HSA in collaboration with SSP and AHPSR initiated research on Social Health Insurance (SHI) in Pakistan

Health Services Academy (HSA) in collaboration with Sehat Sahulat Program Islamabad (SSP) and The
Alliance for Health Policy and Systems Research (AHPSR) of World Health Organization (WHO) initiated
and managed implementation research on Social Health Insurance (SHI) in Pakistan. The purpose of this
competitive research work was to generate indigenous evidence on barriers and facilitators to the social
health insurance program of Pakistan. A seminar was organized for dissemination of key findings of this
research on 30 th September 2022. On this occasion, Special Secretary, Ministry of National Health
Services, Regulations & Coordination (MoNHSRC), Mr. Mirza Nasir-ud-Din Mashhood Ahmad graced the
event as Chief Guest whereas Vice Chancellor of HSA, Prof. Dr. Shahzad Ali Khan, CEO of SSP, Mr.
Muhammad Arshad, Director Health-Diamer GB, Dr. Mubashar Hassan, Director IRMNCH of GB, Dr.
Abdul Mubeen, Head of Global Health HSA, Dr. Mariyam Sarfaraz, Director ORIC-HSA, Prof. Dr. Mubashir
Hanif and many key dignitaries took part.
Dr. Dur-e-Nayab, Joint Director/Pro-Vice Chancellor, PIDE shared her work on “Enhancing beneficiary
enrolment and information provision”.  SSP has been facing the issues of lower utilization due to various
factors including lack of awareness and limited number of empanel hospitals. There is a need for a
grassroots-level communication strategy, especially in districts where the program is universal. The key
messages must be disseminated at the doorsteps of beneficiaries. For this task the program may involve
local notables, education and health departments, and other social safety net departments having a
ground-level presence (i.e., Benazir Income Support Program, Pakistan Bait-ul-Mal and various
provincial social protection/security authorities). Overall communication strategy must be
heterogeneous keeping in view the needs of population. Dr. Sheraz Ahmad Khan, R&D Consultant at ICU
Healthcare (Former Deputy Director, Sehat Sahulat Program KP), shared his work on benefit package
amount, claims processing and engaging public hospitals. According to his research output, the patients
were found to be highly satisfied with the processes and care, though many did not get a chance to
provide their feedback at the time of discharge and had to face some Out-of-pocket (OOP) payment. The
processes were found to have evolved but had not become part of the payer-insurer or the insurer-
provider contracts or codified under the empanelment criteria or the operational manual. The study
found three types of implementation processes, namely (i) the routine processes, (ii) the modified
processes, and (iii) radically modified implementation processes.  Dr. Shujaat Farooq, HoD PIDE School
of Economics, shared his research work on improving grievances redressal processes and mechanisms.
The analysis revealed that although program offers multiple channels to register a complaint to its
beneficiaries including web portal, email, call center and postal letter; however, the main source for
complaint registration is the call center. A limited percentage of the beneficiaries and general public has
the knowledge of call center.