AKHS,P funds come from a variety of sources. As a vital ingredient in social welfare systems, which aim to become self-sustaining, user fees are consistently set, even for the most highly subsidised services. AKDN is testing a wide mix of financing tools, including micro-insurance and the use of vouchers to protect the poor and reduce the reliance on user fees. This principle is actually serving to broaden access to AKHS,P services.
When facilities become self-sustaining, AKHS,P uses any operating surpluses they generate to finance other programmes and to subsidise services to the very poor. AKHS,P addresses the health problems of specific local populations in Pakistan. To do so more effectively, its health care system is decentralised, and the services it offers vary according to the needs of its five programme regions in Karachi, Sindh, Punjab, Gilgit-Baltistan and Chitral. In the rural areas of Pakistan where AKHS,P operates, reaching people in remote areas with primary health care services, especially the high-risk groups such as mothers and young children, continues to be a high priority, as is the provision of adequate diagnostic services, curative care, and referral services for the general population.
AKHS,P operates 125 basic health centres, 6 comprehensive health centres and the Aga Khan Gilgit Medical Centre. AKHS, P now also operates 5 government health centres in public-private partnership agreements. In the North of Pakistan, AKHS,P has been implementing the Northern Pakistan Primary Health Care Programme since 1987. Working in partnership with local communities, the government, and other AKDN institutions, like the Aga Khan Rural Support Programme, the goal has been to find sustainable ways of financing and delivering primary health care in the high-mountain valleys. This has led to a village-based approach -- the designation of community health workers by the local village organisation, the training of these workers in community-based disease prevention, and the reorientation of health professionals (government and private) to primary health care. Through this and related programmes, AKHS,P has been working to promote a new orientation of health services in Pakistan towards primary health care.
Close collaboration with the Aga Khan Foundation (AKF) and the Aga Khan University (AKU), as well as with the government health systems, has been the cornerstone of this endeavour. This is driven by a desire to build health systems linking preventive and curative care efforts, as well as the different levels in the AKHS,P and the government health systems, from the village health centre to the Aga Khan University Hospital in Karachi.