Showing posts with label Healthcare. Show all posts
Showing posts with label Healthcare. Show all posts

Thursday, November 7, 2024

Pakistan to Develop Urdu LLM for Generative AI

National University of Science and Technology (NUST), National Information Technology Board (NITB) and Telecom network operator Jazz have signed a Memorandum of Understanding (MOU) to develop Pakistan’s first indigenous Large Language Model (LLM) with focus on Urdu, including datasets for Pashto and Punjabi languages. It is aimed at empowering individuals, businesses, and organizations with advanced AI tools in their native languages. The envisioned LLM is expected to drive innovation in Generative AI applications, boosting productivity and accessibility in critical sectors like healthcare, education, and agriculture.

GPT-4 Accuracy Scores. Source: The Economist


Generative AI tools such as ChatGPT are powered by large language models, or LLMs. These models need to be trained on vast amounts of data in specific languages to be useful. Unfortunately, the Urdu content of the Internet is less than 0.1%. This will present a challenge for the developers of Urdu LLMs.

Online Content of Various Languages. Source: W3Techs 


Lack of Urdu content available for training ChatGPT affects the accuracy of the results for Urdu language users. For example, the GPT-4 accuracy score in question-answer tests in Urdu is just over 70%, compared with 85% accuracy score in the English language, according to data from OpenAI. Other South Asian languages, including Hindi, Bengali, Punjabi, Marathi and Telugu, suffer from the same problem. 

It's not just a South Asian problem. These challenges exist in the developing world. Non-European languages are generally poorly represented online. It's a major obstacle for non-European nations in developing their own generative artificial-intelligence (AI) models, which rely on vast amounts of training data. Generative artificial intelligence (AI) can produce biased results due to a number of factors, including the data it's trained on, the algorithms used, and how it's deployed. 

The use of AI in developing nations such as Pakistan will remain limited to a small number of people proficient in the use of the English language. Broadening the adoption of AI applications will require LLMs trained on local language content. The absence of this development could cost Pakistan the opportunity to take full advantage of the AI Revolution


Sunday, August 25, 2024

Following the Money: Insights into Pakistan's Budget 2024-25

A look at Pakistan's current fiscal year 2024-25 budget helps gain insights into how the country is run. It shows the money flows from the key sources of revenue and the nation's spending priorities. Total planned federal spending for the current fiscal year is Rs.18,900 billion (about 69 billion U.S. dollars). This figure does not include the transfer of Rs. 7,438 (US$ 26 billion) from the federal government to the provinces. Under the 18th amendment passed in 2010, the federal government is obligated to share 57.5% of its revenue with the provinces. The federal government is primarily responsible for defense, foreign affairs, debt servicing, foreign trade, ports and shipping, and development programs, while food and agricultureeducation, healthcare and housing are devolved to the provinces. There still appears to be some overlap of domestic responsibilities between the federation and the provinces. 

Pakistan's Budget 2024-25 at a Glance. Visualization Courtesy of Prof Adil Najam


The federal government's total revenue is expected to be Rs. 17, 815 billion (US$ 65 billion). In addition, Islamabad plans to borrow Rs. 8,470 billion ($31 billion) during the fiscal year. Interest payments of Rs. 9,775 billion ($ 36 billion) will account for more than half of the federal budget this year.  Debt servicing costs will also exceed the planned borrowing (of Rs. 8,470 billion) for the year. In other words, all of what the government plans to borrow this fiscal year will be used to service the current debt on the books.  

Detailed Budget Visualization By Dr. Adil Najam via Dawn


Federal debt servicing costs (Rs. 9,775 billion or $35 billion, 9.3% of current GDP) have spiked in recent years due to the State Bank's tight monetary policy designed to fight persistent double digit inflation. In fact, interest payments on debt are by far the biggest single federal expenditure line item, far surpassing the Rs. 2, 122 billion ($7.7 billion or 2% of current GDP) defense spending. Higher interest rates have also dramatically slowed down the economy. 

Pakistani provinces raise some of their own revenue on top of the transfers from the federal government. For example, Punjab, the largest of the four provinces, plans to spend an estimated Rs. 4,643.4 billion ($17 billion); including the federal transfer of Rs. 3,683.1 billion and about Rs. 960 billion ($3.5 billion) of provincial tax revenue. 

Sind, the second largest province, has a Rs. 3,056 ($11 billion) budget that includes Rs. 1,854 billion from the federal government, and Rs. 1,202 billion ($4.35 billion) from its revenue sources. KP, the third largest province,  has a Rs1,754 billion ($6.4 billion) budget, including Rs. 1,222 billion from the federal government and Rs. 532 billion ($1.9 billion) provincial revenue. Balochistan's budget is Rs. 956 billion ($3.5 billion) that includes Rs. 667 billion from the federal government and Rs. 290 billion ($1 billion) from its resources.

Altogether, the federal and provincial governments expect to raise about $75 billion in revenue, representing 20% of $375 billion GDP for fiscal year 2023-24. This is not bad for a developing country like Pakistan.  The defense allocation of Rs. 2,122, the second largest federal expenditure, is a mere 2% of the current GDP.  The biggest expenditure this year will be the interest payments of Rs. 9,775, accounting for over 50% of the federal budget and 9.3% of the current GDP. These debt servicing costs will hopefully come down as the State Bank cuts its interest rates this year and next. Lower interest payments in future years should free up money for other more pressing needs in the areas of education, healthcare, energy and infrastructure. 

