The Khyber-Pakhtunkhwa Integrated Health Program (IHP), jointly managed by the Lady Health Workers (LHWs) program and the nutrition initiative, faces severe financial constraints, hindering its effectiveness.

Official sources told The Express Tribune that both programs have fallen short of their targets due to insufficient funding.

Approximately 4,000 IHP employees have gone without salaries for the past five months, receiving payment only once during this period, according to a health department official.

Introduced in 2014 across all four provinces, the IHP underwent challenges after the 18th amendment, requiring individual provinces to create their PC-1 plans. The previous government’s Rs7.5 billion PC-1, developed by consultants from Punjab without a baseline survey, displayed numerous shortcomings, including the delayed recruitment of Lady Health Workers and trained community midwives over four years.

Despite completing their two-year training, these midwives remain unutilized, incurring significant costs to the health department, supported by international donor organizations. Additionally, LHWs and CMWs lack access to government-provided medicines.

The IHP’s primary goal is to reduce maternal deaths during childbirth from 165 per 1,000 to 40. Stabilization centers face similar challenges, with no available food supplements despite the declared nutrition emergency in the province. Only Unicef is currently providing food supplements to select districts, while the government struggles to recruit nutrition specialists and purchase food supplements due to financial constraints.

Targets for underweight childbirths have been substantially missed, raising concerns about the project’s overall efficacy.

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Despite a signed agreement on family planning, purchased items are stored in warehouses, with some recruitments allegedly made based on political affiliations, leading to internal power struggles. The project’s performance and outcomes have become questionable, casting doubt on its overall success.

Background

In May this year K-P Caretaker Chief Minister late Muhammad Azam Khan expressed his unwavering commitment to overcoming the prevailing financial crisis in the province. He emphasized that the provincial government is making extensive efforts to address the situation effectively.

He highlighted that K-P is currently facing a significant financial burden, with substantial outstanding dues owed by the federal government through various federal transfers.

These dues amount to billions of rupees, further complicating the financial challenges faced by the province. In light of this, the provincial government is actively engaging with the federal authorities to resolve these outstanding financial obligations. The CM observed that the erstwhile Fata had been merged into K-P but the share of newly merged districts in NFC was never ever provided. “In order to resolve the financial issues of the province, a number of letters have been sent to the prime minister and federal finance minister,” he shared.

Published in The Express Tribune, December 11^th, 2023.