Publication: Delivering Better Health Services to Pakistan's Poor
Loading...
Date
2010-04
ISSN
Published
2010-04
Author(s)
Editor(s)
Abstract
Pakistan is not on track to achieve most Millennium Development Goals (MDGs) related to health, nutrition and population. Given its current rate of progress, in 2015 Pakistan's infant mortality rate (IMR) will be 65 deaths per 1,000 live births and the under-five mortality rate (U5MR) will be 78, considerably above the MDG4 targets of 33 and 43 deaths per 1000 births respectively. Pakistan will not achieve the MDG related to nutrition. The review aims to develop a limited set of practical options that will allow the government and other stakeholders to improve the availability and use of health services, especially for the poor. The report mainly focuses on synthesizing the available body of knowledge through review of existing studies, reports and research. The report starts with a description of the health and nutrition status of the population, Pakistan's fertility and growth rates and potential to benefit from a demographic dividend, the burden of diseases and trends in the past few years. The second and third chapters describe the performance of the public health care system over time, including coverage and utilization, quality of care, equity, and patient satisfaction and the impact of national programs. Chapter four discusses the financing of the sector, including overall trends, and the composition of public and private expenditures. Chapter five describes the organization and management of the sector and examines the role of government. Chapter six concludes by summarizing the key challenges facing the sector and suggesting a way forward.
Link to Data Set
Citation
“World Bank. 2010. Delivering Better Health Services to Pakistan's Poor. © World Bank. http://hdl.handle.net/10986/12369 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication "...and then she died" : Indonesia Maternal Health Assessment(World Bank, 2010-02-01)Maternal health remains one of the top priorities of the Government of Indonesia (GoI) and the Ministry of Health (MoH) because reductions in maternal mortality have been slows. The current Maternal Mortality Ratio (MMR) for Indonesia is 228 but with existing programs and interventions the government does not believe it will be able to achieve its stated millennium development goal of 102 maternal deaths per 100,000 live births by 2015. There are positive trends in an increased use of skilled birth attendants, almost universal access to some level of antenatal care and continued use of family planning but these are not enough to stem the tide of maternal death. Interventions by the skilled birth attendants in many cases are not in line with existing standards and prove to be ineffective in trying to address the emergence of complications. Antenatal care is important, but it is not where gains in decreased mortality will be obtained. The continued use of traditional birth attendants (TBA) and delivering at home are contributory factors to maternal mortality in Indonesia. In collecting data from verbal autopsies in three districts, (a widely used government initiative to determine the causes of maternal death) 63 out of 76 deaths occurred in home births that had been assisted by a TBA. In order to improve the access of the poor and the near poor to health services, the government is implementing the social insurance scheme, Jamkesmas. Approximately 104 million people should qualify for assistance but there are presently only 76.4 million people covered by this social health insurance (SHI) plan. Even those who are covered are not always able to afford care because of external expenses such as transportation charges which must be paid up front.Publication Fertility Decline in Botswana 1980-2006(World Bank, Washington, DC, 2010-05)Botswana has had a stable democratic government and good governance since independence in 1966. With a sustained high average economic growth (about 9 percent) fueled by the diamond mining industry, it is the only country in Africa listed among the 13 'economic miracles' of the world for 1960-2005. The total fertility rate remains high in Sub-Saharan Africa, with 25 countries showing a rate greater than 5.0. In contrast, Botswana experienced the greatest fertility decline in the region during 1980-2006, with the total fertility rate decreasing from 7.1 in 1981 to 3.2 in 2006. The Botswana national family planning program, judged the strongest in Africa, contributed to this decline. The government strongly committed to meeting family planning needs, integrated maternal and child health/family planning (MCH/FP) and sexually transmitted infection (STI) services in 1973. The government spends about 18 percent of its total budget on health, a higher proportion than the Abuja declaration's target of 15 percent.Publication The Population and Reproductive Health Capacity Building Program(Washington, DC: World Bank, 2008-03-05)This is the Global Program Review (GPR) of the Population and Reproductive Health Capacity Building Program (PRHCBP). Established in 1999, PRHCBP is a merger of three pre-existing programs: population and reproductive health, safe motherhood, and the program to reduce the practice of Female Genital Mutilation (FGM) and adolescent health. The main objective of the program is to build the capacity of civil society organizations to develop and implement culturally appropriate interventions in the sensitive fields of population and reproductive health, leading to healthier behavior at individual and community levels, reducing the impoverishing effects of poor reproductive health, and improving reproductive, maternal and child health outcomes of hard-to-reach populations. The review follows Independent Evaluation Group (IEG) guidelines for preparing GPRs (annex A). These guidelines were first approved in 2006, well after PRHCBP was initially conceived and implemented. As a new evaluation product of IEG, GPRs are attempting to raise the standards of the design, management, implementation and evaluation of Global and Regional Partnership Programs (GRPPs). This is an ongoing process, and programs that are reviewed are not expected to have adhered to all the standards inherent in these guidelines, which had not been established at