Related Links:

Haq's Musings

South Asia Investor Review

Solar Power Boom in Pakistan

Pakistan Electric Vehicle Policy

Nuclear Power in Pakistan

Can Urban Forests Beat the Heat in Pakistani Cities

Pakistan's Response to Climate Change

IPP Contacts Bankrupting Pakistan

Renewable Energy for Pakistan

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Pakistan's Digital Public Infrastructure Transforming Lives

My Family's Contribution to Climate Action

China-Pakistan Economic Corridor

Ownership of Appliances and Vehicles in Pakistan

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Riaz Haq's YouTube Channel

PakAlumni Social Network

Sunday, April 23, 2023

Digital Pakistan 2023: Technology Transforming Women's Lives in Rural Pakistan

Growing access to smartphones and Internet connectivity is transforming the lives of women in rural Pakistan. They are acquiring knowledge, accessing healthcare and finding economic opportunities.  A recent UNDP report  titled "DigitAll: What happens when women of Pakistan get access to digital and tech tools? A lot!" written by Javeria Masood describes the socioeconomic impact of technology in Pakistan in the following words:

"The world as we know it has been and is rapidly changing. Technology has proven to be one of the biggest enablers of change. There has been a significant emphasis on digital trainings, tech education, and freelancing in the last several years especially during the pandemic, through initiatives from the government, private and development sectors. Covid-19 acted as a big disrupter and accelerated the digital uptake many folds. In Pakistan, we saw the highest number of digital wallets, online services, internet-based services and adaptability out of need and demand". 

Pakistani Women in South Punjab. Photo by Shuja Hakim UNDP Pakistan

Digital Transformation:

The report cites the example of Ayesha Abushakoor from Zawar Wala in South Punjab who is a Quran teacher. She is teaching students remotely in and outside Pakistan. She uses digital wallets to receive payments. The same report also cites the case of Samina, from Muzafargharh, who is getting training online to start a livestock business. Another woman Mujahida Perveen from UC Pega in Dera Ghazi Khan is managing her thyroid disease by watching YouTube videos. 

Telehealth is helping more women access healthcare in remote areas of Pakistan. Startups like Sehat Kahani are employing women doctors who work from home to provide healthcare services. Sehat Kahani was founded by Dr. Sara Khurram and Dr. Iffat Zafar who raised seed funding of US$ 500,000 in 2018, followed by a pre-series of $1 million in March 2021. 

Expansion of Digital Services: 

The year 2022 was a very rough year for Pakistan. The nation was hit by devastating floods that badly affected tens of millions of people. Macroeconomic indicators took a nose dive as political instability reached new heights. In the middle of such bad news, Pakistan saw installation of thousands of kilometers of new fiber optic cable, inauguration of a new high bandwidth PEACE submarine cable connecting Karachi with Africa and Europe, and millions of new broadband subscriptions. Broadband penetration among 140 million (59% of 236 million population) Pakistanis in  the 15-64 years age group reached almost 90%. This new digital infrastructure helped grow technology adoption in the country. 

Internet and Mobile Phone Banking Growth in 2021-22. Source: State Bank of Pakistan


Fintech: 

Mobile phone banking and internet banking grew by 141.1% to Rs. 11.9 trillion while Internet banking jumped 81.1% to reach Rs10.2 trillion.  E-commerce transactions also accelerated, witnessing similar trends as the volume grew by 107.4% to 45.5 million and the value by 74.9% to Rs106 billion, according to the State Bank of Pakistan.  

Pakistan Startup Funding in 2022. Source: i2i Investing


Fintech startups continued to draw investments in the midst of a slump in venture funding in Pakistan. Fintech took $10 million from a total of $13.5 million raised by tech startups in the fourth quarter of 2022, according to the data of Invest2Innovate (i2i), a startups consultancy firm. In Q3 of 2022, six out of the 14 deals were fintech startups, compared to two deals of e-commerce startups. Fintech startups raised $38 million which is 58% of total funding ($65 million) in Q3 2022, compared to e-commerce startups that raised 19% of total funding. The i2i data shows that in Q3 2022, fintech raised 37.1% higher than what it raised in Q2 2022 ($27.7 million). Similarly, in Q2 2022, the total investment of fintech was 63% higher compared to what it raised in Q1 2022 ($17 million).

E-Commerce in Pakistan. Source: State Bank of Pakistan


E-Commerce:

E-commerce continued to grow in the country. Transaction volume soared 107.4% to 45.5 million while the value of transactions jumped 75% to Rs. 106 billion over the prior year, according to the State Bank of Pakistan. 

Pakistan Among World's Top 10 Smartphone Markets. Source: NewZoo


PEACE Cable: 

Pakistan and East Africa Connecting Europe (PEACE) cable, a  96 TBPS (terabits per second), 15,000 km long submarine cable, went live in 2022. It brought to 10 the total number of submarine cables currently connecting or planned to connect Pakistan with the world: TransWorld1, Africa1 (2023), 2Africa (2023), AAE1, PEACE,  SeaMeWe3, SeaMeWe4, SeaMeWe5, SeaMeWe6 (2025) and IMEWE. PEACE cable has two landing stations in Pakistan: Karachi and Gwadar. SeaMeWe stands for Southeast Asia Middle East Western Europe, while IMEWE is India Middle East Western Europe and AAE1 Asia Africa Europe 1. 

