KARACHI: The participants in a pre-budget seminar on public health were informed on Wednesday that the public sector provided health care facilities to just 17 per cent people in Sindh.

They added that a sizeable chunk of 6.6pc people have no health care facilities at all, thus the situation benefited the private sector to thrive which catered to a gigantic 76.4pc people on commercial grounds.

The seminar was organised by a non-governmental organisation, Save the Children, at a local hotel to set proposals for the next year’s health budget.

Muhammad Sabir, principal economist at the Social Policy and Development Centre (SPDC), said of the government’s spending on provision of health care facilities for 17pc people, the poorest of the poor benefited the most (31.3pc).

He segregated the middle and the upper-middle classes in a break-up, however, when put together, they get benefited from the facilities just a fraction less than what the poorest people got (31pc). Even 9.8pc of rich people too relied on the government facilities, he added.

He said health came at fifth on the provincial government’s priorities list and a large amount of funds in budget was spent on salaries of employees.

He added that a large portion of budget (around 80pc) was used for the curative purpose while the allocation for preventive budget was extremely low — an opposite approach to the sector unlike what other countries’ policies.

His calling of the health budget as a ‘pro-poor’ was a notion that many other speakers did not buy.

Dr Riaz Sheikh, who heads the social sciences faculty at the Shaheed Zulfikar Ali Bhutto Institute of Science and Technology (SZABIST), went all-out against the very fabric of the provincial health budget and called it anything but pro-poor.

Speaking about the health sector of the country, he said it was too central and based on the biomedical model (clinical treatments).

He said the country gave little priority and funds to the primary health care, thus it was going against what the rest of the world was doing.

He said every district’s priorities were different and so the policies should be made in conformity with ground realities.

The government had generalised the entire sector leaving some territories flooded with unwanted medicines and facilities while putting other areas in deprivation, he added.

Haris Gazdar of the Collective for Social Science Research spoke about the Sindh’s adopting of the inter-sectorial nutrition strategy.

Appreciating the vision behind the policy, he, however, called some targets as too ambitious — one of those was setting of the goal by the provincial government to get stunting in children dropped by 10pc by 2016; from 50pc now to 40pc.

He said priorities should be correctly set in the coming provincial budget for the health sector to get much from limited resources.

He described the meagre 0.9pc for nutrition in current budget as adding an insult to an injury as that too remained unutilised the entire year.

He said the government allocated Rs1.5 billion for medical colleges and just Rs158 million for the nutrition programme this financial year, which showed their misplaced priorities.

“Money for medical colleges is a subsidy for middle class, which is 10 times higher than a highly crucial programme, which will benefit the poor who live in much bigger numbers than the ones benefited by medical college subsidy,” he added.

Iqbal Detho of the Save the Children said the health sector with an allocated budget of Rs53.4 billion for 2013-14 was among the top four priority sectors last year.

Abid Ali Abbassi, research fellow at the Pakistan Study Centre said health issue was on priority in all political parties, including Pakistan Peoples’ Party, Pakistan Muslim league-N and Pakistan Tehrik-i-Insaf, but there was a disconnect when it came to meeting commitments.

Dr Sahib Jan Badar, head of the Sindh Maternal, Neonatal and Child Health Programme stressed for integration of various programmes and strengthening of community midwives.

Dr Iqbal Memon emphasised the need for vaccination programmes.

Sorth Thebo, a member of the Sindh Assembly from the PML-N spoke about the plight of women and children in Thar.

Syed Nasir Shah, PPP MPA and member of the Sindh Infant Feeding Board, said he would raise the recommendations in the standing committee on finance department.

Published in Dawn, May 22nd, 2014