Body formed to assess performance of district health system

The Health Ministry has constituted a technical committee to suggest improvements in future studies to assess the performance of district health system.

The committee comprising of experts from the ministries of Health and Population Welfare will conduct a study on Health System Performance Assessment.

This was decided in a meeting chaired by Health Minister Ejaz Rahim held here on Friday to discuss the results of the survey conducted by the National Health Policy Unit on ‘Health System Performance Assessment’ for evidence-based district performance.

Rahim directed to share the findings of the study report with all provinces and districts and asked for their comments and suggestions.

He said the data sources for future studies should include more indicators to look at wider dimensions of the health system performance to cater to the health needs of the population in an improved way.

He directed that the statistical bureau and the National Health Information Resource centre should coordinate and collaborate to generate quality data for meaningful analysis of health system performance and ranking of the districts. The meeting was informed that the study was conducted with two key objectives included to assess the service delivery performance of devolved district health system in the country based on available quality data sources and to develop ranking of the districts based on health system’s performance.

It was informed that nine indicators were selected to look into different dimensions of the health system, which were scored and ultimately helped to rank district performance at both provincial and national levels. The districts are ranked based on their actual performance and provided an evidence for future policy decisions. The study also provided future directions for evidence-based resource allocation for Poverty Reduction Support Credit-III indicative trigger by the World Bank.

National Health Policy Unit Monitoring and Evaluation Specialist Dr Sohail Amjad presented the results of immunisation and reproductive health coverage including the performance of health facilities.

Excluding FATA, FANA and Azad Jammu and Kashmir (AJK), total 98 districts were included in the study from rest of the country. Out of the 98 districts examined, 15 districts were qualified for the highest performance level, 42 districts were included in high performing districts, while 33 districts had shown medium level performance and eight districts belong to the low performing category.

Gwadar was the top performing district, while Qilla Abdullah stands at the lowest 98th rank in the country. Out of the 10 top performing districts in terms of Expanded Programme on Immunisation (EPI) performance in Punjab, four are among those that are very high performing. Other five districts are from high performing and only Pakpattan belongs to medium performing category on overall provincial performance ranking for Punjab.

On the other hand, regarding reproductive health (RH) performance, five districts from very high performing and high performing categories of provincial ranking respectively and none is from medium performing category.

Similarly, five districts (Rawalpindi, Sialkot, Jhelum, Kushab and Attock) are common among the 10 top performing categories of EPI and RH performance in Punjab but the rest are different districts.

In case of Sindh, the top 10 performing districts in each category of EPI and RH performance include seven common districts in both categories, while three districts in each category are different.

Mirpur Khas district in the RH category, which is a high performing district in overall provincial ranking falls at the bottom in EPI performance. The three districts performing well in EPI do not qualify among top 10 for RH category and vice versa. The comparison of top 10 EPI and RH performing districts in Balochistan do not differ much from other provincial performances. Chaghi district, which stands at the top in RH category, does not even qualify among top 10 in EPI category and the same situation is with Quetta as it is not represented in the RH category.

The comparison of top 10 EPI and RH performing districts in NWFP also follows the same trend as in other provinces. Both the categories have seven districts in common, while the remaining three districts in each category are different.

Chitral district, which tops the EPI category, does not even qualify for the top 10 RH categories. Similarly, Nowshera which is top performing in RH category, is not represented in the top 10 EPI categories, while Peshawar which is among the top 10 in RH category, does not get representation in the EPI category.

Source:www.dailytimes.com.pk