Exploring Barriers, Facilitators and Stakeholders' Perspective to the Implementation of Sustainable Health Equity: A Case of Sindh, Pakistan

The purpose of this study was to explore the barriers, facilitators and perspectives of stakeholders to the implementation of sustainable health equity in the healthcare sector of Sindh, Pakistan. Using a qualitative approach, it study used purposive sampling. Semi-structured, in-depth interviews were conducted with 09 participants, including district health officers, monitoring and evaluation, physicians, and paramedical staff. The data were analyzed through a thematic analysis using NVivo. Participants had a limited understanding of sustainable health equity. Most of them believed that equity would have been achieved by meeting one of the targets of (SDG 3.8), i.e. Universal Health Coverage. The findings show that sustainable health equity in Sindh cannot be achieved through service expansion alone, but rather the progress requires equity-focused governance, inclusion of stakeholders’ views in policy formation. For these steps, financing, monitoring of services and outcomes, and political commitment are required. The study highlights that sustainable health equity can only be implemented if the stakeholders from the healthcare sector of Sindh are actively involved in policy formation. Current health equity policies should be reviewed, keeping in view the points of stakeholders. This study can support sustainable health equity policy implementation in Pakistan and offer lessons for similar healthcare system settings seeking to implement sustainable health equity.