Pakistan is leading the way with its welfare state – the world can learn from its innovation

[Chakar The Great]

Source: Telegraph UK

More than 50 years ago countries as far apart as Indonesia, Tanzania and Guatemala began to train local people as community health workers who can provide some treatments themselves and, as importantly, help their neighbours and communities prevent disease.

The idea took off and spread through low- and middle-income countries with Pakistan, for example, establishing a programme of Lady Health Workers. Health improvement starts in the community and if you tackle challenges at the source, whether it be health, education or skills training, it will have major health and economic benefits later. The community health worker model has been so successful that many years later it was picked up in high-income countries with New York, for example, now having a well-established network.

This community-based approach allows health, education and other social issues to be tackled together in a holistic fashion. Girls and boys who are healthy, for example, are more likely to get a good education and go on to be productive members of society and live healthy lives. The strongest systems work across sectors, breaking through barriers to drive programmes and solutions that touch on health, education, economic livelihoods and beyond.

This is why we should all be looking with particular interest at the work underway in Pakistan to build a sustainable welfare state. Called Ehsaas, which in Urdu literally means ‘empathy’, the new initiative is one of the most comprehensive welfare programmes ever undertaken by a national government, with an underlying ambition to create a social safety net for Pakistan that could transform the lives of millions. It is enormously wide-ranging and ambitious.


Despite some progress since the turn of the millennium, a quarter of people in Pakistan still live in poverty, with rates of rural poverty more than double those in urban areas. With one of the fastest growing populations in the world, Pakistan will have to create a million new jobs each year just to keep up with the number of young people entering the job market. Educational attainment is some of the worst in the region and health indicators are not promising, demonstrated by the fact that Pakistan is one of only two countries where the wild poliovirus remains endemic.


This is the context in which Ehsaas is seeking to end the cycle of poverty faced by many Pakistanis. Acknowledging that no single area will unlock this ambition alone, Ehsaas encompasses 134 policies that range from tackling corruption to creating educational opportunities to providing the elderly with decent homes.

The programme is led by Dr Sania Nishtar, Special Assistant to the Prime Minister of Pakistan on Poverty Alleviation and Social Protection, who has been mandated by Prime Minister Imran Khan to work in partnership across multiple federal ministries that these policies will be driven by, as well with provincial governments who have devolved powers including on education and health. Without a multisectoral approach, it would not be possible to create the welfare state envisioned by Ehsaas.

The launch of a countrywide public consultation was particularly important as it was the first time a public policy in Pakistan had been developed in this way and demonstrates a new level of openness and transparency. Ehsaas’s impact will hopefully go much further than the borders of Pakistan. It will provide many lessons for low-, middle- and high-income countries.


As I argued in my book Turning the World Upside Down, development should not be seen as one-way exchange between the rich and the poor. We can and must all learn from each other. The UK's and other European welfare states that developed in the 20th century covered all sectors and have been very influential; but now our policy makers can learn from Pakistan’s more integrated and cross-sectoral approach with its emphasis on governance and empowerment and greater understanding of the role that gender and other factors play. Too often we are stuck in our silos and not taking this system wide approach.


We should seek to learn from the innovative approaches that Ehsaas plans to take to lift children out of poverty, to ensure girls get the same shot as boys in school and to ensure that millions of young people have both the skills training and a social safety net. This includes empowering the most marginalized women through the latest mobile technology and monitoring school attendance using biometric identification.

There is a long road ahead to achieve the ambitions set out in the Ehsaas programme, which is still in its infancy. Whatever the eventual outcome, it is encouraging to see a country with Pakistan’s potential setting its ambitions so high. As with the community health worker system that turned global health on its head, the breaking down of silos is a vital step in building a welfare state in Pakistan but also provides a blueprint for how other countries can ensure essential services for all.

• Lord Nigel Crisp was Chief Executive of the NHS and Permanent Secretary of the Department of health from 2000-2006. He is Co-Chair of the All-Party Parliamentary Group on Global Health and Co-chair of the global Nursing Now campaign.

 

[Yaseen1]

There is still a long way to go,our health and education conditions are still miserable and less jobs available in market .Look at high spread of dingue these days and failure of govt authorities to control such epidemic.

 

[Hex0maniac]

There is still a long way to go,our health and education conditions are still miserable and less jobs available in market .Look at high spread of dingue these days and failure of govt authorities to control such epidemic.

atleast people gave a f@#k now, about there living standards.

 

[Ghessan]

the development of a nation is based on rule of law, health and quality education. unfortunately everything is missing in this country of 220 million or one can say is deliberately not provided to the masses for the benefit of the elite. that elite is not only sitting in the parliament but have ruled by other sources also. dictators are blamed for not letting democracy come out of its infancy is somewhat true. had the democracy continue for those 72 years, this ruling elite would have been exposed and may have been kicked out of the country. many still do not believe this, they are of the view, the tenures of marshal law were the best times, everybody has his own point of view.

although economic consequences, the riches, the elite keeping wealth with themselves. one thing that is more important is people themselves:

what stops us provide a good upbringing to our kids which is on our part? whatever standard of the education we can provide, we can still help them even if we are ignorant with no or little education.

what stops us from helping our kids to learn how to talk, behave, eat, drink, cross the road, help others? we can expect this from the ignorant masses and not from the rest. agree that uneducated lot is big but this is where the responsibility of the govt comes. only govt can help their children by providing quality education.

the way we behave, we teach the same to our children, they are learning minds and pick things quick. everything they learn is from us either we are their parents or some other guy. this is our collective duty not to our kids only but to every child to preform well hence make them learn good things.

where do we stand? we do not take our moral duty serious and are so ignorant that we can fight with others for our own kid doing wrong. what are we teaching them by doing this?

those in better financial position and are educated are even worst of their kind. they have no time for their kids (but to earn wealth) and blame the society. the best they can do is giving those tiny minds a sense of superiority complex.

the strongest lot of our society is the uneducated, with better financially resources. they are doing worst to the society. kind of upbriging they are providing is dangerous and creating criminals in the society with resources in their hands.

besides school, giving their children academies, academies are playing a very crucial role in developing the character of this young lot by damaging the good out of them.

as a common man when we move in to a society we have a lot to present to the public by showing character but everything we have is superficial. in reality we are what we are at home and it comes out atonce in a conflict of interest.

the collective responsibility of making a society ideal is missing. the only way out is to educate the masses with a quality education. quality education is not defined as the standard of education providing buildings, infrastructure and high tech solutions but by providing quality course material in the form of books and teachers who can make them learn that is provided.

education is the major and most important aspect that help succeeding any program like "Ehsaas" and as many we start we will succeed them.

the only thing is that every person either he or she is educated or ignorant, poor or wealthy must take his or her responsibilities with responsibility.

and there is a lot to to do on govt level which is very challenging because until the thinking is not changed we do not expect any outcome. on national level, the initiative is always expected from govt. quality education is necessary and is a very long process because there is a lot change.