Pakistan: Khyber Pakhtunkhwa Health Systems Strengthening Program
The Khyber Pakhtunkhwa Health Systems Strengthening Program results-based loan (RBL) supports the Revamping Secondary Health Care (RSHC) program,* a flagship and province-wide program of the Government of Khyber Pakhtunkhwa to improve secondary health care (SHC) services.
The RBL program aims to enhance the quality of SHC services in Khyber Pakhtunkhwa Province by (i) ensuring the availability and implementation of clinical protocols, standards, and guidelines at secondary hospitals; (ii) modernizing hospital infrastructure and medical equipment; (iii) reinforcing the planning of human resources and health services; (iv) upgrading the management of the medicine supply chain; and (v) improving the efficacy of service delivery.
The transaction technical assistance "Preparing the Khyber Pakhtunkhwa Health Systems Strengthening Program" was approved on 5 October 2021.
Project Details
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Project Officer
Huitzing, Hiddo A.
Central and West Asia Department
Request for information -
Country/Economy
Pakistan -
Sector
- Health
Related Projects
Project Name | Khyber Pakhtunkhwa Health Systems Strengthening Program | ||||
Project Number | 54297-001 | ||||
Country / Economy | Pakistan |
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Project Status | Active | ||||
Project Type / Modality of Assistance | Loan |
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Source of Funding / Amount |
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Strategic Agendas | Environmentally sustainable growth Inclusive economic growth |
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Drivers of Change | Gender Equity and Mainstreaming Governance and capacity development Partnerships |
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Sector / Subsector | Health / Health sector development and reform |
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Gender Equity and Mainstreaming | Effective gender mainstreaming | ||||
Description | The Khyber Pakhtunkhwa Health Systems Strengthening Program results-based loan (RBL) supports the Revamping Secondary Health Care (RSHC) program,* a flagship and province-wide program of the Government of Khyber Pakhtunkhwa to improve secondary health care (SHC) services. The RBL program aims to enhance the quality of SHC services in Khyber Pakhtunkhwa Province by (i) ensuring the availability and implementation of clinical protocols, standards, and guidelines at secondary hospitals; (ii) modernizing hospital infrastructure and medical equipment; (iii) reinforcing the planning of human resources and health services; (iv) upgrading the management of the medicine supply chain; and (v) improving the efficacy of service delivery. The transaction technical assistance "Preparing the Khyber Pakhtunkhwa Health Systems Strengthening Program" was approved on 5 October 2021. *The RSHC program is more commonly known in government documents as "Revamping of Non-Teaching District Head Quarter Hospitals in Khyber Pakhtunkhwa." |
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Project Rationale and Linkage to Country/Regional Strategy | Khyber Pakhtunkhwa Province is facing tremendous challenges in the health sector. Its health outcomes need significant improvement to achieve the Sustainable Development Goals. The neonatal mortality rate is 41 per 1,000 live births, the infant mortality rate is 53 per 1,000 live births, and the maternal mortality ratio is 165 per 100,000 live births. The health indicators are worse in the merged districts (e.g., maternal mortality ratio of 261 per 100,000 live births in 2014). Because of the lack of access to quality primary health care (PHC) and SHC services, people tend to bypass them and seek treatment directly at tertiary care hospitals. This overburdens tertiary services and limits the resources for those who really need them, and is costly both for the government and for the patients, who usually have to travel far. The provincial government, cognizant of the challenges , made improving the quality of PHC and SHC service delivery a central tenet of its health strategy. Quality of care concerns not only quality medical equipment and infrastructure, hygiene, maintenance, and availability of medicines, but also qualified and well-trained medical and support staff who all collaborate in an organized, conducive, accountable, evidence-based, and optimal manner. The Revamping Secondary Health Care (RSHC) program aims to transform SHC by (i) upgrading the infrastructure of the SHC facilities; (ii) providing quality new equipment; (iii) ensuring posting and availability of medical, technical, and administrative staff; (iv) efficiently outsourcing certain services to the private sector; (v) introducing and enhancing health management information systems, including electronic medical records; and (vi) introducing quality assurance regimes. The Minimum Health Services Delivery Package for Secondary Care Khyber Pakhtunkhwa will be implemented. |
