Background: This paper analyzed historical, political, economic, social and global influences on the health sector reforms in Pakistan.Material & MethodsThe article is based on a critical analysis of secondary data from the public domain as well as from international development agencies. It also draws from scholarly articles about the experiences of health sector reforms carried out in other countries.ResultsHistorically, ever since the independence of Pakistan, the actual power remained in the hands of elite class, therefore, no meaningfulreforms were introduced in the basic socio-political structure of the Pakistani society. Financially, due to high debt burden and the huge military expenditure, the state is shifting its traditional responsibility of providing health services to its masses to the private sector leading to further marginalization of poor and the disadvantaged. Furthermore, social issues such as rapid population growth,unplanned urbanization and emergence of mega cities are putting further pressure on already constrained resources and infrastructure and therefore are a reason and future challenge for health sector reforms in Pakistan.ConclusionsTwo important conclusions can be drawn. One, any reform introduced for the improvement of health status of Pakistani population tosucceed, needs to consider the complex socio-political structure of the society. Second, all the historical, political, economic, social, andglobal factors discussed in this paper reinforces the need for major health sector reforms in Pakistan and it also demonstrates theconstraints that the system must overcome in order to initiate any meaningful change
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