Setting a New Pace: How Punjab, Pakistan achieved unprecedented improvements in public health outcomes
ByFenton Whelan & Will Anderson | On11 April 2018
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Big wins for public health in Punjab, Pakistan.
Between 2014 and 2017, Punjab achieved unprecedented improvements in its health system
Immunisation coverage increased by 35 percentage points, a rate of improvement unheard of in a large health system. By 2017,almost one million more children were being fully immunised each yearagainst a range of deadly childhood diseases, saving thousands of lives.
The proportion of women giving birth in the health system increased by 13 percentage points, meaning that300,000 more children were born each year with medical careduring their first moments of life, againsaving thousands of lives.
A new ambulance servicewas launched handling roughly 25,000 patient transfers a month by December 2017.
Additional vaccines, including rotavirus, were rolled out.
A new referral system for complicated caseswas established.
The performance of primary health facilities rose, with substantial improvements in staffing, medicine availability, facility outlook and patient care.
Behind the scenes,new data systems, management routines and processes were implemented.
Theimprovements targeted and disproportionately benefited the poorest communitiesin the province. Every indicator improved most among the poorest quarter of the population.The health service was extended to large numbers of previously unreached or underserved communities.
The improvements werethe result of a simple set of techniques and processes that could be applied elsewhere. The Punjab Health Reforms Roadmap focused on improving management and implementing simple but effective solutions to problems on the ground. The strategy focused on:
Agreeing priorities based onwhat would make the most difference
Usingcost-effective and innovative new technologies
Gettinggood datato understand what works and to manage performance
Building capacitythroughout the system
Creating routinesto solve problems and drive progress
Engagingpolitical leadership
Punjab’s success demonstrates thatthe key to saving lives in the developing world lies not in complex development theories or massive injections of funding, but rather in the application of good management and innovative technologyto improve the delivery of services on the frontline.
This report is the story of thattransformation.
About the Authors
Fenton Whelan founded Acasus, he has more than a decade of experience in public health and education development. Will Anderson is the lead researcher for public-sector projects at Acasus.