ISLAMABAD: After years of controversies over health issues and disagreements over the regulation of health departments, the federal and provincial governments have finally agreed on a common National Health Vision (NHV) for the entire country.

Endorsed by representatives of all provinces and federating units, the NHV provides a road map to improve the health of all Pakistanis — particularly women and children — by improving universal access to essential health services.

The vision also brings the country’s provincial and federal health policy frameworks in line with international health treaties, commitments and regulations, to which Pakistan is a signatory.

The document, which incorporates input from the private sector, donors, UN agencies, academia and public sector stakeholders, was unveiled by Minister of State for National Health Services (NHS) Saira Afzal Tarar at a press conference on Tuesday.

Accompanied by the health ministers of Balochistan, Khyber Pakhtunkhwa and Sindh, as well as a representative of the Punjab government, the minister said the last national health policy was approved in 2001. While a draft policy was developed in 2010, it was not approved due to the ongoing process of devolution.

National Health Vision aims to make healthcare policies uniform across country

The development of this document started in mid-2015 and extensive consultations were held with all stakeholders. The process began with meetings with provincial health ministers and their teams, the objective of which was to generate consensus for a common national vision on health, she said.

This was followed by technical consultative meetings with all stakeholders, which helped determine the roles and responsibilities, as well as enhancing coordination between the federal ministry and provincial health departments.

The NHV is in line with Vision 2025, international health priorities and based on provincial realities within the framework of constitutional roles in the post-18th Amendment scenario, Ms Tarar said.

“The aim is to achieve universal health coverage, resulting in a fairer, more efficient [system of] health financing that pools risk and shares costs equitably,” she added.

The vision also includes a monitoring and evaluation mechanism, conducted through an inter-provincial health and population council. The council will be responsible for overseeing the vision’s implementation and will endorse reports that will be presented to parliament on an annual basis, the minister said.

The document will now be placed before the Council of Common Interests (CCI) for final approval.

Talking to Dawn, former health minister Dr Sania Nishtar extolled the need for a national healthcare vision, which was necessitated by the governing structures of healthcare delivery in Pakistan.

Dr Nishtar, who authored the seminal 2010 paper ‘Health and the 18th Amendment: Retaining National Roles in Devolution’, was also responsible for the creation of the current Ministry of National Health Services following the passage of the 18th amendment.

“Health was largely devolved after the 18th amendment with the provinces [being] autonomous in their prerogative to [make] health policies as they deem fit. But there are important national roles — information, regulation, coordination and compliance with international agreements — which are the responsibilities of the NHS ministry under the mandates outlined in the federal legislative lists,” she said.

“There are complex federal-provincial inter-dependencies involved in the execution of health policies. For that reason, it is critical for the NHS ministry and the provinces to be on the same page,” she said.

Welcoming the unveiling of the NHV as a welcome step, Dr Nishtar said the policy took a “health systems-based vision, which is required to take forward the international commitments Pakistan has made in relation to the Sustainable Development Goals, particularly Goal 3, which relates to healthcare”.

Published in Dawn, August 31st, 2016