Mobile Data Consumption Growth in Pakistan. Source: ProPakistan


Fiber Optic Cable: 

The first phase of a new high bandwidth long-haul fiber network has been completed jointly by One Network, the largest ICT and Intelligent Traffic and Electronic Tolling System operator in Pakistan, and Cybernet, a leading fiber broadband provider.  The joint venture has deployed 1,800 km of fiber network along motorways and road sections linking Karachi to Hyderabad (M-9 Motorway), Multan to Sukkur (M-5 Motorway), Abdul Hakeem to Lahore (M-3 Motorway), Swat Expressway (M-16), Lahore to Islamabad (M-2 Motorway) and separately from Lahore to Sialkot (M-11 Motorway), Gujranwala, Daska and Wazirabad, according to Business Recorder newspaper.

Mobile telecom service operator Jazz and Chinese equipment manufacturer Huawei have commercially deployed FDD (Frequency Division Duplexing) Massive MIMO (Multiple Input and Output) solution based on 5G technology on a large scale in Pakistan. Jazz and Huawei claim it represents a leap into the 4.9G domain to boost bandwidth. 

Pakistan Telecom Indicators November 2022. Source: PTA


Pakistan's RAAST P2P System Taking Off. Source: State Bank of Pakistan


Broadband Subscriptions:

Pakistan has 124 million broadband subscribers as of November, 2022, according to Pakistan Telecommunications Authority.  Broadband penetration among 140 million (59% of 236 million) Pakistanis in 15-64 years age bracket is 89%.  Over 20 million mobile phones were locally manufactured/assembled in the country in the first 11 months of the year. 

Bank Account Ownership in Pakistan. Source: Karandaaz


Financial Inclusion Doubled In Pakistan in 5 Years. Source: Karandaaz


Documenting Pakistan Economy:

Pakistan's unbanked population is huge, estimated at 100 million adults, mostly women. Its undocumented economy is among the world's largest,  estimated at 35.6% which represents approximately $542 billion at GDP PPP levels, according to World Economics. The nation's tax to GDP ratio (9.2%) and formal savings rates (12.72%) are among the lowest. The process of digitizing the economy could help reduce the undocumented economy and increase tax collection and formal savings and investment in more productive sectors such as export-oriented manufacturing and services. Higher investment in more productive sectors could lead to faster economic growth and larger export earnings. None of this can be achieved without some semblance of political stability. 


Tuesday, December 14, 2021

Naya Pakistan Sehat Card: A Giant Step Toward Universal Healthcare

Prime Minister Imran Khan launched Sehat Card in Punjab, Pakistan 's largest province, on International Universal Healthcare Day 2021. This is essentially a government-funded health insurance program run by insurance companies to cover up to one million rupees worth of care each year at government certified public and private clinics and hospitals.  It represents a major expansion of this program which was first introduced in Khyber-Pakhtunkhwa province.  It is now available to residents of Khyber Pakhtunkhwa, Punjab, Balochistan, Gilgit Baltistan, Azad Kashmir, and Tharparkar district in Sindh under the Sehat Sahulat Program. 

Universal Healthcare Map. Source: World Population Review


Health Card: 

Speaking at the launch event in Lahore, Prime Minister Imran Khan said, “This is a landmark. This is a defining moment towards our course to make Pakistan a welfare state.” “This is not (just) a health insurance (but) rather a health system. Now (the) private sector will build hospitals even in villages where the basic health units remain vacant as no doctor desires to be posted there. Now (the) private sector will come and (the) poorest of the poor will get free treatment,” he added.   

Pakistan Sehat Card


Sehat card was first introduced in Khyber Pakhtunkhwa (KP) by Taimur Jhagra, a former McKinsey consultant who now holds both the health and finance ministry portfolios in the province. Talking with The Telegraph newspaper reporters, he said: “It shows us we can do big things in this country in a short amount of time". He went on: “It's giving quality access to those that tend to be viewed by many as second class citizens and deserving of only second class facilities.” 

The Sehat Card program will fund both public and private healthcare, Mr. Jhagra said. “We are not funding the private sector, we are funding health care for our citizens, wherever they want.,” he said. The Telegraph has spoken with patients using the program in KP. They say it has delivered them from the worry of medical debt, where serious illness often means having to sell land or livestock, or take out loans, to pay medical bills.  

Monthly Usage of Sehat Card in KP. Source: Government of KP

Sehat card is being widely used in Khyber Pakhtunkhwa province with a population of over 30 million. There is data available to understand how the program is being funded. Here's an excerpt of The Telegraph story on it: "Treatment is provided through approved public or private hospitals and the comparatively low cost of healthcare in Pakistan has meant the state-owned insurance provider has been able to provide cover at around £3 ($3.97) per head. The card is currently costing 22bn rupees (£93m  or $123m) out of a total health budget in the province of 146bn rupees (£620m or $820m)"

The final hold-out in Pakistan is Sindh province with its nearly 50 million people. Prime Minister Imran Khan has urged Sindh's ruling party, the Pakistan Peoples Party (PPP), to launch Sehat Card and other social sector programs in Sindh as well. 

Ehsaas Satisfaction Survey. Source: Gallup

Ehsaas Social Welfare Program:

Ehsaas Program was established by Prime Minister Imran Khan in 2019. Aimed at helping the poor and the needy, it has several elements ranging from cash hand-outs and education to health and nutrition. 

