Asian Development Bank has approved the provision of technical assistance of $350,000 on a grant basis to Pakistan for the Developing Social Health Insurance Project, which will be completed before February 2006.
According to an official source, in September 2001, ADB approved its social protection strategy covering five areas identified by ADB as main target areas of social protection: (i) labour markets, (ii) social insurance, (iii) social assistance, (iv) micro-and area-based schemes, and (v) child protection.
The Government of Pakistan's poverty reduction strategy paper gives high priority to improving social protection. ADB is assisting the federal and provincial governments in various areas of social protection.
In August 2003, ADB approved technical assistance (TA) to develop the social protection strategy, which had a component on health insurance-an integral part of social protection.
ADB's country strategy programme for Pakistan (2004-2006) foresees for 2005 a TA for social health insurance. The TA will build on the results of the study mentioned above, which laid out the general framework for social health insurance in Pakistan, while this planned TA will focus on the elaboration of a concept for one province.
It may be recalled that the ADB conducted a fact-finding mission on 7-16 February 2005. The mission met officials of federal and provincial governments and stakeholders (in the NWFP, Punjab and Sindh) and reached an understanding with the provincial government of Punjab on the TA goals, purpose, scope, implementation arrangements, costs, financing arrangements, and terms of reference for the consulting services.
ADB sources the TA is in line with the poverty reduction strategy paper and with the ADB's social protection strategy.
The outcome will be a detailed proposal to the provincial government of Punjab for a comprehensive and co-ordinated design of a social health insurance for Punjab. Punjab was chosen (though NWFP and Sindh were also interested) because initial preparations have already been made and its ownership of the plan is strong. The plan will include (i) target groups; (ii) benefits of the insurance; (iii) possible target districts for the planned health insurance; (iv) identification of needs for administrative and institutional development with a special focus on possible links to the existing institutions; (v) a financial plan; (vi) possible involvement of the provincial government of Punjab, development partners, and ADB; (vii) an overview of service providers and their link to the health insurance; (viii) terms of reference for consulting services and other inputs needed to set up the health insurance; (ix) identification of legal arrangements; and (x) assessment of the economic viability and financial sustainability of a proposed health insurance scheme. The consultants will provide the Punjab government and ADB with a technical background report with the design of the health insurance and measures and resources to implement it.
The TA will also help the Punjab government design a health insurance for the province.
The total cost of the TA is estimated at $440,000 equivalent of which $196,000 will be foreign currency cost, and $244,000 equivalent will be local currency cost. ADB will finance $350,000 equivalent, which will include the entire foreign currency cost and $154,000 equivalent in local currency costs.
The remaining $90,000 equivalent will be contributed by the provincial government of Punjab and will include office accommodation, counterpart staff remuneration, surveys, and workshops.
The federal and provincial governments have been informed that approval of the TA does not commit ADB to finance any ensuing project.
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