Nabeela Ali, Mohsin Saeed Khan.
Devolution and health challenges and opportunities- a year later.
Pak J Public Health Jan ;2(2):62-5.

Political devolution within Pakistan provides a formidable opportunity for healthcare systems to address issues related to systems, planning health care delivery structures, programmes, and services. The 18th Constitutional Amendment has created a vacuum as the devolved functions were not detailed out in any plan of action. The objective of the paper is to present the status of devolution one year after the notification, its effects on the health planning, financing, coordination and service delivery. This is a desk analysis of the processes and progress made after the 18the Constitutional Amendment. The roles of the Federal Ministry of Health have been devolved to eight institutions including provinces of which seven are federal. There is no central coordinating body to oversee policy planning, provide strategic guidelines, set standards, monitor and evaluate health programs, liase with development partners and report on international commitments. Pakistan through its 18th Constitutional Amendment has not only placed challenges for its health sector but also provided opportunities for the provinces to have a prioritized and integrated health programs.

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