Economic Dimensions of Health Protection under Sehat Sahulat Program: A Qualitative Assessment of Urban and Rural Households in Pakistan

Abstract

The study examines the economic costs and advantages of the Sehat Sahulat Program (SSP) in Pakistan based on the qualitative evidence collected in the urban and rural settings. SSP is a landmark health insurance program that would improve the proportionality of healthcare coverage and minimize the out-of-pocket costs. Nevertheless, the differences in implementation and use still define its efficacy. This paper relied upon in-depth interviews and thematic analysis to determine how households (particularly those in the lower-income bracket) perceive the accessibility, affordability, and long-term sustainability of the program. The results are sophisticated in terms of benefits and barriers. On the one hand, SSP saved a lot of direct treatment expenses on covered diseases and gave vulnerable groups a feeling of financial security. Structural and systematic factors, including low awareness, insufficient coverage of hospitals in rural areas, administrative inefficiency, and unfamiliar costs, restrained the potential of the program. Participants in the urban areas reported that they utilized it more due to the increased concentration of empanelled hospitals, whereas those in the rural areas complained about the cost of traveling, late reimbursements, and lack of equity. The study highlights the need to fill these gaps to ensure that SSP is more inclusive and influential. The policy implications indicate the necessity of better awareness campaigns, increased monitoring of the practices in the private hospitals, increased coverage in rural areas, and the transparency of the reimbursement system. This study adds to the literature on health economics and social protection in Pakistan by qualitatively informing the reader about lived experiences, providing lessons to other low- and middle-income countries that may be implementing similar schemes.