Implementation Gap in Health Policies and Inequities at the Community Level in Khyber Pakhtunkhwa

Abstract

The province of Khyber Pakhtunkhwa (KP) in Pakistan has not been left behind as massive changes have taken place in the health sector especially following the 18th Amendment in the Constitution of Pakistan which devolved the health services and granted more powers to the provincial governments. Despite the efforts of the government in controlling the health inequities and providing universal health cover, there is still a significant implementation gap. The paper outlines the challenges and opportunities that arise due to the devolution of the health responsibilities in KP with references made on how it influences the service delivery in the community level. These findings showed that there were systemic weaknesses in the form of bad governance, inadequate and weak infrastructure, a shortage and weak human resources and disparities in healthcare accessibility especially in rural and marginalized districts. These health policy loopholes have resulted in long-term disparities in health among the population although there have been a number of reform and programs such as the Sehat Sahulat Program that consider boosting the percentage of people that have health insurance cover amongst the low-income brackets. This discussion demonstrates that there is an urgent need to strengthen governance, improved resource distribution, and targeted intervention to address the healthcare needs of underserved areas. In the conclusion of the paper, it is recommended how the gap in implementation may be bridged by making sure that the health financing is reinforced, human resource management is strengthened and the coordination between different levels of governance is improved. The systematic reforms and investments can be of only benefit to the health policies of KP and will lead to equitable provision of healthcare in the province.

Keywords:  Khyber Pakhtunkhwa, Health Policy, 18th Amendment, Devolution, Health Inequities, Universal Health Coverage, Implementation Gap, Sehat Sahulat Program, Governance, Healthcare Accessibility, Rural Health, Marginalized Districts, Health Infrastructure, Human Resources, Health Financing, Health Reforms, Service Delivery, Healthcare Needs, Targeted Intervention, Resource Distribution, Public Health Policy.