Role of Technology in Promoting Healthcare Delivery in Pakistan
The pursuit of enhanced well-being and equitable healthcare is a crucial goal for all nations. Access to high-quality healthcare is not only critical to wellbeing and human development but also contributes to to poverty alleviation, boosts productivity in the workforce, and enhances learning capabilities. Although Pakistan has made progress in healthcare provision – evident by the improvement in some of the SDG 3 health and wellbeing indicators, overall expenditure on health as a percentage of GDP has improved only slightly from 2.14% in 2011 to 3% in 2021. In the region, Pakistan ranks second to last in South Asia on the Universal Healthcare Coverage (UHC) front.
The healthcare challenge in Pakistan is multi-faceted, requiring a multi-pronged approach to make progress against national-level health goals and international commitments. A key issue is low GDP allocation towards healthcare, exacerbated by the mounting pressures due to population growth and worsening climate change vulnerability. The nation grapples with a dual-disease burden characterized by both communicable and non-communicable diseases, with approximately 15 million people affected by hepatitis B and C, the country ranking as the 5th highest tuberculosis burden in the world, focal geographical area of malaria endemicity. Non-communicable diseases such as diabetes, cardiovascular conditions and respiratory illnesses account for approximately 60 percent deaths, while there is significant burden of communicable diseases in neonatal conditions.
Intervention is required on multiple fronts to address barriers and challenges, and improve overall efficiency and efficacy of Pakistan’s healthcare system. Tech-enabled solutions for improving healthcare delivery have gained significant prominence and policy-focus around the globe. It is no coincidence that developed countries such as Switzerland and Germany which have the highest UHC, have also performed extremely well in terms of healthcare innovation – of which technology is major component, along with quality, choice and fiscal sustainability – according to the World Index of Healthcare Innovation (2022). Hence, it is crucial to explore how technology can supplement health focused interventions by the private and public sectors, catalyse innovation and have a transformative impact in the health industry of Pakistan.
One key barrier to accessing quality healthcare in Pakistan is a lack of affordability. This is linked to the extremely high cost-of-doing business, cost of financing and growth constraints due to which SMEs in the healthcare sector are unable to benefit scale economies. Furthermore, there are signification market frictions tied to transaction costs. Digital health platforms can reduce reliance on brick-and-mortar establishments for delivering a range of healthcare and associated services, effectively lowering CAPEX and OPEX requirements. For instance, tech-enabled solutions using Machine-Learning and AI models have had success in delivering a range of telemedical and diagnostic services such as interpreting radiology results, conducting psychiatric evaluation, etc. However, such models are data intensive which is a challenge in Pakistan since information sharing between health providers is almost non-existent.
This brings us to another issue which adversely impacts efficiency. In Pakistan, the dynamic of consumers over-relying on private tertiary facilities for healthcare majorly drives up out-of-pocket health expenditure – which is 55% of the country’s total healthcare expenditure. A well-functioning referral system is imperative to achieve resource efficiency by effectively directing patients to primary, secondary and tertiary facilities in a systematic manner, and ensure that patients receive appropriate care at the right level. A key perquisite of such a system is interoperability of medical information. Investment in technology and also policy initiative is required to establish information sharing platforms between private health providers and also link them to the primary and secondary public health facilities, enabling the much-needed synergies between the public and private sectors.
Moreover, a transformative potential of digital platforms is that they facilitate a healthcare network by acting as intermediaries between consumers and health-providers. These can lower customer-acquisition costs and streamlining patient management for health-providers, and also minimise transaction costs associated to accessing healthcare for consumers. In addition, intermediation allows for health-providers to specialise and become centres-of-excellence in their domains, while tertiary-care consumers can be directed according to their specialised healthcare demands.
Specialisation can result in productivity and cost-efficiency-gains for health businesses and also push forward innovation at an industry level.
Furthermore, embedded finance in healthcare is a huge opportunity to unlock real-demand, which can be furthered through tech-enabled solutions. The additionality of technology is that it reduces the cost of financing, allowing consumers to utilize financial tools such as micro-credit and insurance to meet health expenditures. In Pakistan, micro-credit is mainly availed by households to manage their healthcare expenses, which is a significant burden due to high interest rates. Technology platforms can connect existing microfinance providers with healthcare providers without requiring substantial investment by providers, while also making credit cheaper for consumers.
In addition, health insurance is a powerful tool for improving accessibility to healthcare; unfortunately, in Pakistan health insurance coverage is below 50% of the population. The application of AI-enabled technology for insurance pricing is something that has amassed recognition amongst players in insurance industries around the globe; its effectiveness lies in leveraging big data to ensure accurate risk-based pricing which is important to encourage new player to enter the existing market, while also supplement existing health insurance programmes such as the Sehat Sahulat Programme.
Along with UHC, addressing its dual disease burden is a top priority for Pakistan. However, for the health system to be responsive, it needs be able to exploit data to identify priority areas for public intervention and private investment. The high volume of data in the healthcare industry presents the challenge of data management, with exorbitant costs pertaining to hard infrastructure. In this regard, Cloud Computing is can play an instrumental role in promoting data accessibility, scalability and interoperability while also ensuring cost-effectiveness and security.
In conclusion, Pakistan’s healthcare system is confronted with a multitude of challenges. Nevertheless, the advent of technology-enabled solutions holds immense promise in not only tackling these obstacles but also strengthening the existing healthcare infrastructure. However, leveraging technology and realizing its potential for transformative change necessitates substantial investments in technology, policy initiatives, and robust collaborations between the public and private sectors.