Health sector reforms programme in Punjab: a primary healthcare initiative.

Punjab is the largest province of Pakistan with a population of over 85 million. Provision of equal access to primary healthcare is a mammoth task in this developing country with well known resource constraints. Punjab has a network of 2748 primary healthcare (PHC) facilities spread over an area of 205,345 km2. The Punjab government has initiated a two-year Health Sector Reforms Programme (HSRP) to make the primary healthcare network of 2456 basic health units and 292 rural health centres fully operational. Benefits of the programme for medical staff include a substantial salary and an incentive package combined with improved working and living conditions, a pre-service orientation programme and regular in-service training, a supportive monitoring and supervisory mechanism, and periodic third party inspections. The strong political and administrative will to harness all available resources is the key to the success of the HSRP. All of the 35 district governments have signed terms of partnership with the provincial government to execute the programme. Preliminary reports show a rise in the recruitment of healthcare providers in remote rural facilities.