Open AccessCan Cost-effective Reallocation of Inputs Increase the Efficiency of the Public Health System in Pakistan?
Author(s) -
M. Aynul Hasan,
Hafiz A. Pasha,
Ajaz M. Rasheed
Publication year - 1997
Publication title -
pakistan development review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.154
H-Index - 26
ISSN - 0030-9729
DOI - 10.30541/v36i4iipp.669-693
Subject(s) - public sector , business , context (archaeology) , public health , investment (military) , public economics , premise , human capital , health policy , capital expenditure , economic growth , economics , health care , finance , political science , medicine , paleontology , linguistics , philosophy , economy , nursing , politics , law , biology
Heavy investment in many developing countries in the socialsector including health is based on the premise that human capital isvital to the growth and development of a nation. However, Pakistan'sspending on this sector has been one of the lowest in the region. In thepresent environment of high budget deficits, one does not expectsubstantial public funds to be forthcoming and diverted towards thesocial sector in the intermediate- or medium-term future. The criticalissue facing the public sector should then be to design health policieswhich must be cost-effective and efficient. This study examines thesehealth policy issues within the context of an optimisation framework forpublic health system, forecasts future upto (2002-03) and discusses anefficient optimal mix of health inputs, outputs, expenditures, and wagepolicies under alternative scenarios. The study recommends that, first,growth of health infrastructure building in the urban areas be sloweddown in the short-term (two to three years), and some of the resourcesreallocated towards the rural sector either in terms of building newBasic Health Units or upgrading the existing Rural Health Centres.Second, not only attractive wage policies be formulated for healthpersonnel, but the status of nurses in the public health system be alsoelevated by giving them higher grades. Third, for every rupee ofdevelopment expenditure incurred, Public Health Department must plan orkeep provisions for recurring outlays. All this reallocation ofresources is feasible within the projected actual budget and it willlead to efficiency gains in the order of 8 to 10 percent for the entirepublic health system.