This case study was published on 8 December 2022 as part of the WHO delivering results and making an impact: stories from the ground report, which presents a snapshot of how WHO has delivered on its mission in countries and contributed to health outcomes across a wide range of issues during 2020-2021.
In 2018, Pakistan signed the UHC2030 Global Compact,committing to advancing universal health coverage (UHC) as part of the country’s efforts to achieve health-related Sustainable Development Goals (SDGs).
The Government of Pakistan recognizes the fundamental role of primary health care (PHC) in achieving UHC. In view of the dire need for PHC reforms and the country’s recent commitments, international partners came together to agree on the Global Action Plan for Healthy Lives and Well-being for All (SDG3 GAP) agenda. Pakistan has been prioritized by SDG3 GAP for intensified support under two accelerator themes: PHC and sustainable financing for health.
How did Pakistan, with the support of the WHO Secretariat, achieve this?
In view of Pakistan’s commitment to the SDGs and UHC, the WHO Country Office in Pakistan took the lead in establishing an SDG3 GAP coordination committee to enhance and harmonize coordination among partners engaged in the health sector. Further, two technical working groups for PHC and sustainable health financing were established to provide technical support to the committee.
Members of the SDG3 GAP coordination committee in Pakistan comprise WHO (as chair and secretariat); the Gavi Alliance; the Global Financing Facility; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Joint United Nations Programme on HIV/AIDS (UNAIDS); the United Nations Children’s Fund (UNICEF); the United Nations Population Fund; and the World Bank Group. The coordination committee and related technical working groups convene regular meetings to align and accelerate their support, monitor progress and exchange information on recent initiatives. At the most recent meeting, partners acknowledged that the committee was a useful forum for exchanging information for alignment and committed to remaining engaged for the provision of coordinated support to the country.
The WHO Country Office in Pakistan is leading SDG3 GAP coordination at the country level. WHO organized a high-level “primary health care for universal health coverage” (PHC4UHC) mission on 1–5 March 2021, which united eight SDG3 GAP partners in Pakistan to review the status of PHC and sustainable health financing and advise on a model of care to ensure effective implementation of the UHC Benefit Package. The Director of Universal Health Coverage and Health Systems at the WHO Regional Office for the Eastern Mediterranean led the mission, which concluded with a high-level national PHC4UHC forum where representatives from federal and provincial levels, as well as the eight SDG3 GAP partners, signed a joint statement in support of enhancing PHC towards UHC in Pakistan.1
After endorsement of the UHC Benefit Package/essential package of health services2 in October 2020, SDG3 GAP partners supported Pakistan in the development of documents on a provincial/area-specific essential package of health services. Three provinces have already endorsed the package, and the remaining provinces are expected to endorse it soon.
WHO is providing technical and financial support to the Government of Pakistan through a grant provided by the Government of Canada for the pilot implementation of the UHC Benefit Package through a PHC-oriented model of care in two districts (Islamabad Capital Territory and Charsadda). The project support was envisaged to be provided over a four-year period in a phased manner. The first phase was implementation in those two districts from 1 April 2021 to 31 May 2022, which was later extended till September 2022. This phase primarily focused on integrating a holistic health approach and intersectoral collaboration to optimize all health interventions, while addressing the social determinants of health. All SDG3 GAP partners and government stakeholders were engaged in brainstorming the key elements of the proposed model of care. WHO regularly exchanged progress with partners at periodically convened technical working group meetings.
The successful implementation of the model of care will present an example that can be replicated in other districts for implementing the UHC Benefit Package to expand UHC in the country. Given the size of the population (about 230 million), success of the model in general and of UHC expansion in particular is crucial to achieving the target of 1 billion more people benefiting from UHC globally.
References
- Primary health care for universal health coverage in Pakistan: a joint statement. Islamabad: WHO Regional Office for the Eastern Mediterranean; 2021 (accessed 22 July 2022).
- Essential package of health services at community and primary healthcare centre level based on Disease Control Priorities-3. Islamabad: Ministry of National Health Services Regulations and Coordination; 2020 (accessed 22 July 2022).
Source: WHO
