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The World Bank has identified major weaknesses in Pakistan health budgeting that are limiting care and wasting funds. The Bank found that budgets are prepared using past numbers rather than real cost estimates. This practice leads to frequent overspending or underspending and makes planning unreliable.
The report found that decision making is too centralised. Local hospitals and clinics had little influence on their own budgets. Officials at district facilities reported that they could not adjust spending to meet urgent needs. The World Bank said this gap creates a mismatch between allocated funds and actual service needs.
The study also flagged erratic fund releases as a core problem. Health managers said that delayed payments for utilities and supplies frequently disrupted services. The report noted that even small bills face the same slow approval steps as large contracts. The World Bank called this process inefficient and recommended simpler rules for low value payments.
Automated reporting systems exist, but poor connectivity limited timely data from rural facilities. The Bank noted that weak cashflow management and poor revenue forecasts made it harder to track execution in real time. The report welcomed Pakistan Green Corridor steps to speed small transactions but said wider reforms are essential.
The World Bank recommended better costing methods more financial autonomy for frontline health facilities predictable fund release schedules and strengthened information systems. The Bank said these changes would improve service continuity protect patients and make public spending more effective.
Officials will face pressure to act quickly to ensure hospitals can pay for medicines staff and electricity without interruption.
