In depth: Better budgets for primary healthcare services in Punjab

Basic healthcare in Punjab, Pakistan’s largest province with a population of 101 million, falls short of its citizens’ needs and international standards. In 2014, only 59% of deliveries were assisted by skilled midwives, while the under-five mortality rate stood at 104 out of 1000 (nearly double the south Asian average of 55). Not surprisingly, satisfaction with public healthcare is low. Amendments to the Constitution in 2010 aimed to decentralise political power further in Pakistan. They transferred the responsibility for managing resources from the federal government to provincial governments. Provincial governments are closer to the communities and, therefore, considered to be better placed to meet their service delivery needs. This decentralisation process opened up new opportunities for the reform of basic service delivery in the provinces.

This publication was co-authored with Khurram Jilani.