ascNewsflash

A health-sector think tank

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Viewpoint 30 - Budget – five points under the health lens [June 26, 2008]

A new viewpoint entitled “Budget – five points under the health lens” published in The NEWS International on Saturday, June 21, 2008 is accessible as usual on the Forum website http://heartfile.org/viewpoint.htm.

Best regards

Sania

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Viewpoint 28 - Honing the 100-day agenda and Viewpoint 29 - Pakistan's Covert Cartels [June 9, 2008]

Dear Members of the Health Policy Forum,

Please note that two new viewpoints # 28 and 29 entitled “Honing the 100-day agenda” and “Pakistan’s Covert Cartels” published in The NEWS International on Sunday, April 06, 2008 and Thursday, May 22, 2008 respectively are accessible as usual on the Forum website http://heartfile.org/viewpoint.htm.

Best regards

Sania

33

Announcement [March 12, 2008]

Dear Members of the Health Policy Forum,

A doctorate student by the name of Katrina Amna Ronis is undertaking her research thesis from Flinders University, Australia; she is also concurrently based at Heartfile as our Senior Public Health Officer. Katrina’s thesis is focused on Pakistan’s Health Policy Forum; as part of her research she will be ascertaining whether the Forum has achieved its stated objectives and whether it is a model for replication. As part of her research Katrina has designed a questionnaire using the software programme surveymonkey.com. I would like to take this opportunity to inform you that this questionnaire will be emailed to all Forum members within in the next week or so.

It would be advantageous for the Forum to have the findings from this survey; the insights that her research will yield can also be instructive to the restructuring of the forum, which as you know is currently underway. I would therefore encourage your participation in this evaluation. Katrina will shortly be in touch with further details in this regard.

With regards, Sania

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Viewpoint 25: Political party manifestos – a sectoral insight [February 16, 2008]

Dear Members of the Health Policy Forum,

Please note that the recent viewpoint entitled  “Political party manifestos - a sectoral insight” published in The NEWS International on Saturday, February 16, 2008 is accessible as usual on the Forum website http://heartfile.org/viewpoint.htm as viewpoint 25.

Best regards

Sania

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Viewpoint 24: The Social Sector – telling evidence [January 30, 2008]

Dear Members of the Health Policy Forum,

Please note that the recent viewpoint entitled  “The Social Sector – telling evidence” published in The NEWS International on Wednesday, January 30, 2008 is accessible as usual on the Forum website http://heartfile.org/viewpoint.htm as viewpoint 24.

Best regards

Sania

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Viewpoint no. 23: Corruption: the need-greed equation [December 19, 2007]

Dear Members of the Health Policy Forum,

Please find enclosed herewith a recent viewpoint entitled as “Corruption: the need-greed equation” published in The NEWS International on Sunday, December 09, 2007. This is accessible as Viewpoint 23 on the Forum website http://heartfile.org/viewpoint.htm

Best regards

Sania

29

GETTING THE FACTS STRAIGHT ON HIV/AIDS [December 19, 2007]

From: Frank White [mailto:Frank.White@Dal.Ca]

Sent: Friday, December 07, 2007 4:58 PM

To: editor@dawn.com

Cc: sania@heartfile.org

Subject: GETTING THE FACTS STRAIGHT ON HIV/AIDS

Seriously incorrect information on HIV/AIDS was presented in the November 5th issue of Dawn, which stated (page 3) that Pakistan has moved to "high prevalence" from "low prevalence".  To the contrary, it has moved from "low prevalence" to the category of a "concentrated epidemic" so far restricted mostly to high risk groups, particularly injecting drug users, as well as commercial sex workers. This is very different from the category of "high prevalence" (which applies to advanced epidemics, as seen (for example) in many African countries and to some in south-east Asia. The article also states that "in Pakistan, blood transmission accounts for 80% of the HIV cases". This also is false information; while it is critically important to protect the blood supply, the majority of infections (as noted) are in high risk groups.

Factually correct information is vital to understanding where Pakistan stands in relation to the spread of HIV, and the paramount need to prevent its spread from high risk groups to the general population. Pakistan still has time to avert a widespread epidemic: protecting the blood supply is only one among several strategies; as in all countries, behavioural intervention strategies including risk and harm reduction measures are of critical importance.

