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Public sector institutions, politics and outsourcing: Reforming the provision of primary healthcare in Punjab, Pakistan


  • Iram A. Khan

    (Office of the Auditor General of Pakistan, Islamabad, Pakistan)


Lodhran|Rahim Yar Khan (RYK) model of primary healthcare is a home-grown experiment in Pakistan. The model envisaged transferring the management of primary healthcare facilities to a public sector NGO. The paper finds that through the re-alignment of interest groups, the model was replicated in several other districts of the province. It also examines the evolution of stakeholders' behaviour, interest, position and influence in its implementation over a period of time. The study concludes that sustainability of the model remains doubtful unless public sector health bureaucracy is restructured and made to work effectively. Copyright © 2009 John Wiley & Sons, Ltd.

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  • Iram A. Khan, 2010. "Public sector institutions, politics and outsourcing: Reforming the provision of primary healthcare in Punjab, Pakistan," Journal of International Development, John Wiley & Sons, Ltd., vol. 22(4), pages 424-440.
  • Handle: RePEc:wly:jintdv:v:22:y:2010:i:4:p:424-440
    DOI: 10.1002/jid.1574

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    References listed on IDEAS

    1. de Beyer, Joy A. & Preker, Alexander S. & Feachem, Richard G. A., 2000. "The role of the World Bank in international health: renewed commitment and partnership," Social Science & Medicine, Elsevier, vol. 50(2), pages 169-176, January.
    2. Pfeiffer, James, 2003. "International NGOs and primary health care in Mozambique: the need for a new model of collaboration," Social Science & Medicine, Elsevier, vol. 56(4), pages 725-738, February.
    3. Nina Gera, 2003. "Pakistan’s Health Care Under Structural Adjustment," Lahore Journal of Economics, Department of Economics, The Lahore School of Economics, vol. 8(2), pages 65-81, Jul-Dec.
    4. repec:mes:jeciss:v:30:y:1996:i:4:p:1212-1216 is not listed on IDEAS
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