Khyber Pakhtunkhwa: health initiative faces transparency issues

Serious questions have been raised over the source and spending of a still unspecified amount in the much publicised Sehat Ka Insaf (Health for all) programme in Khyber Pakhtunkhwa, according to documents available with Dawn. No one in the PTI-led provincial government appears to have a clue about the source and utilisation of funds in health initiative. Sehat Ka Insaf was launched last month with fanfare, billboards in Peshawar and a massive media campaign. But it soon courted controversy and ANP MPA Sardar Hussain Babak posted a question in the provincial assembly, demanding its details. Background interviews with officials in the health, finance and information departments drew a blank about the identity of the donors, amount of funds and spending mechanism.Senior Finance Minister Sirajul Haq, belonging to PTI’s coalition partner Jamaat-i-Islami, sent a letter to Health Minister Shaukat Yousafzai this week, seeking details about the programme. In the letter, a copy of which is available with Dawn, Mr Haq sought details about the source of funding, transfer mechanism and total allocation for the campaign. He also wanted to know about the major components of the campaign, its activities and timelines, implementing partners and their roles, expenditure break-up and details of the advertisement campaign. While Mr Haq declined to comment and Mr Yousafzai was not available to give his viewpoint, officials said the massive publicity campaign was being run from Islamabad through a Lahore-based advertising agency. Phone calls to the advertising agency, at its head office in Lahore, didn’t go through. The company’s senior executive said he would return with details about the campaign. Who short-listed the company, what criteria were used and whose accounts were being used to pay for the campaign is not known. “Where is the money coming from, to whose accounts it is going and who is authorising the spending and making payments? We have no clue,” an official said. But one official said the Rs240 million publicity campaign was being supervised by a close associate of PTI chief Imran Khan. “We have nothing to do with the campaign other than providing logistic support for the vaccination programme.” An official said the funding was coming from Unicef, but he did not know who had ordered the campaign, which accounts were being used to funnel the amount and whether or not any mechanism had been adopted to short-list the companies involved.

Primary healthcare initiative

Concern has also been shown by some official quarters over attempts by “a powerful lobby within the party” to get the contract of a $16m multi-donor trust fund for revitalisation of basic health units, rural health centres and Tehsil headquarters in six districts. So much so, that, according to credible sources, the issue may lead to the exit of the health minister. The sources said that Mr Yousafzai, who had reportedly refused to succumb to pressure, had been summoned twice to Islamabad by the party leadership in the recent past and informed about the decision. “He was summoned and asked to consider giving out the contract. He flatly refused. Chances are he may either be sacked or given another portfolio in a cabinet reshuffle in the next few days,” a senior PTI leader said. The sources said the lobby wanted the World Bank-funded programme in Lower Dir, Buner, Battagram, Dera Ismail Khan, Tor Ghar and Kohistan to be given to the Peoples Primary Healthcare Initiative without going through the bidding process. The PPHI -- a brainchild of Jahangir Khan Tareen, now PTI’s secretary general, based on his primary healthcare system in Rahimyar Khan -- was launched in 2005. The programme, which was launched throughout the country to strengthen basic healthcare, includes 573 BHUs in 17 districts of Khyber Pakhtunkhwa under the umbrella of the Sarhad Rural Support Programme. The sources said that one of the principal supporters of the PPHI wanted the minister to award it the contract. They said the PPHI had initially participated in the bidding process but later withdrawn, but the contention is disputed by the PPHI. The health department, the sources said, wanted to contract out the initiative through open bidding. They point the finger at Mr Tareen. Mr Tareen, however, denied the accusation. He said that he had no link with the PPHI since 2008. He also denied having exerted pressure to support the PPHI. “This is absolutely wrong. I have nothing to do with PPHI now,” he said. He said his basic objection was over wastage of resources. “What the health department has proposed amounts to wastage of resources. Rs1.5 billion is a lot of money out of which Rs1.05bn has been proposed to be spent on raise in salaries, purchase of cars, workshops and consultancies. Only Rs95m has been set aside for infrastructure.” “This is against PTI’s ideology of providing good healthcare to people at their doorsteps. Some vested interests are involved to spread lies,” he said.