The roundtable with parliamentarians: “Health Issues and Challenges in Sindh Districts” was held in Karachi, on the 11th of May 2015. This was the third of such meetings, part of a larger initiative: “Engaging Parliamentarians to Advance Health Issues in Sindh”. The initiative is planned by JSI and USAID with the help of Governance & Police Advisers. This initiative is progressing forward in the form of a series of seminars and focused group meetings on health related; the goal of these discussions is to sensitize the Sindh parliamentarians on the nature of health risks being faced by communities and challenges of implementation being faced by health administrations in districts and the provincial government; and how can parliamentarians help by working across party lines to bring a sharper focus on issues.
This session was different from the previous two sessions in its thrust. In first session on 30th September 2014, a broader overview was presented, in second session on 15th Jan focus was on budget making; this current session was focused entirely on the issues and challenges being faced inside the districts and how can USAID and its partners provide technical assistance to help improve the situation. Session was very widely attended by the parliamentarians from the fifteen selected districts where USAID projects are ongoing. Dr. MoeedPirzada, of Governance & Policy Advisers, moderated the session. The session was planned such that the five USAID partners on health could give an overview of their work to the district parliamentarians. These were: JSI Research & Training (Dr Nabila Ali), MSS (DrShabnumSarfraz), JPHIEGO/MCHIP (DrFaridMidhet), JHU (DrShuaib Khan) and JSI Deliver (Inamullah Khan).
Dr. Nabila Ali, CoP JSI Research & Training made the first presentation. She started by giving an overview that after the 18th amendment health has essentially become a provincial subject with all leadership and strategy challenges being faced by the provinces. Consequently, ‘District’has emerged as a discrete unit and all planning has to be devolved to this level. Towards the end, ShabbirChandio (USAID) concluded by saying that USAID is providing technical assistance however we all have to work together to solve governance issues and the latter is not something USAID could do for the country itself. Bashir Mangi (DG PWD) and Khalid Sheikh (Special Secretary Health) spoke to explain Sindh Govt.’s perspective on the issues highlighted by the parliamentarians and the USAID partners. Bashir Mangi admitted the challenges in terms of human resource acquisition, development and sustainability however he emphasized that situation is not static and is improving by each year. He explained that recently Rs. 5.6 billion has been approved for contraceptives and within the next 5-6 years this problem (related to shortages and unavailability) will cease to exist. Khalid Sheikh admitted that Sindh Govt. lacks management cadre in health which creates huge problems – many of which were highlighted by the parliamentarians.