key: cord-0921406-4undzn4i
authors: Raza, Muhammad Ahsan Ali; Yan, Chen; Abbas, Hafiz Syed Mohsin; Ullah, Atta
title: COVID‐19 pandemic control and administrative issues in Pakistan: How Pakistan mitigated both pandemic and administration issues?
date: 2021-09-13
journal: J Public Aff
DOI: 10.1002/pa.2760
sha: c61a33255452298ad182ce7c3d5cae39b018c5ae
doc_id: 921406
cord_uid: 4undzn4i

COVID‐19 is wreaking havoc all around the globe, and Pakistan bears no exception. This study explores Pakistan's response toward controlling COVID‐19 Pandemic from the day the 1st case was reported, February 26, 2020, in Pakistan until August 31, 2020. It explores the administrative conflicts among federal and provincial governments and political behaviors of political parties toward the COVID‐19 pandemic by referring Government Response Index. By applying the ARDL model approach, results show that since the administrative harmony had been implemented in Pakistan in July 2020, its positive impact on combating the COVID‐19 situation in Pakistan and substantial improvement in recovered cases and a downward trend new confirmed and fatal cases has observed in Pakistan. The findings demonstrate that administrative efforts scattered due to internal conflicts from February to mid‐July 2020 have ended, and collective aggressive policy enforcement has been mitigating the adverse impact of COVID‐19 in Pakistan since July to date. However, sustainable measures and prudent policy implications are needed to combat the ongoing COVID‐19 pandemic and future calamities.

When nations were welcoming 2020, an uninvited and unexpected calamity called COVID-19 also appeared. A group of coronaviruses spread like a pandemic and engulfed the entire world in no time (Abbas, Xu, Sun, Ullah, et al., 2021a; Shim et al., 2020) . Expecting that developing countries ought to face this pandemic's wrath the most, the actual situation was quite the opposite. Since this pandemic outbreak from Wuhan City of China on December 27, 2019, till today, China's fight against this problem was remarkable and appreciable. On the other hand, developed countries like United States, United Kingdom, Italy, France, and Spain have collapsed utterly in battling against this pandemic socially, economically, and psychologically (Mamun & Ullah, 2020; Moghanibashi-Mansourieh, 2020) . Moreover, along with economic and social, world has also been facing climatic, energy shortage and development issues since the COVID-19 outbreak Le et al., 2020; Nguyen et al., 2021; Ullah, Pinglu, Ullah, & Elahi, 2021) . The COVID-19 cases' situation is somehow better in developing countries; however, governance and response system issues ripped those countries to exposure, making the problem worse.

COVID-19 is wreaking havoc all around the globe, and Pakistan bears no exception. Pakistan is a developing country with a lowermiddle-income category than the World Bank database (World Bank, 2020) . However, since its inception, Pakistan has been facing economic deprivation, health, and socio-economic crisis precisely (Aslam, 2020) . Aged 73 years, Pakistan did not have much significant political stability and state agility in any socio-economic and governance indicators (Saqlain et al., 2020) . These factors are critical to every country's success, providing economic and social freedom and public well-being toward its masses. These variables did not show much progress in every elected government because of internal conflicts and external and other economic and non-economic factors, which becomes a more cause of economic deprivation in Pakistan.

Political instability, political and ethnic conflicts are the biggest hurdles of Pakistan's development. These conflicts and uncertainty are the consequences of bipartisan political regimes, federalism, devolution, and institutional corruption. It can be analyzed that until 2019, Pakistan has not been stable in terms of its political and internal encounters. Due to corruption and poor institutional governance, there is a lack of public confidence in the government (Muçollari, 2018) .

This study has examined the current COVID-19 pandemic in Pakistan and its federal and provincial governments' conflicts toward a policy implementation in tackling this problem using the Government Response Index ( Ashraf, 2020; Hale et al., 2020) . Nowadays, it is a worldwide hot debate about tackling this problem and eradicating it ultimately. Pakistan introduced this problem in late February 2020, and it has been showing an increasing trend throughout the country.

