Sehat Sahulat Program
Pakistan’s national social health insurance programme
From Wikipedia, the free encyclopedia
The Federal Sehat Sahulat Program (FSSP) is Pakistan’s largest government-run social health insurance initiative, aimed at providing cash-free inpatient treatment and financial risk protection to vulnerable households. The programme has been implemented across federal and provincial jurisdictions, offering a standardized framework for social health protection and access to tertiary healthcare services.
| Abbreviation | FSSP |
|---|---|
| Formation | 2015 |
| Founder | Nawaz Sharif[1] |
| Type | Government social health insurance programme |
| Focus | Providing financial protection and cash-free inpatient care to low-income and vulnerable households |
| Owner | Government of Pakistan |
Parent organization | Ministry of National Health Services, Regulations and Coordination |
| Website | pmhealthprogram |
The initiative traces its roots to the Prime Minister’s National Health Programme (PMNHP) launched on 31 December 2015 by then Prime Minister Nawaz Sharif of the Pakistan Muslim League (N). The programme marked Pakistan’s first federal-level social health insurance intervention and laid the foundation for the current Sehat Sahulat Program and Federal Sehat Sahulat Program. [2]
Background
Pakistan has historically faced challenges in healthcare financing. High out-of-pocket expenditures, limited access to specialized care in rural areas, and the financial burden of tertiary care have left large sections of the population vulnerable to catastrophic medical expenses. In 2015, the PML-N government recognized the need for a national social health insurance mechanism to reduce financial barriers and improve access to essential healthcare services.
The PMNHP was conceived as a welfare-driven initiative to provide free inpatient treatment to low-income families through **health cards, facilitating services in empanelled hospitals across the country.
Launch and Early Implementation (2015–2016)
Prime Minister Nawaz Sharif officially launched the Prime Minister’s National Health Programme on 31 December 2015. The program initially covered families living below the poverty line, identified through the Benazir Income Support Programme (BISP) and National Socio-Economic Registry (NSER) databases
Key features of the initial programme:
- Cash-free inpatient treatment for low-income households
- Coverage for surgeries, maternity care, chronic diseases, cancer treatment, and emergency services
- Partnership with selected public and private hospitals (empanelled hospital network)
- Financial coverage limits per family, reducing catastrophic out-of-pocket medical expenses
- Health insurance cards issued to eligible households [3]
The program was piloted in select districts with planned phased expansion, prioritizing districts with high poverty rates and limited access to tertiary healthcare facilities.
Evolution and Renaming (2018–2019)
After the 2018 general elections, the PMNHP was restructured and renamed the Sehat Sahulat Programme. The health insurance card was also rebranded as the Sehat Insaf Card [4]
Federal Institutionalisation
Between 2019 and 2023, the programme transitioned into a federally coordinated social health insurance system, now known as the Federal Sehat Sahulat Program. Expansion included:
- Nationwide enrolment across Punjab, Sindh, Khyber Pakhtunkhwa, Balochistan, Islamabad Capital Territory, Gilgit-Baltistan, and Azad Jammu and Kashmir
- Strengthening hospital empanelment and reimbursement processes
- Integration with NADRA for eligibility verification and card issuance
- Regular updates of coverage packages and benefit ceilings [5]
Structure and Administration
The Federal Sehat Sahulat Program operates as a government-administered social health insurance scheme, involving multiple institutions:
- Eligibility & Enrolment: Beneficiaries are identified using BISP and NSER poverty data. NADRA issues health insurance cards to eligible families. [6]
- Service Coverage: Cash-free inpatient hospital care includes maternity services, surgeries, emergency care, treatment for chronic and severe diseases (cancer, cardiovascular, renal, neuro-surgical care), dialysis, and specialized procedures.
- Administration: The programme is funded by the Government of Pakistan and managed with third-party administrators, primarily State Life Insurance Corporation of Pakistan (SLIC), overseeing reimbursements, hospital contracts, and benefit monitoring.
- Hospital Network: Both public and private tertiary hospitals participate, providing services to eligible cardholders.
Beneficiaries
As of 2023, the programme has enrolled:
- Over 43 million families, approximately 190 million individuals
- Millions of inpatient treatments delivered in empanelled hospitals
- Special focus on vulnerable groups, including women, children, elderly, and chronically ill patients[7]
Impact
The Federal Sehat Sahulat Program has had measurable impacts on healthcare accessibility and financial protection:
- Reduced out-of-pocket spending for low-income households
- Increased access to tertiary and specialized healthcare services
- Strengthened collaboration between federal and provincial governments
- Increased utilization of public hospitals while incentivizing private hospital participation
- Contributed to Pakistan's progress toward Universal health coverage and Sustainable Development Goals related to health
Timeline
- 2015: PMNHP launched by Prime Minister Nawaz Sharif (PML-N)
- 2016–2017: Pilot phase in selected districts, initial enrolment and hospital network establishment
- 2018: Programme reviewed and prepared for expansion under renamed Sehat Sahulat Programme
- 2019: Renamed to Sehat Insaf Card
- 2020–2022: Coverage expanded to additional provinces and regions
- 2023: Federal institutionalisation as Federal Sehat Sahulat Program with over 43 million families enrolled