ISLAMABAD: Taking a momentous decision that is projected to arrest the post-devolution fragmentation of health in Pakistan, the caretaker government has consolidated all key health institutions and health-related functions under the ‘National Health Services, Regulations and Coordination Division’ (NHSRCD). A notification to this effect was issued late Saturday night after caretaker Prime Minister Mir Hazar Khan Khoso approved renaming of the Division of National Services and Regulations as the ‘National Health Services, Regulation and Coordination Division.’ The abolition of the Ministry of Health after introduction of the 18th Constitutional Amendment led to absolute fragmentation of the health architecture at the federal level. All key health institutions were scattered across 8 divisions. Pakistan thus became the only country in the world without a central health structure. Pakistan’s health sector has been in a state of disarray in the two years following devolution, with lack of coordination, disconnect between health information and policy, absence of leadership in health, and obscurities in compliance with international agreements pushing the country’s health profile to dismal lows. The country not only risked international isolation but also a potential travel ban as a result of key failings in the area of communicable disease outbreaks due to disruption of health information flow. Fragmentation of health also severely undermined the federal government’s ability to provide effective health cover to its citizens. Inter-agency turf issues were also rampant due to lack of clarity with respect to roles and responsibilities. Talking to ‘The News,’ the federal government’s focal point on health Dr Sania Nishtar said, “The Federal Legislative Lists Part I and II of the Constitution stipulate national roles in health for which an entity representative of the federation was needed at the federal level; after the measles outbreak, it was amply clear that lack of federal-provincial coordination needed to be addressed as an emergency, which is why a caretaker government had to intervene in this area.” Dr Sania expressed confidence that the renamed division would serve national functions in health in a consolidated manner. She added that the new division will have two functions-regulatory and coordination-related, which are in line with the spirit of the 18th Amendment. The new health structure will help reorganise federal health institutions, and strengthen federal coordination, thereby producing a favourable impact on provincial services as well. Under this structure, the National Institute of Health, the National Health Emergency Preparedness and Response Network, the Pakistan Medical Research Council and the Health Services Academy have been relocated from the Cabinet Division to the renamed division. The coordination of vertical health programmes including interactions with the Global Alliance for Vaccines and Immunization, the Expanded Programme on Immunization and the Global Fund to Fight AIDS, TB, Hepatitis and Malaria have also been relocated from the Inter-Provincial Coordination Division to the renamed division. Other key health functions that have been relocated from the Planning and Development Division and consolidated under the renamed division are: a) planning and development policies pertaining to population programmes in the country; b) matters related to National Trust for Population Welfare and National Institute of Population Studies; c) Directorate of Central Warehouse and Supplies, Karachi; and d) national planning and coordination in the field of health. A long-standing population-health disconnect has been bridged. The Regional Director of the World Health Organization (WHO) Dr Ala Alwan said, “We applaud the decision of the government of Pakistan to consolidate federal responsibilities in the health sector by reducing the fragmentations of health functions at the federal level. This is in line with the recommendations of the multi-partners mission led by WHO.” This is for people of Hafizabad
Posted on: Sat, 08 Jun 2013 10:32:49 +0000