Pakistan’s government must shift from programme-based governance to measurable outcomes in education, healthcare and other public services, a report by Dawn has said, warning that citizens cannot indefinitely compensate for institutional failures.

Pakistan must focus on effective public services and adopt outcome‑focused governance rather than taking for granted the citizens' ability to "adjust" to the precarious economic and healthcare conditions, a new report has said. The report from Pakistan-based Dawn said there are limits to adjustment, highlighting the public shock after the recent deaths of newborn babies in a fire at Islamabad’s premier government hospital.
"When something as fundamental as the safety of infants in a public hospital cannot be assured, institutional failure is no longer an inconvenience. It becomes a matter of life and death," the report said. It noted that ‘Kindly adjust’-- a peculiarly South Asian expression -- has become a norm of the relationship between citizens and the institutions in Pakistan. "Pakistanis have become exceptionally good at adjusting. What we proudly call resilience is often the ability of citizens to compensate privately for the failure of public institutions," the report noted.

It criticised a culture that mistakes government's achievement with programmes, budgets, authorities and committees. The government's success in delivering education is measured by the number of schools, teachers and budgets, and not whether children learn, while healthcare is measured by the number of hospitals and beds. The article urged the government to publish clear, measurable standards for major public services — including learning outcomes for schools, hospital safety, healthcare availability etc.
Performance against those standards must be made public, the report suggested. While Pakistan has too many officials to approve, regulate, inspect and prohibit programmes, few are accountable when a program or an institution fails, the report added. Capacity building in manpower is crucial as a modern economy needs specialisation, lateral entry, merit-based appointments, fixed tenures along with measurable objectives. "The government must also simplify procedures, reduce overlapping responsibilities and give managers enough authority to be accountable. Pakistan needs better people in government, and systems in which good people can perform," the report noted.
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