STRENGTHENING PUBLIC HEALTH SERVICE DELIVERY THROUGH GOOD GOVERNANCE: EVIDENCE FROM PAKISTAN

Abstract

The imperative to enhance public service delivery has placed good governance at the center of health sector reform, particularly in developing countries where state-led healthcare remains a primary source for the majority. This study investigates the impact of good governance on health service delivery in Pakistan, with a specific focus on Balochistan, using the theoretical lens of Public Value Theory. Employing a quantitative, explanatory research design, data were collected from 234 healthcare professionals—including doctors, nurses, pharmacists, and administrators—across public hospitals using standardized scales. Structural Equation Modeling (SEM) via SmartPLS was applied to examine the hypothesized relationship. A positive correlation is statistically significant and exists between the good governance and service delivery. Good-governance dimensions, namely transparency, accountability, regulatory quality, and rule of law have been empirically demonstrated to have positive effects on the important indicators of service quality, such as physician availability, quality of diagnostic services, patient satisfaction with treatment, and continuity of care. These results highlight the criticality of governance practices not only in improving operational efficiency but also in creating value to the population, as a result of alignment of services and the expectations and needs of the people. Besides, the study extends the theoretical evolution of the Public Value Theory through the provision of practical validation of its assumptions in the framework of the healthcare system under the conditions of the limited resources. It also contributes practically by identifying governance-driven pathways to improve health service performance and sustainability. Policymakers are urged to institutionalize governance reforms to ensure equitable, transparent, and citizen-centric health delivery systems in Pakistan.