PESHAWAR: The Khyber Pakhtunkhwa government, under the Good Governance Roadmap, has unveiled a set of reforms aimed at transforming the healthcare system in the province. The reforms are directed at strengthening primary and secondary care, workforce development, digitization, and institutional restructuring.
The Health Department announced that the roadmap, endorsed at the chief secretary’s office, would ensure equitable, efficient, and accountable service delivery across more than 2,500 health facilities, catering to a population of over 40 million with an annual patient volume exceeding 35 million visits. According to official data, per capita health spending in the province was USD 45, of which USD 22 was government-financed while the remainder was borne out-of-pocket.
The provincial healthcare workforce comprises 8,052 Medical Officers, 930 District Specialists, 561 Management Cadre doctors, 662 Dental Surgeons, 6,157 Nurses, 17,466 Paramedics, and 18,315 Lady Health Workers and Lady Health Visitors, bringing the total number of skilled professionals to 52,143.
Services are organized across four levels, community, primary, secondary, and tertiary, with 15,800 Lady Health Workers and 1,485 Community Midwives forming the first line of contact at the community level.
The reforms are structured around five key areas: strengthening primary care, modernizing secondary hospitals, building human resource capacity, digitizing health services, and institutional strengthening. Under primary care, the province is expanding 24/7 Basic Emergency Obstetric and Newborn Care services to 250 facilities, ensuring uninterrupted availability of essential medicines and equipment, and integrating polio outreach with routine immunization.
The Expanded Programme on Immunization has already implemented a low-performing union council plan across 184 UCs, launched intensified outreach in 85 areas, and introduced evening outreach in 62 urban UCs of Peshawar, achieving coverage of over 85 percent of zero-dose children. Vaccination hours at 36 of 53 major hospitals have been extended, with 107 vaccinators deployed out of a target of 150.
Secondary healthcare reforms include the establishment of Level-III trauma centers at divisional headquarters and mammography services at Saidu Sharif and D.I Khan, both of which have received PC-1 approval and equipment procurement. The government is also rolling out ten newborn care units in district headquarters hospitals, with civil works and equipment procurement already underway. A parallel program seeks to achieve 80 percent medicine availability and 90 percent infrastructure improvement across secondary hospitals. Biomedical equipment assessments have confirmed that 97 percent of devices are functional, while recruitment of biomedical engineers is ongoing.
A major thrust of the roadmap is the outsourcing of service delivery to the private sector under the Khyber Pakhtunkhwa Health Foundation. The Board of Governors has approved outsourcing of 72 hospitals, including district, tehsil, and Category-D hospitals. Facilities identified include DHQ Lakki Marwat, Miran Shah, Hangu, Tank, Dargai, and Ghallanai, as well as tehsil hospitals in Sadda, Puran, Banda Daud Shah, Chakdara, Madyan, Takhtbhai, Thathi Nasrathi, Samarbagh, and Serai Naruang. Category-D hospitals numbering 46, including facilities in Banna, Kulachi, Booni, Chakeser, Oghi, Kakki, Lachi, Bisham, and Shahbaz Garhi, are also part of the outsourcing initiative. Simultaneously, operational liabilities under public-private partnerships are being cleared, with revised management contracts vetted by the Law and Finance Departments.
Human resources are being strengthened through a new legal framework for postgraduate medical education and mandatory postings in primary healthcare, with draft legislation under cabinet review.
The Health Department is working to regularize 90 percent of managerial posts, enforce biometric attendance across facilities, and expand nursing education by outsourcing colleges through public-private partnerships. The provincial Human Resource Management Information System has digitized the records of 6,000 medical officers, with further integration underway.
Digitization efforts are spearheaded by the creation of a Health Information Systems Development Unit (HISDU), currently pending PDWP approval, and the expansion of the Independent Monitoring Unit to merged districts, with recruitment proposals under Finance Department review. Institutional strengthening includes revision of the Health Sector Policy 2018 to extend to 2026, restructuring of the Health Sector Reform Unit, revitalization of the Health Care Commission through amendments to the 2015 Act, and strengthening of the Health Foundation as the one-window PPP agency.
Regional directorates are being equipped with proposed allocations of Rs58 million each, while service charges across facilities are under review to align with private sector benchmarks. The roadmap also envisages revitalization of the Integrated Disease Surveillance and Response System (IDSRS), relocation of the Provincial Public Health Reference Laboratory, and creation of a provincial One Health structure linking health, livestock, and environment sectors. The Health Secretariat has digitized transfers, postings, and summaries while initiating electronic procurement and task management systems.
The Directorate General Health Services has begun a restructuring process, including digitization of performance evaluations and HR workflows. Oversight of Medical Teaching Institutions is being enhanced through amendments to the MTI Act and mandatory financial and performance audits by independent firms.
In addressing non-communicable diseases, the government has appointed a regular project director for the Diabetes Control Program and revised a three-year PC-1 to ensure uninterrupted insulin supply. Meanwhile, newborn and maternal health has been prioritized through expanded training programs, integration of family planning commodities into the medicine cycle, and targeted renovation of primary and secondary facilities.
The Health Department stated that the success of the roadmap will depend on timely cabinet approvals, financial support, and coordinated implementation across institutions. Officials added that progress has already been achieved in biometric attendance, digitisation of summaries, EPI strengthening and facility outsourcing, while pending initiatives such as IDSRS institutionalisation, MTI oversight and HR reforms are scheduled for cabinet review in the coming months.
Published in The News on September 1, 2025.