A recent survey conducted by Gallup Pakistan confirms that the program is very popular among the people. Nearly 3 out of 4 Pakistanis (76%) have a good opinion about the Ehsaas program.  Nearly 9 in 10 (89%) Pakistanis who have received assistance from the program are satisfied with the amount of money received.  90% of Pakistanis believe that the program should be expanded to include more people, according to the survey.     

Related Links:

Tuesday, February 16, 2021

Pakistani-American Doctor Fired For Giving Away Expiring COVID19 Vaccine

Dr. Hasan Gokal, Pakistani-American medical director of Harris County COVID Response Team, has been charged with stealing COVID19 Moderna vaccine and fired from his job, according to media reports.  Dr. Gokal's "crime" is to give away unused coronavirus vaccine doses that would have expired and lost if not used within hours. A Texas judge has dismissed charges against him. 

Dr. Hasan Gokal

Each vial of Moderna vaccine has 10 doses. Once it is punctured, the vaccine expires within 6 hours. After administering COVID19 vaccine to all the front-line healthcare workers who showed up for their appointment, Gokal gave the remaining expiring doses of the vaccine to acquaintances and strangers, including a bed-bound woman in her 90s, a woman in her 80s with dementia, several men and women in their 60s and 70s with health issues, and a mother with a child on a ventilator, according to New York Times. After midnight and just minutes before the vial would expire, the final person called and said he wouldn’t make it. Gokal turned to his wife, who has a pulmonary disease that causes shortness of breath, and gave her the last dose.

Even after dismissal of charges against him, Dr. Gokal still doesn’t have a job and instead volunteers at a nonprofit health clinic. Now his lawyer is pursuing a wrongful termination lawsuit, according to ABC Channel13. “An apology by Harris County Public Health and the Harris County District Attorney’s Office towards Dr. Gokal and his family will not be enough,” Paul Doyle, Gokal’s lawyer, told the news outlet.

Dr. Gokal is among thousands of Pakistani-American doctors who have been at the forefront of saving lives in the middle of the devastating COVID19 pandemic that has taken over 400,000 American lives so far. Among them is Dr. Syra MadadPakistani-American head of New York City’s Health and Hospitals System-wide Special Pathogens Program, who is featured in a 6-part Netflix documentary series "Pandemic: How to Prevent an Outbreak".

Pakistani-American doctors are the 3rd largest among foreign-educated doctors in America. Among the notable names of Pakistani-American doctors engaged in the fight against Covid-19 are: Dr. Saud Anwar in Connecticut, Dr. Gul Zaidi in New York and Dr. Umair Shah in Texas. Their work has received positive media coverage in recent weeks.

Dr. Saud Anwar, a Connecticut pulmonologist and state senator, came up with a ventilator splitter to deal with the shortages of life-saving equipment. Dr. Gul Zaidi, an acute-care pulmonologist in Long Island, was featured in a CBS 60 Minutes segment on how the doctors are dealing with unprecedented demands to save lives. Dr. Umair Shah was interviewed about his work by ABC TV affiliate in Houston, Texas.

Related Links:

Haq's Musings

South Asia Investor Review

Ex US Treasury Sec Praises Pakistan's COVID Response

Pakistani-American Health Expert Featured in Netflix Documentary "Pandemic"

Pakistan is the 3rd Largest Source of Foreign Doctors in America

Van Jones on "Geniuses from Pakistan"

Obama Honors Pakistani-American Doctor With Top Technology Medal

Hindus and Muslim Well-educated in America But Least Educated Worldwide

What's Driving Islamophobia in America?

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The Trump Phenomenon

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Silicon Valley Pakistani-Americans

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Two Pakistani-American Silicon Valley Techs Among Top 5 VC Deals

Pakistani-American's Game-Changing Vision 


Sunday, June 23, 2019

Inspirational Story of University-Going Daughters of Karachi's Rickshaw Driver

Three daughters of a Karachi rickshaw driver named Amjad Ali are attending top universities in Pakistan. All three graduated from The Citizens Foundation's K-12 schools located across Pakistan, including poor districts of Pakistan's megacity of nearly 20 million residents. Amina Amjad, the eldest is studying at Dow University of Health Sciences (DUHS) to become a medical doctor, the second daughter is enrolled in Shaheed Zulfikar Ali Bhutto Institute of Science and Technology (SZBIST) to become an engineer and the third Muskan Amjad is going to the Institute of Business Administration (IBA), Karachi's top business school on a full scholarship.

Girls' Education: 

Muskan Amjad
This would be unusual for a poor man's children attending top universities regardless of gender. What makes it particularly noteworthy is that these are daughters of a poor man in a country where girls' education is often ignored.  “People often mocked and criticized me, saying that girls are bound to get married and move out and to stop wasting my hard-earned money on my daughters,” Amjad Ali told hosts of Samaa TV, a private television channel in Pakistan.  The Citizens Foundation (TCF) making it possible by making K-12 education accessible and affordable for Pakistan's disadvantaged children.  There are many success stories of TCF alumni posted on TCF's Facebook page.


Back in 2013, another TCF alumna Anum Fatima, a resident of Ibrahim Goth slum located near Karachi's Steel Town, made history; she went to Harvard Business School as part of a student exchange program. Anum's father is employed as a driver and her mother works as a maid. The slum school she attended is run by The Citizen's Foundation (TCF), a private foundation.

