health for all in principle, resource constraints make this target difficult to achieve. As a result, a private sector facility is the primary means for seeking healthcare for nearly 75% of the individuals in the country. However, a large percentage of Pakistan's population falls below the poverty line and cannot afford costly forprofit hospitals and clinics. Several not-for-profit organizations and charity operations have attempted to fill this gap by providing healthcare services for low-income groups. However, traditional models of charity or donation-based public health services face growing criticism. International donors increasingly perceive development-funding as investments for sustainable services rather than one-time donations. Local donors are similarly keen to support programs that could provide maximum utilization of their charitable contributions.
Consequently, many poor-focused health organizations in Pakistan are developing interest in breaking away from the grant-based approaches and incorporating an income generation facet into their programs to achieve financial sustainability. Financial sustainability of an organization can be described as the “capacity to obtain revenues in response to a demand, in order to sustain productive processes at a steady or growing rate to produce results and to obtain a surplus3. Financial sustainability in the context of this document implies sufficient revenue generation through inherent operational processes to sustain services in the longer term. For public health programs sustainability may arise through a number of processes, several of which are adaptations of for-profit business models. What is the right business model for a public health program to adopt? Are there successful examples of sustainable public health interventions in Pakistan? Despite growing interest in sustainability, very little literature is available on the types of sustainable business models used by public health programs. While government adoption and public-private partnerships have been explored, no particular work focuses specifically on income-generation strategies4.
The latest health brief from IRD - Interactive Research & Development - aims to bridge the current knowledge gap by providing examples of innovative approaches towards financial sustainability used by public health programs in Pakistan.