In Pakistan, doctors report delays under the Sehat Card Plus program
In Khyber Pakhtunkhwa province in northwestern Pakistan, patients may wait a long time for medical services under the Sehat Card Plus program. Senior doctors link this to different rules for distributing program revenue at medical teaching institutions (MTIs), while district hospitals use a single formula approved by the provincial government.
As Dawn reports, district hospitals in Khyber Pakhtunkhwa have used a mechanism for retaining and using funds since 2020. MTIs are managed by their own boards of governors, which, according to medical professionals, have developed different approaches to distributing Sehat Card Plus proceeds.
Doctors' statements
Sources told the publication that at some MTIs, consultants schedule distant appointment or surgery dates for patients using the program because of a smaller share of revenue. According to them, medical professionals may give preference to patients who pay for treatment through institutional practice, as it generates higher income.
Doctors also said that some specialists left MTIs because they disagreed with the distribution of funds and moved to private hospitals. They called on the MTI Policy Board to introduce for these institutions a mechanism similar to the one used in district hospitals. According to the sources, in some hospitals patients are scheduled for surgeries in 2027–2029, while paid services through institutional practice may be available on the same day.
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Distribution of program funds
The approved formula provides for directing 25% of Sehat Card Plus revenue to improving service quality, minor repairs and maintenance of medical facilities. Another 20% is to be spent on consumables, while 30% is to be distributed among doctors, including surgeons, physicians, anesthesiologists, pathologists, radiologists and medical officers. Nurses and paramedical staff are allocated 15%, while administrative and support staff receive 10%.
The Khyber Pakhtunkhwa government allocated 41 billion rupees to the program in the 2026–2027 fiscal year, compared with 35 billion rupees in the previous year. The program covers more than 10.8 million families, or 34 million people; each family can receive services worth up to 1 million rupees per year. It involves 172 accredited hospitals in the province, while 1,000 medical facilities have been designated across the country overall.
MTI Policy Board Chairman Professor Nausherwan Burki told Dawn that all MTIs had been reminded again about the single formula. According to him, the board must ensure that provincial residents benefit from the free healthcare program.