Karachi Rickshaw Driver Amjad Ali and Family 


The Citizens Foundation: 

The Citizens Foundation (TCF) is a non-profit organization, and operates one of the largest privately owned networks of low-cost formal schools in Pakistan. The Foundation runs 1,567 school units, educating 252,000 students through 12,000 teachers and principals, with over 17,400 employees. It has very low overhead by Pakistani NGO's standards. Approximately 94% of the Foundation's expenditure is allocated to the Education program.

Pakistan Truck Art Message From A Girl: "Let me Study; Let me Advance"

TCF plays a very important role in the lives of its students during school and after they graduate. It runs an Alumni Development Program (ADP) where successful alumni inspire and mentor students and fellow TCF alumni.  Muskan Amjad volunteers for ADP.

If you read Pakistan media headlines and donation-seeking NGOs and activists' reports these days, you'd conclude that the social sector situation is entirely hopeless. However, if you look at children's education and health trend lines based on data from credible international sources, you would feel a sense of optimism. This exercise gives new meaning to what former US President Bill Clinton has said: Follow the trend lines, not the headlines. Unlike the alarming headlines, the trend lines in Pakistan show rising school enrollment rates and declining infant mortality rates.

Key Social Indicators:

The quickest way to assess Pakistan's social sector progress is to look at two key indicators:  School enrollment rates and infant mortality. These basic social indicators capture the state of schooling, nutrition and health care. Pakistan is continuing to make slow but steady progress on both of these indicators. Anything that can be done to accelerate the pace will help Pakistan move up to higher levels as proposed by Dr. Hans Rosling and adopted by the United Nations. 

Rising Primary Enrollment:

Gross enrollment in Pakistani primary schools exceeded 97% in 2016, up from 92% ten years ago. Gross enrollment rate (GER) is different from net enrollment rate (NER). The former refers to primary enrollment of all students of all ages while the latter counts enrolled students as percentage of students in the official primary age bracket. The primary NER in Pakistan is significantly lower but the higher GER indicates many of these kids eventually enroll in primary schools albeit at older ages. 

Source: World Bank Education Statistics


Declining Infant Mortality Rate: 

The infant mortality rate (IMR), defined as the number of deaths in children under 1 year of age per 1000 live births in the same year, is universally regarded as a highly sensitive (proxy) measure of population health.  A declining rate is an indication of improving health. IMR in Pakistan has declined from 86 in 1990-91 to 74 in 2012-13 and 62 in the latest survey in 2017-18.

Pakistan Child Mortality Rates. Source: PDHS 2017-18

During the 5 years immediately preceding the survey, the infant mortality rate (IMR) was 62 deaths per 1,000 live births. The child mortality rate was 13 deaths per 1,000 children surviving to age 12 months, while the overall under-5 mortality rate was 74 deaths per 1,000 live births. Eighty-four percent of all deaths among children under age 5 in Pakistan take place before a child’s first birthday, with 57% occurring during the first month of life (42 deaths per 1,000 live births).

Human Development Ranking:

It appears that improvements in education and health care indicators in Pakistan are slower than other countries in South Asia region. Pakistan's human development ranking plunged to 150 in 2018, down from 149 in 2017. It is worse than Bangladesh at 136, India at 130 and Nepal at 149. The decade of democracy under Pakistan People's Party and Pakistan Muslim League (Nawaz) has produced the slowest annual human development growth rate in the last 30 years. The fastest growth in Pakistan human development was seen in 2000-2010, a decade dominated by President Musharraf's rule, according to the latest Human Development Report 2018.

UNDP’s Human Development Index (HDI) represents human progress in one indicator that combines information on people’s health, education and income.

Pakistan's Human Development Growth Rate By Decades. Source: HDR 2018

Pakistan saw average annual HDI (Human Development Index) growth rate of 1.08% in 1990-2000, 1.57% in 2000-2010 and 0.95% in 2010-2017, according to Human Development Indices and Indicators 2018 Statistical Update.  The fastest growth in Pakistan human development was seen in 2000-2010, a decade dominated by President Musharraf's rule, according to the latest Human Development Report 2018.

Pakistan@100: Shaping the Future:

Pakistani leaders should heed the recommendations of a recent report by the World Bank titled "Pakistan@100: Shaping the Future" regarding investments in the people. Here's a key excerpt of the World Bank report:

"Pakistan’s greatest asset is its people – a young population of 208 million. This large population can transform into a demographic dividend that drives economic growth. To achieve that, Pakistan must act fast and strategically to: i) manage population growth and improve maternal health, ii) improve early childhood development, focusing on nutrition and health, and iii) boost spending on education and skills for all, according to the report".

Summary: 

The story of Muskan Amjad shows that the state of Pakistan's social sector is not as dire as the headlines suggest. There's reason for optimism. Key indicators show that education and health care in Pakistan are improving but such improvements are slower than in other countries in South Asia region. Pakistan's human development ranking plunged to 150 in 2018, down from 149 in 2017. It is worse than Bangladesh at 136, India at 130 and Nepal at 149. The decade of democracy under Pakistan People's Party and Pakistan Muslim League (Nawaz) has produced the slowest annual human development growth rate in the last 30 years. The fastest growth in Pakistan human development was seen in 2000-2010, a decade dominated by President Musharraf's rule, according to the latest Human Development Report 2018. One of the biggest challenges facing the PTI government led by Prime Minister Imran Khan is to significantly accelerate human development rates in Pakistan.

Here's a video clip of Amjad Ali and his family's appearance on Samaa TV's Naya Din show:

https://youtu.be/7qXI93xdOn8



Related Links:



Tuesday, June 4, 2019

How Grim is the State of Pakistan's Social Sector?

