Comparative Analysis of the Health Care Systems of Pakistan and Nepal

Abstract

Background: Health care systems are foundational to public well-being and vary significantly across nations, especially in low- and middle-income countries. Pakistan and Nepal, while geographically proximate, differ in system structures, resource allocation, and policy priorities. Objective: To compare and analyze the health care systems of Pakistan and Nepal using the World Health Organization (WHO) Health System Framework, focusing on governance, financing, workforce, service delivery, technology, information systems, and health indicators. Methods: This qualitative document analysis used secondary data from official health ministry reports, international health organization documents, and peer-reviewed literature published between 2015 and 2022. The data were categorized and analyzed thematically using the WHO framework to identify structural differences, strengths, and system gaps. Results: Pakistan operates a decentralized health system with substantial private sector involvement, limited government spending (<1% GDP), and workforce and infrastructure challenges. Nepal, under a centralized federal system, allocates a higher share of GDP (6.3%) to health but faces geographical and access barriers. Both countries show underdeveloped health information systems, limited research output, and struggle with equitable service delivery. Conclusion: Despite structural differences, both Pakistan and Nepal face common challenges in financing, human resources, and quality care. Reforms must emphasize equity, system integration, and investment in primary care and information infrastructure.