Punjab’s Health Sector Reforms Program

Written by Pliro
May 8, 2018 Last updated: Mar 29, 2019

Punjab is the largest province in Pakistan. It has a population of over 80 million people. Such a large population can be difficult to attend even at a very basic level; however, Punjab’s healthcare situation is critical when compared to regional and global standards. Many of these difficulties come from an administrative standpoint. There’s little organization, data on diseases is not properly collected, medicines are difficult to find even when available, funding is misused and staff is overall absent.

All these difficulties and more compelled Punjab’s government to create and enforce a series of reforms over healthcare services in order to decrease birth mortality, improve health services for pregnancy, promote better medicine distribution, motivate health professionals and immunize a larger percentage of the population.

The Health Sector Reforms Program (HSRP) was an aggressive plan developed by the Punjab government adressing Basic Health Center’s (BHC) deficiencies at rural and urbanized areas. Some of the main elements of this program included:

  • Improving provision for facilities in order to meet minimum standards
  • Working on staff availability by making BHCs more appealing for new health professionals
  • Improve service delivery and monitoring of staff.

All of these reforms exist in order to achieve Pakistan’s Millennium Development Goals by 2015.

How good is HSRP implementation?

Although initially, the HSRP was to be applied during a period of 2 years in 2006, implementation proved to be a lot more difficult than expected. Reviewing the overall success for HSRP and other health reforms implementation from 2006 to 2018 is a monumental task. To this day, international and local sources diverge on how successful they have been.

Right now, Pakistan as a whole, didn’t reach its millennium goals, however, it did achieve some improvements as a result of the reforms.

One of the main complaints from international observers where several long periods in which the program appeared to decay. Part of this was due to a very large portion of the program’s funding (73%) remaining unemployed and the overall inefficiency of the administrative sector.

Pros and Cons


  • Strong funding that resulted in more and better ultrasound machines in 60 BHUs, increased vaccine distribution among other measures.
  • 100 clinics planned to enforce protocol to control Hepatitis
  • Awareness campaign about Hepatitis.
  • Infection control program (in the future).
  • In 2014 some reports indicated significant improvement in immunization, births under professional care and filled healthcare positions.


  • Poor management of assigned funding.
  • Very inefficient/ slow implementation
  • Government remains apathetic to the healthcare crisis
  • Frequent management changes cause a lot of complications and delays
  • Many recommendations to improve healthcare reforms remain ignored


Punjab Chief Minister Shahbaz Sharif has made no mention of plans for expansion so far, although initial projections did consider such actions.

If implementation strategies change, then expansion may become possible, but right now, Pakistan’s healthcare administration is still too inefficient to accommodate these reforms and applied them in a reasonable amount of time even with abundant funds.