Federal and provincial governments are trying to mitigate its effects and running various public service campaigns to create awareness among the general public; however, the results are still not promising (Abbas, Xu, & Sun, 2021b , 2021c .

This study attempted to explore Pakistan's response system's gray area, resulting in the further spread of COVID-19, as suggested by (Abbas, Xu, & Sun, 2021b , 2021c . It further analyzed that administrative conflicts and weak health response systems made the country vulnerable to current potential health crises. In the past, dengue fever spread in Pakistan is also one example of an inadequate health response system. Although the situation is somewhat better in Pakistan regarding COVID-19 cases than in other regional countries, it can worsen if effective strategies and action plans will not be implemented in the coming days (Ullah, Pinglu, Ullah, & Elahi, 2021; Ullah, Pinglu, Ullah, & Hashmi, 2021) . This study attempted to examine the situation of administrative conflicts that hike the pandemic cases; however, this study gives an insight into this situation and provides a thought of provoking the government to affect their disputes to the state adversely. They should control the administrative conflicts and instability to draft effective public policies for future causalities.

Since its inception, Pakistan has had different government styles, that is, democratic, autocratic, military, and bureaucratic (Aslam, 2020) .

Nevertheless, it failed to achieve its political stability in all regimes.

The leading cause of this hardship is the tug of war for the command, that is, between federal and provincial administrations for policy implications. Affirmatively, Pakistan has been facing many likewise issues on which weak policy enforcement is observed due to this riddle of command and rule. On the other hand, a bipartisan political government makes public policy enforcement most unpleasant.

Public policy and political experts explained federalism as a governance model where the federal government coordinates and interconnects with the regional government and decisions (Dikshit, 1971) . It further analyzed that this interconnection helps the government to useful policy implications across the country (Kincaid & Cole, 2002) and enhance the public institutional capabilities accordingly (Daumal, 2008; Lane & Ersson, 2005) . Moreover, federalism helps to synchronize the institutions for the equal or appropriate distribution of resources among the regions, revitalizing public institutions' outcomes in efficient manners without conflicts (Weingast, 2009 ). Federalism, along with national unity and harmony, also supports the governments to make healthy and productive international relations and treaties (Fisher, 2015) that lead to economic growth in developing countries (Baskaran et al., 2016) , which has been surveyed and experienced by the public policy scholars (Marlin, 2016) . Although federalism significantly impacts decision-making, no matter whether partisan or bipartisan political allies support the government. However, it also examined that it can create a conflict of interest among policymakers that intimate the shredding of political powers (Martin & Vanberg, 2020) . Moreover, this friction or conflicts of interest in bipartisan political ideologies leads to inefficiency in policymaking (Abbas, Gillani, et al., 2020; Abbas, Xu, et al., 2020; Chan & Fan, 2020) .

In terms of ideologies and political concerns, friction gives birth to other contrasting terminologies in political and public administration studies: Federalization and devolution. These terms describe the delegation of administrative strategies and later for political authorities for autonomous decision making (Bresser-Pereira, 2004) . As some scholars supported federalism for decision making, others support devolution for economic growth at the regional level, where federalism cannot resolve the policy disputes (Balint & Mashinya, 2006; Hudson, 2006) . However, scholars also have some cultural and regional concerns for devolution and do not fully support it (Rose & Miller, 2010; Tsukamoto, 2011) . It further analyzed that devolution enhances ethnic and religious bonding; on the other hand, it arouses institutional corruption or misuse of powers if weakly controlled (Carlucci et al., 2017; Pozdena, 2018) . However, in recent studies, it is also explored that devolution supports regional progress by taking demographic, social, health, and regional challenges and liaison with the federal government in policy implications, especially in developing and populated countries (Chan & Fan, 2020; Gaisie et al., 2019) .

