Skip to main content
SpringerLink
Log in

Decentralization Reforms in the Public Health Sector in Pakistan

  • Chapter
  • First Online:
Public Sector Reforms in Pakistan

Part of the book series: Public Sector Organizations ((PSO))

Abstract

This chapter highlights the major administrative decentralization reforms and the current structure of the public health system in Pakistan. Specifically related to the public health sector, decentralization has widely practiced reforms in both developed and developing countries. These reforms were also initiated in Pakistan to restructure the public health sector and improve service delivery and performance. Having outlined decentralization reforms at provincial level, they critically assess the implementation of these reforms in two provinces (Punjab & KPK) and relate it to the typologies of management mechanisms adopted during each reform. The chapter is based on secondary data sources, including research articles, government documents, WHO reports and website reviews. It provides a fresh way to analyze systematic decentralization reforms in the public health sector in Pakistan and further highlights that hierarchy-type mechanisms have been a prominent trend with some flavor of market- and network-type mechanisms seen in the decentralization reforms in the public health sector of Pakistan.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    These vertical programs include Basic Support of Immunization, TB-DOTs, HIV AIDS Control, Avian Flu, Hepatitis B and C Control, Malaria Control, Maternal and Child Care, Family Planning, Nutrition, and Lady Health Workers.

References

  • Abdullah, M. T., & Shaw, J. (2007). A review of the experience of hospital autonomy in Pakistan. International Journal of Health Planning and Management, 22(1), 46–64.

    Google Scholar 

  • ADB. (2019). Khyber Pakhtunkhwa Health Sector Review: Hospital Care. Asia Development Bank. Retrieved April 25, 2021, from https://policycommons.net/artifacts/392521/khyber-pakhtunkhwa-health-sector-review/

    Google Scholar 

  • Awortwi, N. (2010). The past, present, and future of decentralization in Africa: A comparative case study of local government development trajectories of Ghana and Uganda. International Journal of Public Administration, 33(12–13), 620–634.

    Article  Google Scholar 

  • Barasa, E. W., Manyara, A. M., Molyneux, S., & Tsofa, B. (2017). Recentralization within decentralization: County hospital autonomy under devolution in Kenya. PLOS ONE, 12(8) https://doi.org/10.1371/journal.pone.0182440

  • Bossert, T. J., & Beauvais, J. C. (2002). Decentralization of health systems in Ghana, Zambia, Uganda and the Philippines: a comparative analysis of decision space. Health. Health Policy and Planning, 17(1), 14–31.

    Article  Google Scholar 

  • Bouckaert, G., Peters, B. G., & Verhoest, K. (2010). Coordination: What is it and why should we have it? In The coordination of public sector organizations. Palgrave Macmillan.

    Chapter  Google Scholar 

  • Chaudhary, A. (2021, March 16). Policy Board formed to oversee functions of hospitals. Dawn News. https://www.dawn.com/news/1614634/policy-board-formed-to-oversee-functions-of-hospitals

  • Dan, S. (2014). The effects of agency reform in Europe: A review of the evidence. Public Policy and Administration, 29(3), 221–240.

    Article  Google Scholar 

  • Global Health Workforce Alliance: Pakistan. (2012, November 30). Retrieved May 7, 201, from http://www.who.int/workforcealliance/countries/pak/en/

  • Government of KPK. (2017). KPK Medical Teaching Institutions Reforms (Amendment) Act, : Department of Health KPK. Retrieved July 7, 2021, from http://www.pakp.gov.pk/2013/acts/the-khyber-pakhtunkhwa-medical-teaching-institutions-reforms-amendment-act2017/

  • Government of KPK. (2018). Khyber Pakhtunkhwa Health Strategy Plan. Department of Health KPK. Retrieved April 9, 2018, from http://kp.gov.pk/uploads/2017/11/KP_Public_Health_Forecasting_SC_Strategy_pdf

  • Government of Punjab. (2003). The Punjab Medical and Health Institutions Act. Department of Health Punjab. Retrieved March, 2019, from http://punjablaws.gov.pk/laws/463

  • Government of Punjab. (2018). The Punjab health care facilities management Company, : Department of Health Punjab. Retrieved July 7, 2021, from http://phfmc.punjab.gov.pk/health-facilities/

  • Government of Punjab. (2020). The Punjab Medical Teaching Institution(reform)Act, : Department of Health Punjab. Retrieved May 10, 2020, from http://punjablaws.gov.pk/laws/2760.html

  • Hassan, A., Mahmood, K., & Bukhsh, H. (2017). Healthcare system of Pakistan. International Journal of Advanced Research and Publications, 1(2), 170–187.

    Google Scholar 

  • Javed, T. A., & Amin, S. (2007). Health sector reforms programme in Punjab: A primary healthcare initiative. Clinical Medicine, 7(1), 19–22.

    Article  Google Scholar 

  • Khan, I. (2010). Public sector institutions, politics and outsourcing: Reforming the provision of primary health care in Punjab, Pakistan. Journal of International Development, 22(4), 425–440.

    Google Scholar 

  • Khan, S. (2019). Situation analysis of health care system of Pakistan: Post 18 amendments. Health Care Current Reviews, 7(3), 22–44.

