Business Recorder
EDITORIAL: It turns out that more than 80 percent of Balochistan’s population is now without access to primary healthcare, a reality acknowledged by the provincial health secretary that leaves little room for explanation and none for delay. The admission confirms what has long been visible: the most basic tier of public service delivery in the province remains fundamentally broken. The usual explanations have been repeated again. Vast geography, difficult terrain and limited resources are cited as structural constraints. These challenges are real, but they are also longstanding. A policy environment that continues to cite the same limitations without materially improving outcomes points to a failure of execution rather than a lack of understanding. Budget constraints are central to the discussion. The comparison with Punjab, where the health budget alone exceeds the total development outlay of Balochistan, highlights a severe imbalance. Yet the scale of deprivation suggests that the problem extends beyond the size of allocations. Efficiency in deployment, prioritisation of primary care and accountability in spending remain equally critical, and these have not kept pace. Human resource shortages remain the most immediate bottleneck. The promotion of several hundred medical officers may ease administrative pressure, but it does not resolve the deeper issue of staffing in remote areas. Doctors are reluctant to serve in districts where infrastructure is weak, security is uncertain and career incentives are limited. Without a framework that links postings in underserved areas to meaningful professional and financial incentives, staffing gaps will persist. Security concerns continue to undermine whatever capacity exists. Health facilities cannot function effectively in an environment where personnel face risks to their safety. In several parts of the province, the presence of infrastructure does not translate into service delivery because the conditions required for regular operation are absent. Addressing healthcare in isolation from the broader security context limits the effectiveness of any intervention. The province’s low education profile further constrains outcomes. Healthcare systems rely on awareness and access working together. Low literacy levels and limited public health awareness reduce the utilisation of available services, creating a cycle in which poor outcomes reinforce social and economic vulnerability. Any attempt to improve healthcare delivery must therefore run alongside efforts to raise education and awareness standards. The government’s focus on reforms and digitisation, including plans to connect health centres through satellite-based systems, reflects an effort to bridge geographic barriers. Telemedicine and remote monitoring can support service delivery, particularly in sparsely populated areas. However, these measures can only supplement a system that functions on the ground. Technology cannot compensate for facilities that are understaffed or inaccessible. The central issue is the absence of a shift from recognition to delivery. The problems have been identified, the constraints are well understood and reforms have been announced. What remains missing is a clear demonstration of outcomes. Without timelines, measurable targets and consistent follow-through, policy initiatives risk remaining confined to statements of intent. The consequences of this gap are not limited to the health sector. When primary healthcare fails, pressure shifts to higher levels of care, increasing costs and reducing efficiency across the system. Preventable conditions escalate into more serious illnesses, placing additional strain on already limited resources. The economic impact follows, as poor health outcomes reduce productivity and deepen existing inequalities. There is also a broader national dimension. Persistent disparities in access to essential services weaken the cohesion of the federation. Balochistan’s challenges are often framed in terms of geography and security, but they also reflect a deficit in sustained governance that has yet to be addressed. The path forward is clear in principle. Investment in primary healthcare infrastructure must be prioritised, supported by incentives that attract and retain medical professionals in underserved areas. Security conditions need to be stabilised in parallel with service delivery efforts. Education and awareness initiatives must reinforce access. Most importantly, accountability must be built into every stage of implementation. The acknowledgement of the crisis is no longer the issue. The expectation now rests on delivery. With the scale of deprivation explicitly stated, further delay cannot be justified by constraints that have been known for decades. The measure of progress will not lie in additional announcements, but in whether access to primary healthcare begins to expand in measurable terms within a defined timeframe. Copyright Business Recorder, 2026
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