Franklin White MD

formerly Chair, Community Health Sciences, AKU President, PacificSci <www.pacificsci.org>, Canada Pakistan Health Policy Forum, Islamabad

Frank White [mailto:Frank.White@Dal.Ca]

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Viewpoint no. 22:   Does corruption lurk in the health sector of Pakistan? [August 9, 2007]

Dear Members of the Health Policy Forum,

Please find enclosed herewith a recent viewpoint of Pakistan’s Health Policy Forum entitled as “Does corruption lurk in the health sector of Pakistan?” which appeared in THE NEWS INTERNATIONAL on Sunday August 05, 2007. This is accessible as usual on the Forum website http://heartfile.org/viewpoint.htm

Best regards

Sania

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 Viewpoint no. 21:  Disease Diplomacy [August 2, 2007]

Dear Members of the Health Policy Forum,

Please find enclosed herewith a recent viewpoint of Pakistan’s Health Policy Forum entitled as “Disease Diplomacy” which appeared in THE NEWS INTERNATIONAL on Sunday July, 11^th 2007. This is accessible as usual on the Forum website http://heartfile.org/viewpoint.htm

Best regards

Sania

25

Launch of Gateway Paper II – Health Indicators of Pakistan [June 28, 2007]

Dear Members of the Health Policy Forum,

I am pleased to be communicating this newsflash to you which announces the launch of  Gateway paper II entitled “ Health Indicators of

Pakistan”. This book was launched by Prime Minister Shaukat Aziz on June 26, 2007; details about the launch can be accessed through our homepage http://heartfile.org  whereas the pdf version of the document is posted at http://heartfile.org/gwhiop-doc.htm

Copies have already been posted to all members of the forum and limited number of additional copies can be made available be sending a request to aamra@heartfile.org

Many thanks to those of you who shared their data and helped review sections.

With regards, Sania

24

Newsflash - Launch of the Gateway Paper 2 [June 23, 2007]

Dear Members of the Health Policy Forum,

I am pleased to be inviting you the launch of the Second Gateway Paper entitled “Health Indicators of Pakistan”. Many of you have been involved in providing your valuable inputs/sharing data and I am extremely grateful to you for all your contributions.

Gateway Paper II serves many purposes; firstly, it constitutes the situational analysis for the draft of the upcoming national and provincial health policies, work on which is close to completion. The publication sets forth a set of health indicators and reflects data collected from various data sources in the country as these indicators. In doing so, it also yields information of relevance to the health information systems of Pakistan in addition to health status. It therefore offers recommendations to strengthen Pakistan’s health information system and forms a template for periodic reporting of health indicators within the country – the collaboration with the Federal Bureau of Statistics will ensure institutional linkages for that purpose.

The launch is scheduled to be held on June the 26^th at 11.30 am at the Prime Minister’s secretariat in Islamabad. The event is scheduled to last an hour and a half. We have courier posted invitations to all member of the Forum and this note is in addition to that. For any queries I or Azhar Iqbal (azhar@heartfile.org; 0300 8543686) can be contacted.  

We look forward to welcoming you.

With regards, Sania

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Viewpoint no. 20:   How "healthy" is our budget 2007? [June 18, 2007]

Dear Members of the Health Policy Forum,

Please find enclosed herewith a recent viewpoint in relation to budgetary allocations for health in the National budget of 2007. Entitled "Health and the budget 2007 – How "healthy" is our budget?", the article appeared in THE NEWS INTERNATIONAL on Sunday June, 10 ^th 2007 and is accessible, as usual, on our website http://heartfile.org/viewpoint.htm

Best regards

Sania

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Invitation to Post Gateway Stakeholders meeting on Disabilities in Karachi, 27 January 2007 [January 16, 2007]

As you are aware, Heartfile is currently hosting a number of Health policy networking meetings with stakeholders as part of the development of a new health policy which is being based on the Gateway Paper’s approach to health systems; members of the Health Policy Forum are participating in this effort.  

As an active member of the Health Policy Forum, Murshid Hospital and Health Care Centre (MHHCC), Karachi is proactively partnering in this effort to mainstream the policy perspective of disabilities into the new policy. We are committed to a ‘reduction in excess mortality, morbidity, and disability and especially in poor and marginalized populations.’^[1]   Murshid Hospital and Health Care Centre has taken small steps in our chosen strategic directions laid down in the Plan.  The October 8 earthquake disaster prompted many knee-jerk reactions to help the traumatized survivors.  Although the response of MHHCC Board to reach out to the physically challenged persons in the devastated areas was an emotional one, it followed the key ingredients of PHPF’s Strategic Plan, posted at http://heartfile.org/pdf/phpf_Strategic_plan.pdf

You are invited to a stakeholders meeting on Saturday, January 27, 2007 at 3:00pm at the Pearl Continental Hotel, Karachi.  A detailed programme is included below.  CHAL in coordination with six Rotary Clubs of Karachi are co-hosts of this meeting with PHPF.  CHAL, is a network anchored in MHHCC and comprises of existing rehab units and professionals committed to serving the disabled in the quake hit areas.  CHAL is supported by international relief agencies, local corporate sector, NGOs and philanthropists.  It has established two remote rehab centres in collaboration with Pakistan Institute of Prosthetic & Orthotic Sciences.  Financial support to sustain these centres for three years is assured.  In the meantime, efforts are underway to build capacity and empower the local communities to take ownership of these centres.

