Health sector reform in Pakistan: why is it needed?
OBJECTIVE
The health care system in Pakistan is beset with numerous problems--structural fragmentation, gender insensitivity, resource scarcity, inefficiency and lack of accessibility and utilization. Moreover, Pakistan is faced with a precarious economic situation, burdened by heavy external debt and faltering productivity and growing poverty. These circumstances, on the one hand, underscore the need for innovative health sector reform and, on the other, indicate the complexity of the task involved. The recently announced Devolution Plan of the Government of Pakistan (GOP) that seeks to introduce elected district level local bodies, offers an opportunity to assess the existing publicly funded health care system and introduce far-reaching reforms to make it more efficient and effective.


METHODS
Based on a critical analysis of secondary data from the public domain as well as from various research projects undertaken by the Aga Khan University, the paper intends to present convincing arguments for fundamental health sector reform in Pakistan.


CONCLUSIONS
(a) All factors point to the need for a fundamental reform of the health sector in Pakistan; and (b) the Devolution Plan presents an unique opportunity that must be seized to reshape the health care system and make it more efficient and effective.
Islam
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Department of Community Health Sciences, Aga Khan University, Karachi.
D003906:Developing Countries; D018166:Health Care Reform / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D020380:Needs Assessment; D010154:Pakistan; D011050:Policy Making; D011787:Quality of Health Care