PESHAWAR, Jan 7: Dependence on several departments regarding plans and strategies and lack of interest on part of political leadership have been hampering the reform process started by the health department, experts say.

“We have to look towards finance, planning and development and other line departments for devising projects and programmes to improve patient care.

The health department has not been able to achieve desired benefits from the reform process,” they said.

The United States Agency for International Development, as part of its support to the Women Health Project in the province, had offered training scholarships in healthcare financing and administration to 10 doctors in the UK and Germany.

When those doctors returned, they said healthcare delivery could be improved by putting in place new strategies and mechanisms.

Sources said a task force on health, under the deputy speaker of the provincial assembly, had underlined the need for preparing plans to improve referral system, develop health model, area focused approach and clear direction, but the then government ended in 1999.

They said the reform process went into background and a need was felt to reorganise the provincial director-general office in view of the Local Government Ordinance (LGO) that provided for decentralisation of power at the district level.

The district, they said, had no capacity and would need support to facilitate implementation of the LGO and save the system from failure.

So, they added, a three-year project, Health Sector Reforms Unit (HSRU), was designed with a view to improving access to quality healthcare, facilitating devolution of power to the districts in line with the LGO and devising ways for development of human resources and healthcare financing.

The project, the sources said, received only Rs12 million against its projected cost of Rs72 million according to PC-1.

They said the idea was presented at the Pakistan Development Forum where the GTZ, a German agency, showed interest and extended support to the HSRU in the shape of Support to Health Sector Reforms that aimed at helping the department in introducing reforms in eight selected districts.

The GTZ was supposed to help the HSRU in development of standards for quality healthcare, strengthening the role of the Health Regulatory Authority, making a plan for granting financial and administrative autonomy, making annual work plan for staff training and devising a mechanism for space analysis in implementation of the projects and programmes of the health department, they said.

From 2002, the HSRU operated with two technical persons because it lacked money to hire chief and deputy chief and other staff till the approval of another three-year PC-1 of Rs30 million, which enabled it to raise the staff strength to nine.

The sources said the GTZ support failed to gain any marked improvement in the reform process because it concentrated mainly on training of health officials and ministers in Germany, UK and Australia etc.

The health department, they said, depended on many departments that it could not pursue its plans for development of human sources, training of staff and starting projects according to its own needs.

Also, the sources said, lack of interest by the minister and other political leadership had made the HSRU a dormant body.

Despite all these bottlenecks, they said, the HSRU had prepared different plans, including social health insurance scheme for government employees and other micro development plans at district and provincial levels, but things could not be done to a desired level.