Lack of such critical essential facilities in the country in general will severely hamper us to attain our stated goal.  CHAL has, with the collaboration of six Rotary Clubs of Karachi and PHPF invited stakeholders to a meeting in Karachi to discuss the ways forward to upgrade or establish workshop/s and also consider initiating a BSc programme certified by the International Society of Prosthetics & Orthotics (ISPO).  Ultimately this initiative is intended to be rolled out nationally to support existing rehab service providers.

In this role, MHHC and Chal, as members of the forum are truly operating within the spirit of the Forum to act as civil society mechanisms for fostering change within the health sector, helping institutionalize change, and bringing stakeholders on board to assist in this effort.

Confirmations/requests for assistance may please be sent to Rotarian Nisar Shaikh, details are given below after the programme.

Haamid Jaffer

Member, Health Policy Forum

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Viewpoint 17: A new paradigm for regulating drugs and pharmaceuticals [January 7, 2007]

Dear Members of the Health Policy Forum,

Please find enclosed herewith a recent viewpoint of Pakistan’s Health Policy Forum on the role of “the Drug Regulatory Authority” which appeared in THE NEWS INTERNATIONAL on Sunday January, 7^th 2007. This is accessible as usual on the Forum website http://heartfile.org/viewpoint.htm

Best regards

Sania

Best regards

Sania

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Viewpoint no. 14, 15 and 16 [November 16, 2006]

Dear Members of the Health Policy Forum,

I am pleased to inform you that the next three viewpoints of the Health Policy Forum have been published and can be accessed through http://heartfile.org/viewpoint.htm.  The themes are contemporary and their titles appear as under:

16. Dengue and its likes – long term context, Sunday, November 05, 2006

15. Opening the insurance market – the health perspective, Sunday, October 01, 2006

14. “Playing” Social Protection with a new stack of cards!, September 2006

Best regards

Sania

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Comments Re: Viewpoint 11 [September 27, 2006]

Dear Members,
Please see Dr Tasleem Akhtar’s response on the BHU restructuring comment by the Minister of Health of NWFP.
Dear Sania,
The suggestions given by Mr. Inayatullah are in line with the concept of Primary Health Care and need to be implemented. The PMRC Health Systems Research Project in village Budhni, Peshawar District has established a Primary Health Care Centre which through a collaborative strategy has been implementing the various components of PHC along with Health Systems Research to document the impact of the interventions introduced. The project has established collaboration with the community, NGOs and public sector departments working in the area. Hand pump wells and pour flush latrines have been introduced in collaboration with Public Health Engineering Department. School boundary walls and toilets have been built in collaboration with Education Department and Public Health Engineering Department. Women Literacy and Skill centre has been established in collaboration with APWA.99% immunization coverage has been achieved in collaboration with EPI and contraceptive use has been increased in collaboration with Population Welfare Department.
As suggested by Inayatullah, PHC level curative services are being provided by Paramedics and LHVs. But leadership has been provided by the Sociologist who has been incharge of the project. The projects impact has been recorded in a recently released report. Infant mortality, which was 88/100 at the start of the project in 1986 has been reduced to 44. Immunization coverage has gone up from less han 30% to over 90%. No cases of neonatal tetanus have been recorded since 1998.
The projects message is that PHC can be achieved if you have leadership at the community level. The incharge of the BHU can give such leadership. The incharge maybe a doctor or any other senior level professional who can acquire community respect and trust and who can link up with other departments and convince and facilitate them to effectively provide their services to the community. This requires a clear job description and necessary training for the BHU incharge. I am told that the Medical Officer incharge of BHU is an ex-officio member of the Union council. This provides him/her the opportunity of being an leader in the community.
Best regards,
Tasleem

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Comment Re: Viewpoint 11 [September 26 , 2006]

