Policy Making And Implementation Processes Of Public Health Interventions: A Case Study Of Sehat Sahulat Program
Author: Asim Saeed


This study explores the policymaking and implementation processes of the Sehat Sahulat Program (SSP). Using the qualitative research strategy and exploratory research design, this research attempts to understand the policymaking process and implementation through the Stage Heuristic Model of policymaking. The Stage heuristic model explains a policy event in a complete cycle starting from problem identification to policy revision of a specific policy. The data were analyzed using thematic analysis of semi-structured interviews with the stakeholders. A phone-based survey was conducted with the program’s beneficiaries to understand their perception and satisfaction with the initiative. Findings suggest that the purpose of initiating the Sehat Sahulat Program was to address the inadequacy of the existing public health infrastructure in Pakistan and provide financial risk protection to the vulnerable population segment. The federal ministry of health devised this policy with the technical assistance of GIZ, WHO, and SLIC. For implementation, the Program Management Unit (PMU) has been established, which implements the policy with the coordination of SLIC and the district health department. The program is executed in empaneled hospitals in the public and private sectors after a thorough investigation of their quality and standards. SSP has impacted the private healthcare sector the most. Firstly, it has enabled the private sector to improve its quality and outreach across the country and created a competitive environment within the private sector delivering healthcare. Secondly, it was found that the impact of the SSP intervention on the public health sector was not meaningful, and it has no role in improving the service delivery in the public healthcare sector. Thirdly, in achieving Universal Health Coverage milestones for Pakistan, the SSP has impacted the financial risk protection component the most. In contrast, the intervention has not impacted the other components of the UHC and SGD 3.8 targets. Overall, 95 percent of the beneficiaries were satisfied with the treatment they got from the empaneled facilities. Most of the beneficiaries considered the process of acquiring the program’s benefits easy to access, and all of the beneficiaries considered the SSP intervention helpful in reducing their health expenditures. The research findings recommend a legislative, institutional, and financial framework for the sustainability and viability of the program.

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Keywords : Insurance Based Healthcare, Policy Implementation, Policymaking, Sehat Sahulat program, Social Health Protection, Stage Heuristic Model, Universal Health Care
Supervisor: Najam uz Zehra Gardezi

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