GOOD SAMARITAN Dr. Sania Nishtar (Founder & President Heartfile)

GOOD SAMARITAN Dr. Sania Nishtar

Founder & President Heartfile

Report filed by Adil Ahmad (Editor, TCS CONNECT Corporate Magazine)

Rana and Saeed Allawala, both members of the Heartfile Leaders Network, hosted a reception recently at which Dr. Sania Nishtar, the Founder and President of Heartfile, introduced the Heartfile Health Financing Program, her global award winning social protection program which protects people from foregoing medical care, or being pushed into poverty as a result of medical costs..

Heartfile is a non-profit NGO think tank with a focus on policy analysis and innovative solutions for improving health systems in Pakistan. “Here at Heartfile, we seek to act with integrity, to be inclusive, and to work co-operatively while retaining our independence at all times,” says Dr. Sania Nishtar.

Heartfile was established by Dr. Sania Nishtar who, in 1999, left a lucrative career as Pakistan’s first woman cardiologist to establish the NGO. Heartfile today is the most powerful health policy voice and catalyst for health reform in Pakistan, and is recognized as a model for replication in other developing countries.

The Sania Nishtar Health Fund was launched at an event hosted by the Rockefeller Foundation in New York on September 20, 2011. The fund has been set up to support the work of Heartfile Health Financing and has been created with the Global Innovation Award that Dr. Nishtar received in July from the Rockefeller Foundation. Participating agencies included Partners for a New Beginning at the Aspen Institute, the American Pakistan Foundation, the World Economic Forum and the World Heart Federation. Amongst its organizational donors it counts the Rockefeller Foundation, Pakistan Poverty Alleviation Fund, Sulamaniyah Trust, and Pak Iran Joint Investment Company Limited, amongst others.

Recently elected a member of the Federal Interim Cabinet, Dr. Sania Nishtar holds a Fellowship of the Royal College of Physicians and a Ph.D from Kings College, London. Internationally she is a member of many Expert Working Groups and Task Forces of the World Health Organization, a member of the board of the International Union for Health Promotion, the Alliance for Health Policy and Systems Research, the World Economic Forum’s Global Agenda Council, the Ministerial Leadership Initiative for Global Health, the Clinton Global Initiative, and is Chair of GAVI’s Evaluation Advisory Committee.

Sania Nishtar is the author of 6 books, more than 100 peer review articles, and around the same number of op-eds.

Her latest book Choked Pipes was published by Oxford University Press in 2010. She is the recipient of Pakistan’s Sitara e Imtiaz, the European Societies Population Science Award, the Global Innovation Award, and many accolades of the International Biographical Centre and the American Biographical Center.

“In a poverty perpetuating and precipitating context, economic shocks involving catastrophic spending are the most common risks facing households in Pakistan,” says Dr. Sania Nishtar as she explains the Heartfile Health Financing Program. “‘Spending catastrophically’ means spending of critical savings, selling assets, relinquishing basic needs and/or borrowing in order to finance healthcare through out-of-pocket payments. Two thirds of the households recently surveyed in Pakistan reported that they had been affected by one or more health shocks and had spent catastrophically during the last 3 years.”

Since the breadwinners of most of these poor households are in the non-formally employed sector, there are difficulties in using insurance as a means of protecting them against the risks of economic health shocks. The other feasible option to protect against catastrophic spending is to enable cash transfers from a ‘social protection’ or ‘health equity fund’. 

“Pakistan’s existing social protection mechanisms for health have a very small envelope and suffer from a number of deficiencies, including abuse and patronage in targeting, unpredictability of coverage and lack of transparency in the use of resources,” she says. 

The Heartfile Health Financing Program involves an IT-supported, automated demand side health financing instrument, its website, that can be accessed by local health care workers to seek urgent support for those running the risk of spending catastrophically. This website is integrated with a custom-made technology platform that enables processing of requests, received through registered service requesters. Heartfile (the clearing house) then ascertains eligibility, verifies requests and subsequently authorizes cash transfers to underwrite the cost of healthcare.

The pilot is envisaged to enable efficient, timely and well targeted cash transfers to protect the poor against catastrophic spending on health, and has the potential to limit abuse. In addition, a seed ‘Health Equity Fund’ has also been established as a means of resourcing cash transfers. 

This system has been designed to eliminate duplication and abuse. In comparison with other social protection systems established by the private sector in the country, this system will provide better visibility to donors, says Dr. Sania Nishtar. “It has been configured to ensure that donors have the ability to view the use of their funds on a transaction basis and have the ability to instruct demand-specific use of their funds. The system also enables donors to have full view of the administrative costs incurred and above a certain category, enables them to request for audit of any transaction or demand processing. As such therefore, this platform is unique even by international standards and offers unprecedented advantages.”

Great going, Dr. Sania Nishtar!

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