巴基斯坦卫生融资体系评估：为国家和次国家卫生融资战略对话提供经验基础政策简报（英）2025

Investment Rating - The report does not explicitly provide an investment rating for the health sector in Pakistan Core Insights - The Government of Pakistan has prioritized Universal Health Coverage (UHC) and primary health care access as central goals in its health policy agenda, as outlined in the National Health Vision 2016–2025 [3] - The implementation of the Essential Package of Health Services (EPHS) and the Sehat Sahulat Program (SSP) are significant initiatives aimed at expanding health coverage and improving public health financing efficiency [4][5] - Despite recent increases in public health expenditures, Pakistan's per capita health spending remains low compared to regional averages, indicating a need for further investment and reform [7][40] Summary by Sections Health Financing and UHC - The report emphasizes the need for financing reforms to support the expansion of provincial social health insurance programs and district-level EPHS packages [5] - Current per capita public health expenditures in Pakistan are approximately US$14, significantly below the estimated US$28 needed to finance a comprehensive EPHS [40] Public Health Expenditures - Per capita public health spending varies across provinces, with Sindh at US$10.0, Punjab at US$10.3, Balochistan at US$8.7, and Khyber Pakhtunkhwa at US$7.8 [7] - The South Asia Region average for per capita public health expenditures was US$17.5 in 2017, highlighting that no province in Pakistan meets this benchmark [7] Efficiency and Resource Allocation - The report identifies a historical trend of stagnant public health financing growth, which has recently shifted, with real per capita public health expenditures increasing by approximately PKR 1,000 between FY2011 and FY2018 [8] - There is a significant disparity in health outcomes across provinces, suggesting opportunities for efficiency improvements in health financing [15][16] Health Equity and Out-of-Pocket Expenditures - Out-of-pocket (OOP) expenditures account for 60% of current health expenditures in Pakistan, with rates varying by province, indicating a critical equity concern [33][34] - The cost of medicines and vaccines is identified as the primary driver of OOP expenditures, necessitating targeted health financing interventions [37] Recommendations for Improvement - The report recommends increasing the share of health expenditures allocated to primary health care (PHC) and implementing the EPHS to improve health financing efficiency [22][45] - It suggests conducting feasibility studies on health taxes and soft earmarking to enhance funding for health initiatives [42]