Title

A qualitative study on paucity of laws regulating private health care sector in Pakistan

Date of Award

2006

Document Type

Thesis

Degree Name

Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)

Department

Community Health Sciences

Abstract

Almost all developed countries and most developing countries have legislation to regulate the private healthcare sector. In Pakistan, however no worthwhile steps have been taken to regulate this sector although private health sector provides the bulk of healthcare needs of the population (as much as 70-80%). World Bank mentioned rendition of poor quality of care by private health care providers is as the main problem area in Pakistan's health system. In the key area 7 of National Health Policy 2001: it is mentioned that a draft for the regularization of the private health sector is being circulated to the provincial governments and that would eventually be presented in the cabinet, but as yet no progress has been made (except in the case of Balochistan where reasons for making regulations were different). The objectives of this study were to study the present position in formulation of laws for regularization of laws for regularization of private health sector; study the reasons/factors that deter regularization and to give suggestions and recommendations for formulation and implementation of regulations for the private sector. This is a qualitative study and is structured on in-depth interviews from the key informants which were conducted in Balochistan and the federal capital. The data was analyzed manually in three phases: in the first phase responses of the respondents were analyzed question wise. In the second phase the answers of the questions were analyzed and concepts were derived from the answers. Finally in the third phase the complete interviews of the respondents were analyzed. The themes were derived from these three phases and that process finally produced the core of the data that is; 'perceptions of the key informants' and the second core 'absence of regulations'. Results show that there is poor governance in health sector, need for introducing a participatory approach in formulation and implementation (and evaluation of implementation) of regulations for the health sector, implications of regulations, absence of standards, ethical and equity issues. The main stakeholders in the private health sector have surprisingly been identified as the public sector doctors as they constitute the mainstay of the private health sector according to 80% of the key informants. The study recommends steps in developing the networks among different stakeholders; platforms for formulation and implementation of laws and regulations; developing the standards for the health sector (irrespective of private or public); constitution of an independent body to oversee the health sector in the country; need for another cadre to augment health manpower; strategic planning for health manpower growth and for institutional practice; and stress the importance of awareness and of uniformity of laws. Since the study was conducted in Balochistan and federal capital, details from other provinces is not obtained. The views of general public could not be obtained due to the time constraints. Future research is proposed for the census of health facilities, establishment of standards, monitoring mechanism and proposals for the establishment of new cadre of health professionals.

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