If you read Pakistan media headlines and donation-seeking NGOs and activists' reports these days, you'd conclude that the social sector situation is entirely hopeless. However, if you look at children's education and health trend lines based on data from credible international sources, you would feel a sense of optimism. This exercise gives new meaning to what former US President Bill Clinton has said: Follow the trend lines, not the headlines. Unlike the alarming headlines, the trend lines in Pakistan show rising school enrollment rates and declining infant mortality rates.

Key Social Indicators:

The quickest way to assess Pakistan's social sector progress is to look at two key indicators:  School enrollment rates and infant mortality. These basic social indicators capture the state of schooling, nutrition and health care. Pakistan is continuing to make slow but steady progress on both of these indicators. Anything that can be done to accelerate the pace will help Pakistan move up to higher levels as proposed by Dr. Hans Rosling and adopted by the United Nations.

Pakistan Children 5-16 In-Out of School. Source: Pak Alliance For Math & Science


Rising Primary Enrollment:

Gross enrollment in Pakistani primary schools exceeded 97% in 2016, up from 92% ten years ago. Gross enrollment rate (GER) is different from net enrollment rate (NER). The former refers to primary enrollment of all students of all ages while the latter counts enrolled students as percentage of students in the official primary age bracket. The primary NER in Pakistan is significantly lower but the higher GER indicates many of these kids eventually enroll in primary schools albeit at older ages. 

Source: World Bank Education Statistics


Declining Infant Mortality Rate: 

The infant mortality rate (IMR), defined as the number of deaths in children under 1 year of age per 1000 live births in the same year, is universally regarded as a highly sensitive (proxy) measure of population health.  A declining rate is an indication of improving health. IMR in Pakistan has declined from 86 in 1990-91 to 74 in 2012-13 and 62 in the latest survey in 2017-18.

Pakistan Child Mortality Rates. Source: PDHS 2017-18

During the 5 years immediately preceding the survey, the infant mortality rate (IMR) was 62 deaths per 1,000 live births. The child mortality rate was 13 deaths per 1,000 children surviving to age 12 months, while the overall under-5 mortality rate was 74 deaths per 1,000 live births. Eighty-four percent of all deaths among children under age 5 in Pakistan take place before a child’s first birthday, with 57% occurring during the first month of life (42 deaths per 1,000 live births).

Pakistan Human Development Trajectory 1990-2018.Source: Pakistan HDR 2019

Human Development Ranking:

It appears that improvements in education and health care indicators in Pakistan are slower than other countries in South Asia region. Pakistan's human development ranking plunged to 150 in 2018, down from 149 in 2017.

Expected Years of Schooling in Pakistan by Province 


There was a noticeable acceleration of human development in #Pakistan during Musharraf years. Pakistan HDI rose faster in 2000-2008 than in periods before and after. Pakistanis' income, education and life expectancy also rose faster than Bangladeshis' and Indians' in 2000-2008.

Now Pakistan is worse than Bangladesh at 136, India at 130 and Nepal at 149. The decade of democracy under Pakistan People's Party and Pakistan Muslim League (Nawaz) has produced the slowest annual human development growth rate in the last 30 years. The fastest growth in Pakistan human development was seen in 2000-2010, a decade dominated by President Musharraf's rule, according to the latest Human Development Report 2018.

UNDP’s Human Development Index (HDI) represents human progress in one indicator that combines information on people’s health, education and income.

Pakistan's Human Development Growth Rate By Decades. Source: HDR 2018

Pakistan saw average annual HDI (Human Development Index) growth rate of 1.08% in 1990-2000, 1.57% in 2000-2010 and 0.95% in 2010-2017, according to Human Development Indices and Indicators 2018 Statistical Update.  The fastest growth in Pakistan human development was seen in 2000-2010, a decade dominated by President Musharraf's rule, according to the latest Human Development Report 2018.

Pakistan Human Development Growth 1990-2018. Source: Pakistan HDR 2019


Pakistan@100: Shaping the Future:

Pakistani leaders should heed the recommendations of a recent report by the World Bank titled "Pakistan@100: Shaping the Future" regarding investments in the people. Here's a key excerpt of the World Bank report:

"Pakistan’s greatest asset is its people – a young population of 208 million. This large population can transform into a demographic dividend that drives economic growth. To achieve that, Pakistan must act fast and strategically to: i) manage population growth and improve maternal health, ii) improve early childhood development, focusing on nutrition and health, and iii) boost spending on education and skills for all, according to the report".

Pakistani Children 5-16 Currently Enrolled. Source: Pak Alliance For Math & Science


Summary: 

The state of Pakistan's social sector is not as dire as the headlines suggest. There's reason for optimism. Key indicators show that education and health care in Pakistan are improving but such improvements are slower than in other countries in South Asia region. Pakistan's human development ranking plunged to 150 in 2018, down from 149 in 2017. It is worse than Bangladesh at 136, India at 130 and Nepal at 149. The decade of democracy under Pakistan People's Party and Pakistan Muslim League (Nawaz) has produced the slowest annual human development growth rate in the last 30 years. The fastest growth in Pakistan human development was seen in 2000-2010, a decade dominated by President Musharraf's rule, according to the latest Human Development Report 2018. One of the biggest challenges facing the PTI government led by Prime Minister Imran Khan is to significantly accelerate human development rates in Pakistan.