Dear Members of the Health Policy Forum,
Please find enclosed herewith feedback on Viewpoint 11 ► (Restructuring Basic Health Units in Pakistan - posted at http://heartfile.org/viewpoint.htm ) by the Minister of Health of NWFP, Inayatullah Khan.
Comments from the Minister:
Dear Sania Nishtar,
I have gone through your reflections on RYK model and I fully agree with you that there can be more than one options and to me one such solution is as follow:
One, abolish the post of doctor from BHU and covert it into a real PHC center for promotion of healthy life style and prevention of diseases with minimum necessary focus on curative side, using it only as first aid center with medical technician as incharge.
Two, expand the role of LHW and make it a real bridge between the community and the nearest health facility.
Three, start a structured and fully financed by the government program for effective involvement of the opinion makers including Imam-i-masjid, local elders, elected councilors, school teachers and civil society. For example sermons on different public health issues can be developed for religious leaders to be delivered on Friday prayers. Moreover, Aiam-i-masajid can also be trained for delivering different routine services including TB dots and immunization.
Similarly, local elders can be motivated for the revitalizations of the BHUs and sensitization of the community on different public health issues. Together with Imam-i-masjid a management board can be developed for the running of the BHU and in this way BHU could effectively function as PHC center.
Four, develop an essential health care package and define the minimum level of services the state is going to provide up to the secondary level. This should include all programs of preventive and promotive health along with routine diagnostic services, medication for most common medical problems and routine procedures.
Fifth, strengthening of RHC and civil hospital by making it operational for twenty four hours with round the clock EMOC services. Shifting the abolished posts of Doctors from BHU to these two facilities and linking all the BHUs with the nearest RHC for weakly outreach programs.
Sixth, developing an attractive career development and financial package for both male and female workers.
Seventh, linking essential health care package with referral system. Introduction of social health insurance system for the services which are not covered by essential care package.
Eight, for improvement of management and promotion of healthy competition within health sector the gradual selection of all administrative posts from market on open competition.
And last but not the least a strong political will for going ahead steadfastly.
The Frontier government is working on some of the areas.
Regards
Inayatullah

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Viewpoint 13: Health in ECNEC [September 19 , 2006]

Dear Members of the Health Policy Forum,
August the 23rd ‘s Executive Committee meeting of the National Economic Council (ECNEC) of the Government of Pakistan (the highest project approval authority in Pakistan) deferred four schemes which constituted all of the health projects on the agenda – incidentally all from NWFP – on the premise that the envisaged federal co-sponsors of these were not available for deliberations. A valid argument indeed! However, some have read otherwise into the situation and contrary impressions relating to how political processes impact the fate of social sector programs have been echoing in the corridors of power, ever since. The Health Policy Forum has issued and published a viewpoint on the subject in the NEWS international on September 10, 2006. Please also note that the newspaper version can be accessed online at ► 
With regards,
Sania

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Viewpoint 12: The Health and Technology Nexus [August 30, 2006]

Dear members of the Health Policy Forum,
Please find enclosed herewith a recent viewpoint of Pakistan’s health Policy Forum on the role of technology in health, which appeared in THE NEWS International on Sunday August the 27th. This is accessible as usual on the viewpoint page ► http://heartfile.org/viewpoint.htm and its text is enclosed herewith,
Best regards,
Sania

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Viewpoint 11: Restructuring Basic Health Units in Pakistan [August 22, 2006]

Dear Members of the Health Policy Forum,

Please find another viewpoint of the Health Policy Forum relating to the recent efforts underway to restructure basic health units in Pakistan, which was published in the NEWS daily on August 6, 2006. The viewpoint can be accessed at http://heartfile.org/viewpoint.htm ►

I am also enclosing it in its text form in the body of this e mail given that some of you have been experiencing difficulties accessing the web versions. 

With regards,
Sania

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Comments Re: Response to Viewpoint 8 - 9 [August 17, 2006]

Dear Members of the Health Policy Forum,
In response to Viewpoint on the Federal Health Budget for 2006/07 (► http://heartfile.org/viewpoint.htm , please find enclosed herewith comments of Dr Shafiquddin, Chief Health Planning; Government of Pakistan. ) “Health budget while being reviewed as a part of the macro-economic framework of the country and analyzed on the percentage share basis of GNP/GDP, should also be analyzed in the context of Development versus Non-Development, Federal versus Provincial and Preventive versus Curative Services. (It is pertinent to note that although we have got access to federal documents on the web-site of Federal Government i.e. Planning Commission and Finance Division. However it is not possible to see the same on the web-site of the provinces.
ii) The last 2 years’ documents when compared to the budget 2006-07 show that although the Development Budget for Health of the Federal Government is showing a consistent increase (more than 25% yearly), the same is not visible on the non-development side and the reason is very obvious viz Federal Government is involved in a very limited way in the provision of service on curative side (it has only 6 major hospitals and some 60 dispensaries). While, it is not the same when we look at the provincial figures i.e. non-development and the development budget are increasing at almost the same constant ratio (8-10% yearly.
iii) Taking the micro-analysis of the Health Sector Development Budget over the past 3 years, it is Rs. 4.6 billion in 2003-04, Rs. 6.5 billion in 2004-05 and Rs. 10.8 billion in 2005-06 considering the overall Federal Development Budget (PSDP) as Rs.160 billion, Rs.202 billion and Rs.272 billion in these 3 years thus having a %age share of 2.8,3.2 and 3.9 in 2005-06.Then,during the current year i.e.2006-07 an allocation of Rs.12.3 billion for health against the total PSDP size of Rs.435 billion thus having a %age share of 2.8 which is again showing a decreasing trend for Health Sector allocation. Allocation for Preventive programme have decreased from 85% in2005 to 56% now(2006-07) because of the increasing investment in hospital services especially cancer treatment centers. The analysis of allocations for six major preventive programmes shows that there is no consistent policy of ensuring increasing or at least stable allocation for these programmes.”
With regards, Sania

