Role of Street Level Bureaucracy to Counter COVID-19 in Pakistan


The Coronavirus (COVID-19) pandemic has compelled countries around the world to implement immediate and long-term governance initiatives to reduce disease transmission and save lives. The pandemic has put a real test for global governance. Every country is placing its utmost efforts to beat this deadly virus through effective governance mechanisms. However, it is important to assess how well the global governance is responding to it?

No country in the world was ready to face a pandemic on such a huge scale. COVID-19 has exposed the different global models of governance. Various strategies and governance techniques are utilized to address this issue. For example, China has authoritarian governance system and it was successfully able to reverse the pandemic. On the other hand, the most democratic western model of governance failed to neutralize the challenge in an effective way. It is important to understand and dig out that why Chinese model was successful and later was unsuccessful and this will be covered in one of my upcoming pieces.  Today, one of the common and very important aspects of governance is being exercised in most of the countries in the form of the Street Level Bureaucracy (SLB).  The SLB is internationally recognized and being utilized to address the pandemic. This article is dedicated to understand the role of the SLB in Pakistan to tackle COVID-19. 

Pakistan has decentralized governance structure to handle the crises with certain interventions from federal government. Provincial governments are responsible for dealing with the pandemic. The virus puts immense pressure on Pakistan’s governance structure especially the fractured healthcare system. However, this is not only the healthcare system, but also the other institutions like police, district administration, civil society and so on that are equally involved to curb the virus.

In Pakistan, the SLB is highly relevant subject to counter COVID-19 considering its decentralized governance structure.  Before, I come to Pakistani case, it is important to understand what actually the SLB mean and from where the concept came from?. Back in 1969, political scientist Michael Lipsky coined the concept of the SLB and described it as “public service workers who interact directly with citizens in the course of their jobs, and who have substantial discretion in the execution of their work”.  Hence, SLB are frontline workers including doctors, nurses, school teachers, and police officers and so on. Their work is between policymakers and the general public to implement policy objectives.

Pakistan has 1,279 public hospitals and 220,829 registered doctors for a population of 220 million, according to Pakistan’s Economic Survey 2018-2019. The country spends only 2% of its gross domestic product while global average is 10 per cent.  Pakistan health system is one of the weakest systems in the region. World Bank data show that in 2016, Pakistan spent around $40 annually per citizen on healthcare in the comparative figure in India was $62, and Iran $415. Pakistan has a mixed health system that includes public, parastatal, private, civil society, philanthropic contributors, and donor agencies.

The hospitals at provincial and at district levels are mainly handling the pandemic with certain directions and help from the federal government.  The local governance structure is the right governmental tier that can effectively respond to the pandemic keeping in view the massive spread of virus everywhere in all localities. The local hospitals and administrations are in a better position to act immediately and trace the contacts of positive cases correctly when the spread of the pandemic is impending. This manifest the importance of the local healthcare system to deal with the crisis.

The local police are also playing a key role for maintaining the lockdown throughout the country. The police have a presence in all areas; it is in a better position to immediately act as first responder. Besides, the Staff House Officer (SHO) of an area knows better how to engage and motivate local community. It is not possible for centralized or even provincial governments to enforce implementation mechanisms at local scales, especially in the rural areas. Thus, local governmental institutions are driving force for the policy implementation to curb the virus. 

The district administrations have also an important role to paly to ensure the policy implementations, set by the federal or provincial governments, through local actors. The administrations, across Pakistan, are tirelessly working not only for addressing COVID-19 challenge in collaboration with the local healthcare departments, but also ensuring the other administrative issues like controlling food prices, maintaining food chain, and helping civil society organizations in distribution of rations to the needy masses. The financial assistance from federal government to the poor segment of the society is also being distributed through the district and local administration. Moreover, it acts quite quickly to disseminate the policy decision and involves local actors for implementation within no time. As such, these critical situations demand urgent actions and that can only be possible at the local scales.  

Despite, the schools, universities, and all other educational institutions across the country are closed yet, teachers are playing their role to educate communities about the pandemic especially in rural areas. In these regions, the masses are not taking the pandemic seriously, but teachers are playing promising role to motivate them through social media to adopt pre-cautious measures as directed by the government.

In last month, the National Command and Operation Centre devised latest approach of Test, Track and Quarantine (TTQ) strategy for effective diagnosis of the COVID-19 patients to contain the spread of pandemic in the country. For implementation of this strategy, it highly emphasized the role of local administrations. Hence the crises demands timely and urgent decisions that can only be possible by utilizing the local tiers of government. 

Thus, it has been reached that the SLB has a leading role to eliminate the pandemic. However, in Pakistan, it is confronting multiple challenges due to weak institutional capabilities and lack of financial and human resources. The federal and provincial government must take measures to improve the performance of the SLB to make it more effective in dealing with the similar crisis in future.


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