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Wednesday, September 26, 2018

Pakistan Lags in Human Capital Development

Pakistan's human capital has doubled from three years of learning in 1990 to six years of learning in 2016, according to a human capital study of 195 countries recently published in the journal The Lancet.  However, Pakistan still ranks a poor 164th in the first-ever scientific study ranking countries for their levels of human capital. India has also more than doubled its human capital from 3 years to 7 years but Bangladesh stands out by tripling its human capital from two years to six years of learning since 1990.  In 2016, the Lancet study shows that 44 countries achieved more than 20 years of expected human capital while 68 countries had expected human capital of less than 10 years. Bangladesh, India and Pakistan have less than 10 years of learning, putting them in the category of low human capital countries. Learning is based on average student scores on internationally comparable tests.

What is Human Capital?

Dictionary defines human capital as "the collective skills, knowledge, or other intangible assets of individuals that can be used to create economic value for the individuals, their employers, or their community".

The Lancet study says it "provides a new measure of expected human capital for 195 countries, consisting of four components: educational attainment, learning, health, and survival, based on a systematic analysis of all available data. This measure, in units of health, education, and learning-adjusted expected years lived between age 20 and 64 years, is estimated each year from 1990 to 2016 and can be updated annually."  Learning is based on average student scores on internationally comparable tests.

Human Capital Growth in South Asia. Source: The Lancet
South Asia's Low Human Capital:

Both Pakistan and India have seen their human capital double from three years of learning in 1990 to six years of learning in 2016 but both still rank low with significantly less than 10 years of learning,  according to a human capital study of 195 countries recently published in the journal The Lancet.

In fact, the entire South Asia region continues to rank low in terms of human capital. Among South Asian nations, Sri Lanka ranks the highest at 102 (13 years), Maldives 116 (12 years), Bhutan 133 (9 years),  Nepal 156 (7 years),  India 158 (7 years),  Bangladesh 161 (6 years), Pakistan 164 (6 years) and Afghanistan 188 (4 years). Countries with less than 10 years of learning are considered having "low human capital" by the authors of the study.

In 2016, the Lancet study shows that 44 countries achieved more than 20 years of expected human capital while 68 countries had expected human capital of less than 10 years. Bangladesh, India and Pakistan have less than 10 years of learning, putting them in the category of low human capital countries.


Change in Global Human Capital Maps. Top 1990, Bottom 2016. Source: Lancet

Global Human Capital Rankings:

Finland tops the human capital charts with 28.4 years of learning, United States ranks 27th with 23 years of learning and Turkey and China rank 43rd and 44th respectively, each with 20 years of learning. The countries with the least human capital are those in sub-Saharan Africa. Mali ranks 191st (3 years), Burkina Faso 192nd (3 years), Chad 193rd (2 years), South Sudan 194th (2 years) and Niger (2 years)  at the very bottom ranked 195th.

Conducted by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in collaboration with University of California, Los Angeles (UCLA), the study on the measurement of human capital has been published in the journal The Lancet.

Impact of Human Capital on Economic Growth:

The Lancet report says that "human capital is characterized as the aggregate levels of education, training, skills, and health in a population, affecting the rate at which technologies can be developed, adopted, and employed to increase productivity".

Growth in human capital is associated with faster economic growth. The top quartile of countries in terms of absolute change in human capital from 1990 to 2016 had a median annualized growth in gross domestic product of 2·60% (IQR 1·85–3·69) compared with 1·45% (0·18–2·19) for countries in the bottom quartile, according to the Lancet report.

Human Development in Pakistan: 

In addition to the human capital report by The Lancet, UNDP’s Human Development Index (HDI) is another indicator of human progress that combines information on people’s health, education and income. The latest Human Development Report (HDR) shows Pakistan's HDI ranking sank to a new low of 150 in 2018.

Pakistan's Human Development Growth Rate By Decades. Source: HDR 2018

Pakistan saw average annual HDI (Human Development Index) growth rate of 1.08% in 1990-2000, 1.57% in 2000-2010 and 0.95% in 2010-2017, according to Human Development Indices and Indicators 2018 Statistical Update.  The fastest growth in Pakistan human development was seen in 2000-2010, a decade dominated by President Musharraf's rule, according to the latest Human Development Report 2018.

The Human Development Index (HDI) is a composite index focusing on three basic dimensions of human development: the ability to lead a long and healthy life, measured by life expectancy at birth; the ability to acquire knowledge, measured by mean years of schooling and expected years of schooling; and the ability to achieve a decent standard of living, measured by gross national income per capita.

Not only has Pakistan's economy slowed since 2008 but its progress in education sector has seen a dramatic slowdown. Data shows that Pakistan's literacy and enrollment rates are not rising in spite of significantly increased education spending over the last several years. Education budgets at federal and provincial levels have seen double digit increase of 17.5% a year on average since 2010. And yet, school enrollment and literacy rate have remained essentially flat during this period.  This lack of progress in education stands in sharp contrast to the significant improvements in outcomes seen from increase education spending during Musharraf years in 2001-2008. Why is it?

Is the money not being spent honestly and wisely? Is the education budget being used by the ruling politicians to create teacher jobs solely for political patronage? Are the teachers not showing up for work? Is the money being siphoned off by bureaucrats and politicians by hiring "ghost teachers" in "ghost schools"? Let's try and examine the data and the causes of lack of tangible results from education spending.

