Pakistan’s Free Healthcare Insurance Benefits Women, Poor

Universal Health Care priorities in Pakistan have been boosted by free healthcare insurance for the poor. Credit: Ashfaq Yusufzai/IPS

PESHAWAR, Feb 22 2023 (IPS) – A free health insurance initiative started in Pakistan has benefited poor patients, especially women who have outnumbered men in using the cashless health services under the Sehat Card Plus programme.

The initiative is in line with the ICPD25 Programme of Action, under which 4.5 million people have received free services, with 62 percent of them women. In the last three years, we have been able to cut down maternal mortality rate from 186 deaths per 100,000 live births to 172, Dr Muhammad Riaz Tanoli, CEO of the Sehat Card Plus (SCP), told IPS.

The International Conference on Population and Development (ICPD) held in Nairobi in 2019 set a programme of action aimed at empowering women and girls. The SCP aims to ensure Pakistan meets the 2030 deadline for sustainable development goals for universal health and women.
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So far, USD 80 million have been spent on treating patients at 1,100 hospitals across the country.

Shaheen Begum, a resident of Peshawar, is thankful to former Prime Minister Imran Khan, who launched the programme and said that her sister had died of delivery-related complication years ago because they didn t have money to get quality treatment. She was lucky to undergo a caesarean section at one of the city s top private hospitals on SCP, and she and her newborn baby are in good health.

Since my first-month of pregnancy, I have been getting diagnostic services free of cost. Two days before delivery, I was admitted because of complications, and doctors performed a caesarean operation, Begum, 26, a housewife, said.

Pakistanis living abroad with chronic ailments return to the country for treatment. Muhammad Kashif, 55, recently arrived from Malaysia to undergo liver transplant surgery.

Kashif said that the cost of a liver transplant in Malaysia was USD 7,000. Not only was it beyond his reach, but he would have had to call relatives to Malaysia to donate a liver. That would have been impossible, he said in an interview with IPS.

One of my friends called me and asked to come back and get the surgery free of cost. I came to my native Khyber Pakhtunkhwa province in November last year, and next month, my transplant was done at one of the country s premier hospitals, he said.

Like Kashif, Mushtari Gul, a Pakistani nurse working in Saudi Arabia, became extremely sick as her kidneys stopped functioning.

Initially, I received dialysis for two months, but doctors advised renal transplant that wasn t possible there due to its cost and donor, she said.

Gul, 51, is one of the 235 people who received free renal transplants under the SCP. She said it wasn t possible without an insurance scheme because its cost was  USD 6,500, not affordable even by affluent people.

Pakistan Medical Association (PMA) is appreciative of the scheme. It is an unprecedented programme where the people are able to get services in expensive hospitals. Most patients who couldn t afford heart surgeries are among the beneficiaries, PMA s Secretary, Dr Qaisar Sajjad, told IPS.

PMA has been asking the government to ensure World Health Organization s aim for Universal Health Coverage is delivered, and this was a step in that direction, Dr Qaisar said.

Public health specialist Dr Fayyaz Shah told IPS that the system has been very good. Unlike the health insurance schemes in developed countries where people deposit annual premiums, here, the government pays the insurance company without charging people.

Before the programme s launch, the infant mortality rate was 41 per 1,000 live births, which has now come down to 35. Shah elaborated that other health indicators also show improvement as poor people receive timely treatment.

Patients are getting free services for renal and liver transplants and major ailments and procedures, including cancers, surgeries, cardiac diseases, hernia, cataracts, gynaecology, eye, ear, nose and throat and other diseases.

The major beneficiaries are women and children, followed by cancer, heart, dialysis and people with urinary and diabetic problems, he said.

Local gynaecologist Dr Naseem Akhtar terms the programme a blessing for women. Ever since the start of the programme, there has been a drastic decline in mortality among women for pregnancy-related complications.

Our staff also work harder because they get extra financial incentives from the funds generated from SCP. The patients in hospitals also get free medicines and diagnostic services, she said.

At the end of every month, we send patients details and expenses to the government, and the payment is made within a week. The state-run insurance company is implementing the programme on behalf of the government, which has proved beneficial both for patients and healthcare providers, she said.

A senior nurse, Sania Ali, at a local hospital, said her monthly salary is $200, but she earns $300 additional from the patients undergoing treatment on SCP.

Our doctors, nurses and paramedical staff want the mechanism to continue as it was a big source of their extra income they received in addition to their fixed salaries, he said.

This system has not only helped the poor patients but is also a big source of income for private hospitals. We are extremely busy dealing with patients, and our staff is working round-the-clock to operate on more patients and get more money, said Dr Shah Raj, a public health physician. She said that each family is entitled to $4,500 per year from the programme. In case of liver and kidney transplants, the patients benefits are around $20,000, she said.

IPS UN Bureau Report