their outset.Publication Sparing Lives : Better Reproductive Health for Poor Women in South Asia, Summary for Policymakers(New Delhi: Macmillan India, Ltd., 2008)In this context, the overall purpose of this review is to bring attention to the opportunities that five countries in the region - Bangladesh, India, Nepal, Pakistan and Sri Lanka - have to strengthen and expand interventions to improve the reproductive health of poor women. The specific objectives are: i) to provide an accurate picture of the current status of women's reproductive health, describe the use of reproductive health services and barriers to use, and identify the improvements required to increase their effectiveness and improve health outcomes; ii) to elucidate individual and household characteristics that affect reproductive health status and use of services so that the most important of these can be used to identify women and households with the greatest need for care to achieve better health; iii) to describe a simple and effective approach - decentralized action planning - that can be used widely in all five countries to improve reproductive health service delivery and outcomes, and point to a body of best practices in reproductive health that provides models and lessons for improvements in South Asia; and iv) to strengthen the case for investing in poor women's reproductive health by demonstrating the links between poverty, inequality, reproductive health care and expenditure.Publication Economics and Ethics of Results-Based Financing for Family Planning : Evidence and Policy Implications(World Bank, Washington, DC, 2013-12)This paper was developed for World Bank task team leaders (TTLs) and teams designing results-based financing (RBF) programs in family planning (FP). It explores the rationale for introducing such incentives based on insights from classical and behavioral economics, to respond to supply- and demand-side barriers to using FP services. To help the reader understand why incentivizing FP requires specific attention in RBF, the evolution of incentives in vertical FP programs introduced from the 1950s to the early 1990s and the ethical concerns raised in these programs are described. RBF programs after the 1990s were also studied to understand the ways FP is currently incentivized. The paper also touches on the effects of the incentive programs for FP as described in the literature. Finally, it examines ethical concerns related to FP incentives that should be considered during the design, implementation, and evaluation of programs and provides a conceptual framework that can be of use for task teams in the decision making process for FP in RBF programs. It should be noted that the paper is concerned exclusively with developing a framework that can help design ethical programs to address the unmet need for FP.
Users also downloaded
Showing related downloaded files
Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication The Journey Ahead(Washington, DC: World Bank, 2024-10-31)The Journey Ahead: Supporting Successful Migration in Europe and Central Asia provides an in-depth analysis of international migration in Europe and Central Asia (ECA) and the implications for policy making. By identifying challenges and opportunities associated with migration in the region, it aims to inform a more nuanced, evidencebased debate on the costs and benefits of cross-border mobility. Using data-driven insights and new analysis, the report shows that migration has been an engine of prosperity and has helped address some of ECA’s demographic and socioeconomic disparities. Yet, migration’s full economic potential remains untapped. The report identifies multiple barriers keeping migration from achieving its full potential. Crucially, it argues that policies in both origin and destination countries can help maximize the development impacts of migration and effectively manage the economic, social, and political costs. Drawing from a wide range of literature, country experiences, and novel analysis, The Journey Ahead presents actionable policy options to enhance the benefits of migration for destination and origin countries and migrants themselves. Some measures can be taken unilaterally by countries, whereas others require close bilateral or regional coordination. The recommendations are tailored to different types of migration— forced displacement as well as high-skilled and low-skilled economic migration—and from the perspectives of both sending and receiving countries. This report serves as a comprehensive resource for governments, development partners, and other stakeholders throughout Europe and Central Asia, where the richness and diversity of migration experiences provide valuable insights for policy makers in other regions of the world.Publication Lebanon Economic Monitor, Fall 2022(Washington, DC, 2022-11)The economy continues to contract, albeit at a somewhat slower pace. Public finances improved in 2021, but only because spending collapsed faster than revenue generation. Testament to the continued atrophy of Lebanon’s economy, the Lebanese Pound continues to depreciate sharply. The sharp deterioration in the currency continues to drive surging inflation, in triple digits since July 2020, impacting the poor and vulnerable the most. An unprecedented institutional vacuum will likely further delay any agreement on crisis resolution and much needed reforms; this includes prior actions as part of the April 2022 International Monetary Fund (IMF) staff-level agreement (SLA). Divergent views among key stakeholders on how to distribute the financial losses remains the main bottleneck for reaching an agreement on a comprehensive reform agenda. Lebanon needs to urgently adopt a domestic, equitable, and comprehensive solution that is predicated on: (i) addressing upfront the balance sheet impairments, (ii) restoring liquidity, and (iii) adhering to sound global practices of bail-in solutions based on a hierarchy of creditors (starting with banks’ shareholders) that protects small depositors.Publication Argentina Country Climate and Development Report(World Bank, Washington, DC, 2022-11)The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.Publication World Development Report 2006(Washington, DC, 2005)This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.