Pakistan Education Budget:

The total money budgeted for education by the governments at the federal and provincial levels has increased from Rs. 304 billion in 2010-11 to Rs. 790 billion in 2016-17,  representing an average of 17.5% increase per year since 2010.



Education and Literacy Rates:

Pakistan's net primary enrollment rose from 42% in 2001-2002 to 57% in 2008-9 during Musharraf years. It has been essentially flat at 57% since 2009 under PPP and PML(N) governments.

Source: Economic Survey of Pakistan 2015-16

Similarly, the literacy rate for Pakistan 10 years or older rose from 45% in 2001-2002 to 56% in 2007-2008 during Musharraf years. It has increased just 4% to 60% since 2009-2010 under PPP and PML(N) governments.

Source: Economic Survey of Pakistan 2015-16

Four Levels of Development:

The extensive data compilation and research by Professor Hans Rosling of Sweden has shown that the binary categorization of nations into developed and developing is no longer useful. Instead, he has proposed using 4 levels of development based on health and wealth indicators, a proposal that has now been accepted by the United Nations and the World Bank. Here's how Rosling and the United Nations define these 4 levels:

1. Level 1: One billion people live on level 1. This is what we think of as extreme poverty. If you’re on level 1, you survive on less than $2 a day and get around by walking barefoot. Your food is cooked over an open fire, and you spend most of your day traveling to fetch water. At night, you and your children sleep on a dirt floor.

2. Level 2: Three billion people live on level 2, between $2 and $8 a day. Level 2 means that you can buy shoes and maybe a bike, so it doesn’t take so long to get water. Your kids go to school instead of working all day. Dinner is made over a gas stove, and your family sleeps on mattresses instead of the floor.

Level 3: Two billion people live on level 3, between $8 and $32 a day. You have running water and a fridge in your home. You can also afford a motorbike to make getting around easier. Some of your kids start (and even finish) high school.

Level 4: One billion people live on level 4. If you spend more than $32 a day, you’re on level 4. You have at least a high school education and can probably afford to buy a car and take a vacation once in a while.

Imran Khan's Ambitious Agenda:

Imran Khan laid out his agenda in his first speech to the nation after taking the office of the prime minister.  It was more like a fireside chat in which he spoke directly to the people to explain his priorities that emphasize education,  health care and human development. These are the keys to leading Pakistan from level 2 to level 3. In order to pursue his priorities, Mr. Khan needs to first address the more urgent economic crisis which he acknowledged. Pakistan needs to deal with excessive public debt and pay for the necessary imports to move forward.  He must also deal with financial corruption and mismanagement to free up the resources for his ambitious agenda of economic and human development of the nation.

Mr. Khan will almost certainly face stiff opposition from the status quo forces which stand to lose from the changes he seeks. They will fight to preserve their patronage networks and their power and privilege. They will try to bring down his coalition government with all they have got. They might even threaten his personal safety and security.

Democracy and Development:

Professor Hans Rosling has compiled extensive socioeconomic data and done serious research to understand how nations develop. He has shared his work in "Factfulness" that he co-wrote with his son Ola Rosling and daughter Anna Rosling Ronnlund. Here's an except on democracy and development from Factfulness:

"This is risky but I am going to argue it anyway. I strongly believe that liberal democracy is the best way to run a country. People like me, who believe this, are often tempted to argue that democracy leads to, or its even a requirement for, other good things, like peace, social progress, health improvement, and economic growth. But here's the thing, and it is hard to accept: the evidence does not support this stance.

Most countries that make great economic and social progress are not democracies. South Korea moved from Level 1 to Level 3 faster than any other country had ever done (without finding oil), all the time as a military dictatorship. Of the ten countries with the fastest economic growth, nine of them score low on democracy.

Anyone who claims that democracy is a necessity for economic growth and health improvements will risk getting contradicted by reality. It's better to argue for democracy as a goal in itself instead of as a superior means to other goals we like."

Summary:

Pakistan's human capital has doubled from three years of learning in 1990 to six years of learning in 2016, according to a human capital study of 195 countries recently published in the journal The Lancet.  However, Pakistan still ranks a poor 164th in the first-ever scientific study ranking countries for their levels of human capital. India has also doubled its human capital from 3 years to 6 years but Bangladesh stands out by tripling its human capital from two years to six years of learning since 1990.  Learning is based on average student scores on internationally comparable tests.

Pakistan saw average annual HDI (Human Development Index) growth rate of 1.08% in 1990-2000, 1.57% in 2000-2010 and 0.95% in 2010-2017, according to Human Development Indices and Indicators 2018 Statistical Update.  The fastest growth in Pakistan human development was seen in 2000-2010, a decade dominated by President Musharraf's rule, according to the latest Human Development Report 2018. Pakistan's newly elected Prime Minister Mr. Imran Khan has laid out an ambitious agenda that could accelerate Pakistan's human development progress to take his country from level 2 to level 3 of socioeconomic development. It is achievable but the odds are against him because he faces stiff opposition from the status quo forces. The powerful dynastic duopoly of PPP and PMLN still dominates Pakistan's Senate whose support will be required for major reforms. The research by Professor Hans Rosling shows: "Of the ten countries with the fastest economic growth, nine of them score low on democracy." It's also supported by Pakistan's economic history where pace of development has consistently been faster under military governments than during civilian democratic rule. Can Prime Minister Imran Khan's leadership change the course of history and deliver faster human progress under democratic rule? Let's wait and see.