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Viewpoint 10: Piecemeal doesn’t cure [July 20, 2006]

Dear Members of the Health Policy Forum,

Please find enclosed herewith a recent viewpoint of the Health Policy Forum, which appeared in SUNDAY NEWS DAILY on July the 2^nd. Entitled “Playing health with a new stack of cards”, this was carried by the editor in THE NEWS by the name of “Piecemeal doesn’t cure”  The context of this relates to the tabling of the Vision 2030 forecast exercise by the Planning Commission of Pakistan. The article was released to bring clarity to the manner in which health needs to be restructured as part of such a planning and forecasting exercise. The viewpoint can be accessed at ► http://heartfile.org/viewpoint.htm
With regards, Sania

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Viewpoint 8 - 9: Budgetary allocations for health in the fiscal budget of 2006-07 [June 30, 2006]

Pakistan’s Health Policy Forum has issued two viewpoints relating to the budgetary allocations for health in the Federal Government of Pakistan’s fiscal Budget of 2006-07. One was issued a day prior the Budget release on June 4, 2006 in the NEWS International entitled “Money as Cure” and the other has just been published in the business magazine Blue Chip June issue which featured a cover story on the budget.  The Health Policy Forum took the lead in the health sector to offer its views on budgetary health allocations in this popular magazine; the title of the viewpoint was “Budget 2006-07 – an ode to health”. Both these articles have been uploaded on the PHPF website and are accessible through ►

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Comments Re: Viewpoints 2 - 7 [June 22, 2006]

Dear Members of the Health Policy Forum,

Kindly find enclosed herewith a recent communication from Prof. Franklin White, former chair of the Department of Community Health Sciences at the Aga Khan University in response to the Health Policy Forum’s group message on June 08, 2006 regarding “Viewpoints of the Health Policy Forum”.

Best regards, Sania

-----Original Message-----
From: Pacific Health & Development Sciences [mailto:pacificsci@shaw.ca]
Sent: Friday, June 09, 2006 8:42 AM
To: Sania Nishtar
Subject: COMMENTS Re: Viewpoints of the Health Policy Forum

Dear Sania:

Thank you for bringing the developing set of policy papers to my attention (and the attention of others in the Forum) in such a convenient package.  I had already read some, but not all, but this was a good way to review the progress of this effort.

You are to be congratulated for the development of such well-focused pieces, which (being also short) should fit the attention span of many politicians and senior beaurocrats, and most general readers.  That's quite an accomplishment! 
Much more to the point, the level of analysis is consistently good and definitely highly relevant to the Pakistani agenda.  Many of the topics are politically sensitive, and by delinking what are often overlapping issues, you have found a way of minimizing the potential for negative reactions from some quarters, as you build the case for steady reform, which is a long term process.

I can well understand that you would like others to contribute, as I suspect that you need a break at least once in a while; it may be difficult to sustain this approximately monthly monthly flow of high quality commentary.  Now spekaing personally, I am not ready to contribite myself, largely due to the newness of my CIDA monitorinr role.  However, I will keep this possibility in mind. 

In the meantime, well done with all of this!  While I have been largely silent lately, I am following your efforts with interest.
Regards.

Frank

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Viewpoint 2 - 7: for titles see ► [June 08, 2006]

Dear members of the Health Policy Forum,

Kindly note that the Health Policy Forum/Think Tank has regularly started posting viewpoints on contemporary health issues in major national newspapers; these are accessible at h►
I would like to invite contributions to this theme of the Health Policy Forum/Think Tank’s scope of work. Those of you who would like to contribute viewpoints related to your scope of work as it cross cuts with the Forum’s objectives are welcome to do so; I welcome expressions of interest so that we can deliberate on this further.
Best regards,
Sania

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