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Health Policy and Planning; 16(2): 180-186
© Oxford University Press 2001

Using costing as a district planning and management tool in Balochistan, Pakistan

A Green1, B Ali2, A Naeem2 and A Vassall3

1 Nuffield Institute for Health, University of Leeds, UK,
2 Department of Administrative Sciences, University of Balochistan, Pakistan and
3 Royal Tropical Institute (KIT), Amsterdam, The Netherlands

This paper reports on two studies in the province of Balochistan, Pakistan, analyzing the costs of primary care facilities and district and divisional hospitals. There are no known previous cost studies within Balochistan and the information gained is a critical element in developing a more rational allocation of resources within the health sector. The results demonstrate both the high level of under-funding of primary care within the health sector and the current inefficiency of allocation towards primary care and, within budgets, between different line items. Medicines in particular are significantly under-funded at the expense of staffing costs. The results are of use in developing more bottom-up budgeting systems within a more rational resource allocation system that is being developed as an element of the more decentralized health system towards which the province is working.


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