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ISLAMABAD: The annual per capita Current Health Expenditure (CHE) for Pakistan as per the National Health Accounts (NHA) 2019-20 is $40.7 or Rs 6,432 while in NHA 2017-18 it was $48.1 or Rs 5,283, says Pakistan Bureau of Statistics (PBS).

The NHA is a macro-economic accounting framework for revealing a country’s aggregated expenditures on health. The compilation of NHA-Pakistan reports follows international standards set by WHO and OECD. This report presents the results for fiscal year 2019-20 which is the 8th round of such a compilation.

Earlier, rounds were published for fiscal years 2005-06, 2007-08, 2009-10, 2011-12, 2013-14, 2015-16 and 2017-18.

Total health expenditure in Pakistan in the fiscal year 2019-20 is estimated as Rs 1,466 billion. This shows an increase of Rs 260 billion over the fiscal year 2017-18, which is a 21.6percent increase in nominal terms as it includes inflation of healthcare goods and services.

As per the results of ‘financing agents’ for fiscal year 2019-20, it has been observed that out of total health expenditure in Pakistan, 39.8percent are made by general government. Out of total general government health expenditures, 14.9percent are incurred by the federal government whereas 62 percent accrue from its civilian part and 38percent from its military setup.

Around 59.7 percent of the health expenditures are made through private sector out of which 88.6 percent is out of pocket (OOP) health expenditures by private households. Development partners/donor’s organizations have 0.5percent share in total health expenditures of Pakistan for the fiscal year 2019-20.

The annual per capita Current Health Expenditures (CHE) for Pakistan as per NHA 2019-20 are ($40.7) Rs 6,432 while in NHA 2017-18 it was ($48.1) Rs 5,283. According to NHA-2019-20 report, the ratio of CHE to Gross Domestic Product (GDP) is 3.0percent, while the ratio of general government health expenditures to total general government final consumption expenditure is 10.4percent.

The ratio of private sector health expenditures according to NHA over total household final consumption expenditure are 2.3percent.OOP spending as a share of total current health expenditure measures the size of OOP in the total national current health spending. It shows how much the health system relies on households OOP spending to finance it.

The above table shows that OOP spending is still the largest source of health care financing in five out of eight SAARC countries as OOP spending is more than 50percent of CHE and pharmacies), official patient cost-sharing within defined public or private benefit packages, and informal payments For the eight rounds of the NHA 2019-20, the results of the census of big hospitals and survey of the rest of health care providers for FY 2009-10 have been extrapolated forward in order to arrive at the respective estimates for the year 2019-20.

In its 8th round, the big advantage of including data of the private health care providers is to authenticate or reconcile information based on demand-side data with that derived from supply-side data (private providers).

Despite of its name ‘National’ Health Accounts, NHA also provides figures for the four provinces Punjab, Sindh, Khyber-Pakhtunkhwa, and Balochistan. It is not fully comprehensive as the total health expenditures for the provinces do not sum up to the national total.

For empirical reasons only Rs 1,338 billion of Pakistan’s total current health expenditures could be allocated to the provinces (‘regionalized’). Overall, the results of the respective provinces show that the shares of financing agents of the health expenditures are relatively heterogeneous between different provinces.

Copyright Business Recorder, 2022

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