Sehat Sahulat Programme
Informations de base
Pays
Régions
Type de programme
Groupe de population
Persons with disabilities, Poor households
Détails du programme
Objectifs du programme
Improve access of the poor population to good quality medical services, through a micro health insurance scheme.
Date de début
Couverture
Over 42 million families are enrolled, as of October 2023
Sehat Sahulat Program website. n.d. <https://www.pmhealthprogram.gov.pk/> Accessed 23 October 2023
Dépenses du programme
The Government of Punjab allocating Rs. 65 billion to implement SSP on 9 December 2020.
Ciblage et éligibilité
Méthodes de ciblage
Proxy Means Test
full universal access to all families domiciled in KP, AJK and Tharparkar district (Sindh), irrespective of their financial status.
Groupes cibles
Transgenders (nationally) and peoples with disability (nationally), people living in poverty
Critère d'éligibilité
(i) Must be a permanent citizen of Pakistan and A a family must be below or just above the poverty line. The eligibility income thresholds was set at approximately $60 per month (about Rs. 9000 per month) in 2022.
(ii) Transgenders (nationally) and peoples with disability (nationally), irrespective of their financial status.
(iii) Full universal access to all families domiciled in Khyber Pakhtunkhwa (KP), Azad and Jammu Kashmir (AJK) and Tharparkar district (Sindh), irrespective of their financial status. The families in KP and Tharparkar can access the health facility through their National Identity Cards without needing to enroll in the SSP system.
Couverture et autres informations
Type de bénéfices
Montant des bénéfices
i.A Family can use initially up to 300,000 PKR for priority healthcare services and 60,000 PKR for secondary healthcare services per year.
ii.The coverage could be extended up to 1,000,000 PKR under special circumstances. In some cases, the treatment/services will be offered even if the initial coverage limit is exhausted.
iii.All hospitalizations will be covered except for the exclusions agreed with the Insurance Company;
iv.The beneficiary can go to any empanelled hospital across Pakistan; One day pre and five days post-hospitalization expenses are covered, including medicine.
Fréquence de paiement/livraison
Mécanisme de versement des bénéfices
The provision of services to the beneficiaries is executed through an insurance company.
Both public and private healthcare facilities registered by Punjab Healthcare Commission are entitled to empanelment in the scheme.
Durée minimale et maximale des prestations (le cas échéant)
Beneficiaries themselves and their families (defined as husband, wife and any unmarried children).
Mécanismes et fréquence de suivi et évaluation
The National Database and Registration Authority (NADRA) developed a central management information system, which tracks: the number of enrolled beneficiaries; number of admissions and discharges; level of financial utilisation; complaints management and redressal; hospital claims and reimbursements; and beneficiary feedback. The government also conducts random team visits and third parties should conduct patient satisfaction surveys.
Legal Framework
i.Article of Association; ii.Certified AOA & MOA; iii.Memorandum of Association; iv. Companies Act 2017.