Since its inception 73 years ago, Pakistan has struggled for democratic and exemplary leadership (Asghar, 2013; Aslam, 2020) . Pakistan comprises four provinces (Punjab, Sindh, Khyber Pakhtunkhwa, and Balochistan) and three special administrative regions (Islamabad Capital Territory, Azad Jammu and Kashmir, and Gilgit Baltistan). At the same time, the President is head of state, and Prime Minister is the head of government. Moreover, more than a dozen political parties are working in Pakistan. However, among them, four are prominent, that is, Pakistan Tehreek-e-Insaf (PT1), Pakistan Muslim League-Nawaz (PML-N), Pakistan's People Party (PPP), Pakistan Muslim League-Quaid-e-Azam (PML-Q), and Jamat-e-Islami Pakistan (JIP). Several parties worsen as everyone has their own political and national agenda for running the state (Martin & Vanberg, 2020) . This multiparty battle for the ruling has significantly impacted Pakistan's stability and progress. Pakistan has been facing a tug of political war for many years between federal and provincial governing.

Especially since the announcement of the transformational devolution plan in 2000 for the precision of the federal and provincial government's rules of responsibilities (Ahmad & Akif, 2007) . It further empirically analyzed that this plan or reform significantly impacted the institutional quality for public services outcomes, resulting from coordination among federal and provincial governments (Agranoff, 2011; Aslam & Yilmaz, 2011) . It further explored that devolution or delegation of political power will help construct a strong constitution of Pakistan and develop a robust regional bonding among provinces (Myerson, 2014) . However, some issues originate in its transition period (Lind, 2018) , which needs to resolve with a healthy leadership system (Ahrens et al., 2020) .

Being a developing country, Pakistan has been facing many socioeconomic and health crises in the past, that is, earthquake 2005, flood 2010, dengue fever 2011, and recent COVID-19. World Health Organization has issued Pakistan's operational guidelines as an early disease warning system for health systems' preparedness from any uncertain epidemic (WHO, 2010) . These programs address the danger of virus issues in developing countries, for example, dengue fever, SARS, MEARS, and other virus issues. The dengue fever epidemic affected more than 50,000 people, with more than 300 deaths in different periods in , 2015 in Pakistan (WHO, 2019b . Although this virus affected Pakistan as a pandemic a couple of years ago, earlier than 2011, it never turned into an epidemic. It further analyzed that emerging infectious viral attacks are the most deadly in developing countries (Bakhsh et al., 2018; Khalil et al., 2017; Zubair et al., 2016) . The dengue epidemic is linked with environmental changes and mainly outbreaks in the summer season due to mosquito biting; that is why proper awareness and early response system needs to be activated before it happens (Bakhsh et al., 2018) . However, the development of a dengue emergency response committee, closure of Educational institutes, and imposed article 144 in the country was taken as preventive measures to mitigate its effects and control the situation.

As per the United States Centre for Disease Control and Prevention (CDC), most deaths occur in Pakistan due to virus-related diseases. In 2020, a novel coronavirus (COVID-19) pandemic was challenging and exposing Pakistan's response system (Faisal, 2020) .

COVID-19 has produced a global panic and chaos situation among public and health professionals since December 31, 2019, due to its unique contagious characteristics, making it challenging to track and control (Xiao, 2020). As per the Ministry of National Health Services Pakistan (NHS) and John Hopkins University Corona Resource Centre, as of August 31, 2020, more than 25,486,747 patients globally and 296,170 locally have been affected in Pakistan, although it hit Pakistan on February 26, 2020. As per the studies, Pakistan had to be vigilant because the response was not as quick as it would be (Nafees & Khan, 2020) . So far, Pakistan does not have adequate measures and facilities (Quarantines and Isolations centers), making it unable to cope with this situation (Abbas et al., 2021b; Waris et al., 2020) . cies, socio-economic support to masses, and emergency health investment) toward COVID-19 worldwide and ranges value (0-100, on the scale of weak to strictest policy implementation) from January 01, 2020, to date (Abbas et al., 2021b; Hale et al., 2020) . Further, later data was discussed to assess Pakistan's health care response system and the government's strategies for controlling COVID-19 analysis at a federal and provincial level in Pakistan. In a nutshell, this study has applied the mixed approach of descriptive, theoretical, and empirical estimations to make this study comprehensive and novel concerning Pakistan and its battle to COVID-19.