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Impact | Accessible, equitable, and quality health care for all people of Khyber Pakhtunkhwa to advance the community's well-being, productivity, and prosperity improved |
Project Outcome | |
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Description of Outcome | Quality of care of secondary hospital services in Khyber Pakhtunkhwa enhanced |
Progress Toward Outcome | |
Implementation Progress | |
Description of Project Outputs | Clinical protocols, standards, and guidelines available and implemented at secondary hospitals Hospital infrastructure and medical equipment modernized Planning of human resources and health services reinforced Management of medicine supply chain upgraded Effectiveness of service delivery improved |
Status of Implementation Progress (Outputs, Activities, and Issues) | |
Geographical Location | Khyber Pakhtunkhwa |
Summary of Environmental and Social Aspects | |
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Environmental Aspects | |
Involuntary Resettlement | |
Indigenous Peoples | |
Stakeholder Communication, Participation, and Consultation | |
During Project Design | |
During Project Implementation |
Responsible ADB Officer | Huitzing, Hiddo A. |
Responsible ADB Department | Central and West Asia Department |
Responsible ADB Division | CWSS |
Executing Agencies |
Department of Health, Khyber Pakhtunkhwa |
Timetable | |
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Concept Clearance | 05 Oct 2021 |
Fact Finding | 30 Mar 2022 to 08 Apr 2022 |
MRM | 22 Jul 2022 |
Approval | 22 Sep 2022 |
Last Review Mission | - |
Last PDS Update | 26 Sep 2022 |
Loan 4222-PAK
Milestones | |||||
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Approval | Signing Date | Effectivity Date | Closing | ||
Original | Revised | Actual | |||
22 Sep 2022 | 04 Nov 2022 | 15 Dec 2022 | 30 Jun 2026 | - | - |
Financing Plan | Loan Utilization | ||||
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Total (Amount in US$ million) | Date | ADB | Others | Net Percentage | |
Project Cost | 417.60 | Cumulative Contract Awards | |||
ADB | 100.00 | 29 Jan 2023 | 0.00 | 0.00 | 0% |
Counterpart | 317.60 | Cumulative Disbursements | |||
Cofinancing | 0.00 | 29 Jan 2023 | 25.00 | 0.00 | 25% |
Project Data Sheets (PDS) contain summary information on the project or program. Because the PDS is a work in progress, some information may not be included in its initial version but will be added as it becomes available. Information about proposed projects is tentative and indicative.
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Title | Document Type | Document Date |
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Loan Agreement (Ordinary Operations [Concessional]) for Loan 4222-PAK: Khyber Pakhtunkhwa Health Systems Strengthening Program | Loan Agreement (Ordinary Resources) | Nov 2022 |
Program Agreement for Loan 4222-PAK: Khyber Pakhtunkhwa Health Systems Strengthening Program | Project/Program Agreements | Nov 2022 |
Khyber Pakhtunkhwa Health Systems Strengthening Program: Report and Recommendation of the President | Reports and Recommendations of the President | Sep 2022 |
Khyber Pakhtunkhwa Health Systems Strengthening Program: Program Implementation Document | Project/Program Administration Manual | Sep 2022 |
Khyber Pakhtunkhwa Health Systems Strengthening Program (KPHSSP): Initial Poverty and Social Analysis | Initial Poverty and Social Analysis | Oct 2021 |
Safeguard Documents See also: Safeguards
Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.
Title | Document Type | Document Date |
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Khyber Pakhtunkhwa Health Systems Strengthening Program (KPHSSP): Program Safeguard Systems Assessment | Program Safeguard Systems Assessments | Jul 2022 |
Evaluation Documents See also: Independent Evaluation
None currently available.
Related Publications
None currently available.
The Access to Information Policy (AIP) establishes the disclosure requirements for documents and information ADB produces or requires to be produced in its operations to facilitate stakeholder participation in ADB's decision-making. For more information, refer to the Safeguard Policy Statement, Operations Manual F1, and Operations Manual L3.
Requests for information may also be directed to the InfoUnit.
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ADB Program to Improve Secondary Health Care in Pakistan’s Khyber Pakhtunkhwa Province
ADB has approved a $100 million results-based loan to help strengthen the quality of secondary health care in Khyber Pakhtunkhwa province in Pakistan.
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Procurement Plan
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