Zarmina Khan

Sehat Sahulat program is a micro health insurance program. According to the World Health Organization (WHO) guidelines, “Universal Health coverage” scheme named “Sehat Sahulat Program” launched in Khyber Pakhtunkhwa, a province of Pakistan, in 2015. This program was introduced as a “Health Facility Program” and it had been observed that it made a prominent progress in KPK, therefore, Nawaz Shareef government had also adopted this health care scheme in central Punjab in 2015 and under the Shehbaz Shareef government, this scheme had been further expanded in 2016.  Imran khan government decided to launch Health Cards in KPK and later Health cards had been launched in Punjab in December 2020.

Sehal Sahulat Program’s important component is “Central Management Information System.” Through this mechanism, the registration and operations are being properly tracked and recorded. SSP Program had made a setup of call center with the cooperation of Third Party “NADRA” to have the feedback about the delivery of services and to ask every beneficiary (who had discharged from the hospital) to provide feedback on the services delivery and the treatment, they got. “Naya Pakistan Qaumi Sehat Card” gave access to free treatment to KPK citizens and then it was being replicated in Punjab, AJK, ICT, GB, Sindh (Tharparkar). Federal, Regional, and provincial participant governments focused on social health protection of citizens by “Sehat Sahulat Program” and the key target of this scheme is to take favorable steps towards the social welfare by ensuring the availability of the health care services for every under privileged citizen of the country in an exalted manner without any financial compulsions. “State Life insurance corporation” manages the “Sehat Sahulat Program” in Pakistan and it is subsidized by the Pakistan government which administers the health expenses of the all registered users.

In 2020, Punjab Government introduced the “Sehat Insaf Card” by allocating almost 65 billion for the implementation of SSP in Punjab. Later on, PM of Pakistan had extended that program to AJK in December 2020. This program covered a wide range of health care services in empaneled hospitals.

Punjab is the most populous province; therefore, a brief explanation of the SSP in Punjab is discussed here. According to the updated statistical data of “Punjab Health Initiative Management Company” almost 42082184 families are enrolled in this program and PHIMC has provided a four digit number “8500” to check the eligibility. Approximately 98 percent beneficiaries are satisfied with hospital services, hospital staff behavior, and SSP staff actions. Moreover, Services have been categorized in two segments. Priority treatment, contains almost 300,000 family/per year initial coverage and 300,000/ family additional coverage. Secondary care services which contain 60,000/family/year initial coverage and 60,000/ family additional coverage.

In primary treatment, In Patient Services which includes all medical and surgical procedures. Furthermore,  Diabetes Mellitus Completion, Chronic infections (Hepatitis/Rheumatology/HIV), Heart diseases (Angioplasty or bypass), Organ Failure (Liver, Lungs, heart, kidney), Burns and RTA (Life, Prosthesis implants, Limb Saving Treatment), Neurosurgical Procedure, Cancer (Radio, Chemo, Surgery) and End stage kidney diseases/ dialysis are included.

In secondary care, In Patient Services all medical procedures and surgical procedures are included. Moreover, Maternal Consultancy for family planning, nutrition and  vaccination, Motherhood Services (Normal Delivery or C – Section), Emergency Treatment demanding admittance, Post hospitalization, Motherhood Consultancy, four times before delivery checkups  and one follow up  after delivery checkup), Providing of transport to tertiary care hospitals, Breakages and several Injuries, Local Conveyance Cost of PKR 1,000 (thrice per year) are included.

In March 2023, “State Life Insurance Company” gave signals about the closure of SSP program in Punjab due to the delay in releasing funds but PHIMC Chief Executive Officer Ali Razzaq stated that he is trying to mediate between government and state insurance company to make possible for the release of pending funds.

Punjab Cabinet had made a decision regarding Sehat card policy on 21 June 2023 regarding heart and gynecological patients. It is said that free treatment policy for heart and gynecological patients in private hospitals will be abolished. State Life Insurance company officials stated that Punjab Government had requested to charge 30% of the total treatment cost from the heart patients, therefore, the free treatment services on Sehat card will be suspended until the deserving beneficiaries would be identified. This decision is made to ensure the monetary relief for the health care institutions. On the other hand, Care Taker Provincial Health Minister Dr Javaid Akram said that the heart treatment services on the health card would be continued in Private hospitals as before.

Other provinces such as KPK has its own numbers regarding enrolled families. According to the statistical data, 47, 93,337 families are enrolled. “Sehat Card Plus” KP is Micro Health insurance program and all the secondary and tertiary health diseases like diabetes, accidents, kidney dialysis and transplant, chronic diseases, hepatitis B and hepatitis C, all kinds of cancers, cardiovascular diseases are included in it.

In 2023, Baluchistan health department has initiated the “Health Card program” with the cooperation of “State Life Insurance Cooperation” to ensure the accessibility of the 1.8 million families of Balochistan to the health care services. Sehat card is still not available for all Sindh citizens like Punjab or KPK yet. There are limited hospitals in Karachi from where people can get free treatment. “Qaumi Sehat Card” can only be used for indoor treatment and it delivers cashless healthcare facilities. Outdoor treatment facilities are not included in this scheme. Moreover, any person who is a permanent resident of Punjab, AJK, ICT, KPK, GB and District “Tharparker” of Sindh according to the NADRA card, is eligible and national identity card is his health card.

The writer is Research Associate at School for Law and Development.

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