Download Social Sector Overview

Protecting the Poor
Pakistan Development Forum
Nov 14, 2010
Shahnaz Wazir Ali
Special Assistant to the Prime Minister
on Social Sectors
Demographic Profile (2010)
GB
0.3%
KPK
14%
AJK
2%
54.5%
BALOCHISTAN
5.4 %
SINDH
23%
Population 174m
Male
52%
Female
48%
Urban
33%
Rural
67%
1
POPULATION PYRAMID
TFR=3.6
Female
65+
Male
12%
0-14
Female
Male
12%
WRA
15-49
WRA
50-64
TFR=2.8
26%
26%
26%
27%
35 %
32%
2010
2020
174m
214m
2
Key Education Challenges
Quality/ Access
Equity
(Primary NER %)
25.5M
68%
8.8M
Private
26%
Out of School
53%
3%
16.7M
Enrolled
Public
42%
50%
1.2M
Primary
Tertiary
Urban
Rural
3
Key Education Challenges
4.0% of GDP
$ 6.7bn
Funding Gap
Rs.213bn
($2.4 bn)
4.7
Public/Private
Investment
Rs.372bn
($4.3 bn)
(FY 9/10)
4
Government Policy Framework
 Service Provision: Focus in rural areas/urban slums and girls
 Targeted: Stipends, food incentives/vouchers (e.g. PEF, SEF)
 Basic facilities, free textbooks/materials and good teachers
 Standards/improved monitoring and accountability
 Donor collaboration at provincial level / maximize aid effectiveness
 Non-state/para-state initiatives (e.g. Citizen’s Foundation, NCHD)
5
26
180
24
160
22
140
120
20
100
18
80
16
60
14
12
Population
Millions
Wheat Production
‘000 tones
Food Security and Nutrition
40
Wheat
Population
10
Factors that impact household consumption
1. Production/ availability
2. Distribution/ access
3. Affordability/ inflation
20
0
6
Food Security and Nutrition
 Caloric intake: 1920 to 1650 cal/d
 Malnourishment in population: 24%
 Malnourishment among children: 38%
 FER 57% of HH income
7
Food Security and Nutrition
Government Response
 BISP
 School Feeding (WFP)
 Disaster/ flood food support (WFP)
 Iodized salt, Vit A, E (ed oil)
 Iron in wheat fortification
 Utility Stores (subsidized)
 FSP (Punjab)
8
Health Sector
Financing
 Public Sector $1 bn (0.6% GDP)
 Private spending $2 bn on health
 Preventive: 45% GoP allocation
 Curative: 55% public and all private funds
Services
 Public Sector: Preventive >95%, Curative 20%
 Private sector: Preventive <5%, Curative 80%
9
Primary Role of State
 Maternal and Child Health
 Ensuring safe deliveries
 Family Planning
 Vaccination (polio eradication)
 Integrated Disease Surveillance
 Essential Health Services Package
 Quality, Standards and Regulation
 Human Resource for Health
10
HRH: Types of Healthcare Providers
Rawalpindi (Urban)
Other
13%
Doctor
35%
Dispensor
12%
Homeopa
th
24%
Hakim
16%
Tando Allah Yar (Remote Rural)
Other
4%
Rawalpindi (Close Rural)
Other
19%
Doctor
25%
Doctor
32%
Hakim
2%
Dispensor
52%
Homeopat
h
17%
Dispensor
19%
Homeopath
16%
Hakim
14%
11
Family Planning Services
Private sector accounts for >50% of FP services
Missing data
4.5m
13%
MoH 0.6m
17%
Out of Pocket
1.3m
39%
3.4 million (14%) of MWRA receive FP
services any given year
MoPW 0.67m
18%
NGOs/Private
Hospitals
0.4m
13%
12
Protecting the Poor and Vulnerable
A. Programs of Social Assistance:
 BISP (Rs 22bn to 88bn)
 Baitul Mal – Health net, Child Labor, orphanages, disabilities
 Zakat (Rs 4.2bn)
B. Programs of Social Insurance
 Social Health Insurance (BISP)
 EOBI, Workers Welfare Fund
 Employees Social Security Scheme
 Workers Profit Participation Fund
 Workers Children Education cess
 Provincial initiatives
13
Protecting the Poor and Vulnerable
1. Rural Support Programs:
Govt funding: Rs 4.5bn
 Donors Rs 2.3bn
 Coverage 3.5m HH via community mobilization

2. Private Philanthropy: Est at Rs 150bn
(39% health and 30% education)
3. PPAF (Rs 14.3bn) 4.1m beneficiaries
4. NCHD
14
Critical Trends
 Transfer from Federation to Provinces (18th Amendment
and the NFC Award)
 Shrinking state services and increasing role of markets
 Mediation by State for
 Equity
 Quality
 Types of services
 Financing
15