Development Expenditure on Health in Perspective of Overall PSDP during 2000-2010

SYNOPSIS MSc Health Economics and Management 2010-2012 Health Services Academy, Cabinet Division, Islamabad, Pakistan

INTRODUCTION
 Health is a central goal and an important determinant of development and economic growth.  Extending the coverage of crucial health services to the world s poor could save millions of lives each year, reduce poverty and enhance economic development (WHO)

 Health in Pakistan was a shared responsibility of the federal and provincial governments being on the concurrent list in the constitution prior to the 18th amendment in the constitution.  Federal budget was aimed to support the provincial health budgets.

 Pakistan, which has a population of over 170 million, facing various health problems.
 Pakistan is spending under 1% of the GDP

on health.

 The health budget comprises of development and nondevelopment expenditures.  The non-development budget is mainly for the recurrent expenses of the health sector.  Development expenditure comes under the annual public sector development program (PSDP).

 Public sector development program is (PSDP) an annual document which lists all the public sector programs /projects with explicit allocations made for each one of the them in that particular financial year.  Funds allocated in the annual PSDP are mainly used for new initiatives and investments for the development in the health sector.

 Curative services and preventive services were strengthened through annual PSDP s.  Vertical programs were initiated to address the specific problems in the health sector to improve the health status of the people.

 The importance of development and the nondevelopment budgets is very much to the health sector of Pakistan, but there should be a balance between the two.  The development budget should be increased to have positive effects on the health sector.  The role of PSDP is not very much highlighted in Pakistan and its importance is not perceived in real terms.

OBJECTIVES
 To find out the development expenditure on health with respect to overall PSDP during 20002010. To find out the development expenditure on various functions of the health system of Pakistan. To calculate the development expenditure on various vertical programs.

LITERATURE REVIEW
 80% of the financial resources in the public sector are provided by the Government of Pakistan with nondevelopment and recurring expenses dominating the allocation in health.  spending on health by the public sector is Rs.375 of which Rs.80 is contributed by the partners and majority of the partner s contribution is spent on development projects.  The study concluded that additional 250 billion rupees are required by the health sector to meet the MDG-15 targets.  (khalife Bile Mohammaed, 2007)

 Development health care spending as percentage of GDP remained lower relative to non-development expenditures.  After 2002 development health care spending increased, and presently the government is allocating more on social sector especially on health and education through increased spending on the Public Sector Development Program (PSDP).  Government should prioritize health care expenditures spent on developmental and non-developmental.  (Faisal Abbas, 2011)

 expenditure on preventive measures and health facilities are highly subsidized by the federal government in Pakistan through its vertical programs.  Government spending in this sub-sector is more effective and progressive.
 (Akram, 2007)

 The literature clearly established the importance of more investment in the health sector in terms of per capita GDP and as a share of the total GDP, along with the importance of the donor s assistance in the health system.  But there is no study which describes the impact of federal PSDP of Pakistan on the health sector and the allocation and expenditure differences in the federal PSDP.  The study aims to find out the share of PSDP for health in the overall PSDP and the trend in the last decade i.e. from year 2000 to 2010. Further PSDP expenditure on the health system of Pakistan will be functionally classified.

METHODOLOGY
 Duration of the Study

 Data of previous 10 years will be analyzed i.e. from 2000 to 2010.  Data Source  Data will be collected from the PSDP which stands for Public sector development program. PSDP is compiled and published by Planning Commission of Pakistan annually.

Data Analysis
 A simple analysis of the aggregated data will be carried out to find out the available financial input in the health sector during the fiscal year 2000-2010.  The development versus non-development expenses, trends in contributions to vertical programs, and other descriptive analyses will also carried out.  Various financial inputs and areas of interest will be arranged in a tabulated form and graphs for ease of reference.  The results will be discussed in the context of output of PSDP in health. For family planning program, EPI program, T.B control program and LHW program graphical analysis will be done.

RECOMMENDATIONS

 On the basis of results and discussion, recommendations will be made which will serve as policy guidelines.