Pakistan’s health governance rated poor

Brookings study ranks Pakisan 17th out of 18 nations on Health Governance Capacity Index

LAHORE: Pakistan’s health sector is extremely unhealthy among the 18 economies surveyed by the Brookings institution United States. It scored poorly in leadership and management capacity and health policies; its scores were better in regulations and health systems. 

The countries assessed in the report are Bangladesh, China, Democratic Republic of Congo, Ethiopia, Ghana, India, Indonesia, Kenya, Liberia, Mozambique, Nigeria, Pakistan, Philippines, Sierra Leone, South Africa, Tanzania, Uganda, and Vietnam.

Its neighbouring economies of India and Bangladesh though ranked above Pakistan are also way behind African countries. Bangladesh, the Democratic Republic of the Congo, Pakistan, and Nigeria rank lowest on the HGCI. These nations received low scores on the dimensions of “Management Capacity” and “Health Systems,” indicating that targeted efforts to improve those areas could have a significant impact on their ability to absorb new investments relevant to global health goals. 

Of the 18 countries studied, Vietnam, South Africa, China, and Ghana rank highest on the authors’ Health Governance Capacity Index (HGCI), indicating that these nations have a strong ability to attract and leverage private investment in health R&D. The researchers empirically assess what they call “overall health governance capacity” by examining 25 indicators related to the management capacity, regulatory processes, health infrastructure and financing, health systems, and policy conditions in each of the 18 examined nations.

The ranking is based on various dimensions including leadership and management capacity, health policies, regulations and health systems. Each dimension is scored out of 20 possible points. Thus, Pakistan received 54 out of 100 total possible points on the HGCI. On the basis of this Pakistan is ranked 17th out of 18 nations on the Health Governance Capacity Index (HGCI) that calls for efforts to remove flaws in its system.. Its scores on each dimension are as follows sector global health R&D investors, and offers policy solutions that can boost those returns. . Among their key findings are many facts that are relevant to stakeholders and policymakers in Pakistan.

On Leadership and Management Capacity Pakistan’s score was 40 percent of 20 possible points. Its subsections included Political Stability Index where its score was ¼ out of possible 100 points, On Transparency International Corruption Index its score was2/4. Its score was 2/4 on Net Official Development Assistance (ODA) received by the country as percentage of GNI. Poor foreign direct investment flows reduced its score on this count to ¼. On external resources as percentage of GDP its score was 2/4.

Pakistan’s health policies fetched the country 45 percent points. In its sub-dimension of rule of law it got 2/4 points, poor immunization of population reduced its score in this sub-dimension to 1/4.  High evel of tariff on imports of pharmaceutical products resulted in score of ¼. The tariff on medicines imports according to the report is higher than both India and Bangladesh. On Intellectual Property rights its score was 2/4 and on being free from patent restriction on manufactured drugs the score was better at ¾.

On the dimension of regulation Pakistan’s overall score was better at 65 percent. In its sub-dimensions its scored 2/4 on regulatory quality, 2/4 on business climate, only ¼ on health expenditure as percentage of GDP. It got 100 percent on international health regulation scoring 4/4. The same score of 4/4 was awarded for having a drug regulatory authority.

Pakistan scored 55 percent on Infrastructure and Financing. On overall level of statistical capacity it obtained ¾, access to electricity 4/4, private health expenditure 2/4, out of pocket expenditure ¼, private insurance ¼.

On Health Systems country got a score of 65 percent in which score on nurses and midwives per 1000 people was 2/4, physicians per 1000 people 4/4, infant mortality per 1000 live births ¼ , life expectancy at birth ¾ and population at risk of malaria ¾.

The Brookings Private Sector Global Health R&D Project report seeks to find ways to address investment shortfall in health sector. The project recognizes the need to complement the research on the social returns to global health R&D by examining the potential financial returns to private

In general, low- and middle-income countries can attract greater private investment in health R&D by increasing government transparency and stability, lowering tariffs on medical products, expediting the regulatory process for new drugs, investing in health infrastructure, and increasing government spending on health care (to the amount fiscally possible) in an efficient and targeted manner.