    Article  Google Scholar 

  • Malik, A., Poel, E., & Doorslaer, E. (2017). Did contracting effect the use of the primary health care units in Pakistan? Health Policy and Planning, 32(7), 1032–1041.

    Article  Google Scholar 

  • Mashhadi, S., Hamid, S., Roshan, R., & Fawad, A. (2016). Healthcare in Pakistan – A systems perspective. Pak Armed Forces Medical Journal, 6(2), 136–142.

    Google Scholar 

  • Nishtar, S. (2011). Health and the 18th amendment. In Retaining national functions in devolution: Heart file, 2011.

    Google Scholar 

  • Pollitt, C., & Bouckaert, G. (2017). Public sector reform: A comparative analysis. University Press.

    Google Scholar 

  • Provan, K. G., & Huang, K. (2012). Resource tangibility and the evolution of a publicly funded health and human services network. Public Administration Review, 72(3), 366–375.

    Article  Google Scholar 

  • Qazi, M. S., & Ali, M. (2009). Pakistan’s health management information system: Health managers’ perspectives. Journal of Pakistana Medical Association, 59(1), 10–39.

    Google Scholar 

  • Salman, Y. (2015). Ph.D. Dissertation. Public management reforms in developing countries: The case of health sector reforms in Punjab. Edinburgh Research Archive.

    Google Scholar 

  • Shaikh, S., Naeem, I., Nafees, A., Zahidie, A., Fatmi, Z., & Kazi, A. (2012). Experiences of devolution in district health system of Pakistan: Perspectives regarding needed reforms. Journal of Pakistan Medical Association, 62(1), 28–33.

    Google Scholar 

  • Smith, B. (1997). The decentralization of health care in developing countries: Organizational options. Public Administration and Development, 17(2), 399–412.

    Article  Google Scholar 

  • Smoke, P. (2015). Managing public sector decentralization in developing countries: Moving beyond conventional recipes. Public Administration and Development, 35(4), 250–262.

    Article  Google Scholar 

  • Suhail, A. (2021). HR Autonomy in public hospitals in Pakistan: Increased employee outcomes and performance or myth adopted? (ISBN 9789075376654 Doctoral thesis, KU Leuven.

    Google Scholar 

  • Suhail, A., & Azhar, A. (2016). Managing human resources in public health care system in South Asia: Case study of Pakistan. South Asian Journal of Human Resources Management, 3(1), 75–83.

    Article  Google Scholar 

  • Tarin, E., & Omar, M. (2009). Policy process for health sector reforms: A case study of Punjab Province (Pakistan). International Journal of Health Planning and ßManagement, 24(4), 56–70.

    Google Scholar 

  • Torrisi, G., Andy, P., Tomaney, J., & Vassilis, T. (2013). Defining and measuring decentralization: A critical review. Munich Personal RePEc Archive, 51441, posted 16. Retrieved July 7, 2021, from https://mpra.ub.uni-muenchen.de/51441/

  • Turner, M. (2002). Choosing items from the menu: New public management in Southeast Asia. International Journal of Public Administration, 25(3), 1493–1512.

    Article  Google Scholar 

  • Zahra, A. (2020). Structural Reforms and Performance Management systems: An exploratory analysis of State Organizations in Pakistan. Doctoral Dissertation, KU Leuven Public Governance Institute, Belgium. https://lirias.kuleuven.be/3172020?limo=0

  • Zaidi, S., & Idrees, N. (2016). Primary health care system (PRIMASYS) case study from Pakistan. G. World Health Organization.

    Google Scholar 

  • Zaidi, S. A., Bigdeli, M., Langlois, E. V., Riaz, A., Orr, D. W., Idrees, N., & Bump, J. B. (2019). Health systems changes after decentralization: Progress, challenges and dynamics in Pakistan. BMJ Global Health, 4(1). https://doi.org/10.1136/bmjgh-2018-001013

Download references

Author information

Authors and Affiliations

  1. Department of Human Resource Studies, Tilburg University, Tilburg, The Netherlands

    Aneeqa Suhail

  2. Department of Punjab Primary and Secondary Healthcare, Government of Punjab, Lahore, Pakistan

    Awais Gohar

  3. Public Governance Institute, Katholieke Universiteit Leuven, Leuven, Belgium

    Trui Steen

Authors
  1. Aneeqa Suhail
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Awais Gohar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Trui Steen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aneeqa Suhail .

Editor information

Editors and Affiliations

  1. Public Governance Institute KU Leuven, Leuven, Belgium

    Abiha Zahra

  2. Public Governance Institute KU Leuven, Leuven, Belgium

    Geert Bouckaert

  3. Institute of Administrative Sciences, University of the Punjab, Lahore, Pakistan

    Muhammad Zafar Iqbal Jadoon

  4. Institute of Administrative Sciences, University of the Punjab, Lahore, Pakistan

    Nasira Jabeen

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Suhail, A., Gohar, A., Steen, T. (2022). Decentralization Reforms in the Public Health Sector in Pakistan. In: Zahra, A., Bouckaert, G., Zafar Iqbal Jadoon, M., Jabeen, N. (eds) Public Sector Reforms in Pakistan. Public Sector Organizations. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-96825-0_9

Download citation

Publish with us

Policies and ethics

Search

Navigation