Is it too much for Pakistanis to ask for their basic rights as enshrined in the 1973 Constitution? Naturally or pre-maturely (due to disease, sickness, enmities, calamities, violence or stress), we are all dead in the long run! The way one dies, however, is largely determined by the way one chooses to live.
Among others, healthcare and primary education services are considered to be basic rights of human beings; essential ingredients for a decent living and core responsibilities of a welfare state.
The federal budget for FY12 has been announced and it is being vociferously dissected by experts and novices alike. Folks following the budget are cutting everything apart, everything - except the health and education affairs.
Although the public sector expenditures (federal and provincial) on health and education in Pakistan have grown in absolute terms over the last five years, these increases are heavily skewed towards current expenditures. The intriguing fact is that the public health expenditures have persistently deteriorated as a percentage of GDP over the years.
The policymakers rhetoric-meshed, indifferent attitude towards increasing the health and education outlays has manifested itself in Pakistans unimpressive social indicators across the region. Pakistan is also, reportedly, lagging behind in the 2015 Millennium Development Goals targets related to health, education and disease prevention.
The federal government allocated a paltry Rs2.64 billion for health affairs in recurring expenditures for FY12, primarily for provision of services in government hospitals. Under the revised estimates, only Rs42 billion would be spent on health affairs by end-June 2011.
The education services have been earmarked Rs39.5 billion in current expenditures for FY12, with almost three-fourths of the expenditures to be incurred in tertiary education affairs and services.
While the health affairs, and primary & secondary education services have not been allocated any development funds, the Higher Education Commission (HEC), which has been the focus of much controversy, has been earmarked Rs14 billion in the Federal PSDP for FY12.
The limited federal spending on health and education is understandable, because in the post-devolution scenario, provinces are responsible for these services. Provincial budgets for the next year are awaited in this regard, as their respective Annual Development Plans would have the details, scope and magnitude of development spending in these areas.
It is being argued by some quarters that the transition process from federation to the federating units should have been more organized and smooth, in sync with provincial capacity development.
Agreed!
The provinces, however, must not use this argument to shirk from their constitutional responsibilities after the passage of 18th amendment. It is imperative that this transition must not fall victim to politicking.
The CCI decision in this regard should be followed for a phased and timely transition. The federal government is already doing that by financing vertical health programmes in FY12, funding the HEC and accommodating the surplus pool of federal government employees.
The planners and policymakers in the provinces need to realise that an impoverished and illiterate person is more susceptible to be motivated by the ideologies which focus on destroying rather than creating something new, and taking others down rather than pulling them up! The stakes couldn have been higher.
There is, however, a bright silver hue on the sky. If each province takes stock of its social sector development landscape, formulates long-term policies with short-term reviews, and reaches out to its populace with adequate healthcare and educational facilities, the current deteriorating social indicators could be reversed before it is too late.
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Health & Education Indicators: Regional Comparison
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Pakistan Bangladesh China India Sri Lanka
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Health
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Population Growth Rate 2.1 1.6 0.5 1.3 0.9
Life Expectancy (years) 67.2 66.9 73.5 64.4 74.4
Infant Mortality Rate (per 1000) 63.3 50.7 16.1 47.6 9.7
Mortality Rate (<5, per 1000) 89 54 21 69 15
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Education
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Adult Literacy Rate (>14 years) 53.7 55 93.7 62.8 90.6
Primary Enrollment Rate 66.1 88 112.1 89.8 99.7
Secondary Enrollment Rate 32.5 41.5 74 57 87
Mean years of Schooling 4.9 4.8 7.5 4.4 8.2
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Source: UN report on Human Development, 2011
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