Asian Development Bank - Khyber Pakhtunkhwa Health Sector Review: Hospital Care

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KHYBER PAKHTUNKHWA HEALTH SECTOR REVIEW

HOSPITAL CARE

OCTOBER 2019

Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO)

2019 Asian Development Bank

6 ADB Avenue, Mandaluyong City, 1550 Metro Manila, Philippines

Tel +63 2 8632 4444; Fax +63 2 8636 2444

www.adb.org

Some rights reserved. Published in 2019.

ISBN 978-92-9261-764-6 (print), 978-92-9261-765-3 (electronic)

Publication Stock No. TCS190481-2

DOI: http://dx.doi.org/10.22617/TCS190481-2

The views expressed in this publication are those of the authors and do not necessarily reflect the views and policies of the Asian Development Bank (ADB) or its Board of Governors or the governments they represent.

ADB does not guarantee the accuracy of the data included in this publication and accepts no responsibility for any consequence of their use. The mention of specific companies or products of manufacturers does not imply that they are endorsed or recommended by ADB in preference to others of a similar nature that are not mentioned.

By making any designation of or reference to a particular territory or geographic area, or by using the term country in this document, ADB does not intend to make any judgments as to the legal or other status of any territory or area.

This work is available under the Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO) https://creativecommons.org/licenses/by/3.0/igo/. By using the content of this publication, you agree to be bound by the terms of this license. For attribution, translations, adaptations, and permissions, please read the provisions and terms of use at https://www.adb.org/terms-use#openaccess.

This CC license does not apply to non-ADB copyright materials in this publication. If the material is attributed to another source, please contact the copyright owner or publisher of that source for permission to reproduce it. ADB cannot be held liable for any claims that arise as a result of your use of the material.

Please contact if you have questions or comments with respect to content, or if you wish to obtain copyright permission for your intended use that does not fall within these terms, or for permission to use the ADB logo.

Corrigenda to ADB publications may be found at http://www.adb.org/publications/corrigenda.

Notes:

In this publication, $ refers to United States dollars.

On the cover: Hospital bed and overcrowded patients in Khyber Pakhtunkhwa (photos by Mr. Hiddo Huitzing and Michael Niechzial).

Cover design by Francis Manio.

TABLES, FIGURES, AND BOXES

Tables

	Health Facility Network
	Authority Lines and Responsibilities for Health Facilities
	Distribution of Selected Payment Responsibilities across Public Facilities
	Inpatient Admission per 1,000 Population, 20092015
	Outpatient Visits per Capita, 20092015
	Performance Data of the Most Frequented Secondary Level Hospitals, 2017
	Inpatient Services at Surveyed Hospitals
	Projected Demand for Episodes and Capacity for Dialysis, 20202035
	Planned and Filled Health Workforce, 2018
	Health Workforce Composition at Surveyed Hospitals
	Consolidated Current Budget of Health Sector
	Consolidated Allocations by Major Line Items
	Current Health Expenditures by Activities, 20152016
	Consolidated Current Budget and Expenditure of Secondary Care Facilities
A1	Status of Facility Boards
A2	Overview of Phases of the Social Health Protection Initiative (Sehat Sahulat Program)

Figures

	World Health Organizations Dimensions of Health Sector Governance
	Public Health Facilities by Hierarchy of Service Provision
	Health Care System and Service Delivery
	Proportion of Doctors in the Public Sector and Population by Districts, 2017
	Proportion of Nurses in the Public Sector and Population by Districts, 2017
	Good Example of Quality Improvement Tools and Mechanisms (Guidelines/Clinical Pathways) for Patients with Symptoms of Heart Failure
	Flow of Government Funds to Health Facilities
	Sectoral Share of Health Budget Allocations: Trend Analysis
	National Health Accounts, 20152016
	Average Allocation (5 Years) by Items of Expenditure for Secondary Care Hospitals
	Expenditure MixSalary and Non-Salary (Secondary Health Care Facilities)
A1	Elements of a Strong Contract

Boxes

Standards for Intensive Care Unit Adjacencies: Health Building Notes of the United Kingdoms National Health Service
A1	World Health Organization Health Systems Framework and Quality of Care

FOREWORD

The Asian Development Bank (ADB) has been providing technical and financial support to the health sector in Pakistan, particularly the Khyber Pakhtunkhwa Province, for the last 2 decades. ADBs Operational Plan for Health 20152020 identifies three key areas of investment for supporting the developing member countries achieve universal health coverage.

Knowing that good governance guided by a health systems approach promotes effective delivery of health services and that investment in health care leads to economic growth, the Government of Khyber Pakhtunkhwa desires to lead the province in the 21st century with approaches that are in tandem with international best practices, taking guidance from global research and local circumstances. The main strategies for taking forward this intent would be (i) strengthening health systems for better governance; and (ii) collaborating with health and non-health sectors, public and private sectors, and the citizens for a shared vision and interest. Further, delivering quality health care services to all is the goal of the Government of Khyber Pakhtunkhwa, which seeks to improve the health status of an increasing number of citizens on an equal basis through expanded access to effective essential health care, backed by adequate referral services and resources.

Health is coexistent with other sectors such as economy, environment, education, transport, food security, and other non-health sectors. A holistic approach is necessary to achieve the desired objectives of a better performing health sector.

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