This study applied the auto regressive distributed lag (ARDL) cointegration approach (Pesaran et al., 1999 (Pesaran et al., , 2001 . In recent studies, 1 http://covid.gov.pk/stats/pakistan researchers analyzed that due to the co-integration approach ARDL model is one of the most common dynamic unrestricted modes used in ARDL literature nowadays (Ghouse et al., 2018) . In further studies, scholars identified in a long and short-run analysis that autoregressive distributed lag model (ADRL) is suitable for taking appropriate Lags numbers, which help capture correlation in cointegration variables (Shrestha & Bhatta, 2018) . In an ARDL model, two-step rooted in a long-run analysis; first, identify the long-run and second estimation of co-efficient in the long-run and short-run in the same equation (McCann et al., 2010; Sulaiman et al., 2019) . In a more profound analysis, this study applied robustness tests;

Durbin-Watson test and Breusch-Godfrey test for identifying the serial correlation and no correlation, Breusch-Pagan, and LM ARCH Tests to check the heteroscedasticity and Ramsey RESET Test for specification are the critical testing tactics for ARDL (Shrestha & Bhatta, 2018) .

Model 1 equations equation can be written as follows;

Model 2 equations equation can be written as follows;

Model 3 equations equation can be written as follows;

where NCC represents new confirmed cases, RC indicates recovered cases, and DC is the deaths indicator. While GRI represents the Government Response Index. Apart from that, B 0 is the constant value, whereas μ serves as an error term. Cross-sectional units are detonated by subscript i and t denoted time. Pakistan is politically unstable due to internal politics more than external factors and threats, which raised the ineffectiveness toward policy implementations. (Ashraf, 2020) . Hence, as the COVID-19 has been devastating worldwide same and Pakistan bears no exception. From the start of July 2020 to date, COVID-19 and government policies show a strong positive correlation, which is a positive sign toward the resumption of the country's social, economic, and psychological aspects.

It was observed that in the 6 months of the pandemic in Pakistan, confirmed infected cases are 1575, deaths were 34, and recovered cases were 1495 per day. Furthermore, it shows that in August 2020, recovered patients showed significant improving trends (in the red squared area) in Figure 2 , compared to confirm and instances of death.

However, initially, the government could not tackle the situation just like the rest of the world.

As per the current constitution arrangement of Pakistan's health system, the provincial government is accountable for providing health in the respective region, and the federal health ministry plays only a governing and policy implications role. Owing to this arrangement, the provincial response toward controlling the COVID-19 is crucial in this discussion. As per Tables 4 and 5, Sindh is the second most populous region and comprises more than 22% of Pakistan's population. As of July 15, 2020, federal and provincial governments proposed the two-week complete lockdown across the country, but Sindh province refused this proposal and continues the partial lockdown and extended the tighten policy enforcement toward preventative measures. Sadly, these conflicting outcomes showed that policies have

been ineffective yet regarding COVID-19 cases, which shows that policies lack effectiveness, as depicted in Table 3 . However, for future policy measures, the government should consider the stringent guidelines by assuming socio-economic crises to control the COVID-19 trend and make a comprehensive policy to cater to future unforeseen calamities (Ashraf, 2020) , and educate the public in a better way to adopt social distancing and other precautionary measures (Shim et al., 2020) . Table 3 depicted that government policy implementation has remained ineffective throughout the pandemic until the end of July 2020, mainly since May to July was the crucial time for Pakistan.

Although the government response index shows a much higher value, province has not been equipped enough compared to its population ratio due to administrative conflicts between federal and Sindh provincial governments. However, by administrative harmony and unity, a better picture has been depicting on controlling the COVID-19 situation in Pakistan since July to date (Ayub, 2020; Abbas et al., 2021b) . show that NCC and DC are positively correlated with GRI, while RC is negatively correlated with GRI. The analysis shows that with time, relaxation in policy implications in Pakistan has been observed. A high degree of policy enforcement but interval political conflict had a low positive impact on controlling the COVID-19 situation in Pakistan in a more profound analysis. However, even to a low degree, internal harmony and joint aggressive policy enforcement positively impact combating the COVID-19 crisis in Pakistan and hike the recovered cases, negatively correlating with the government response index.

By applying the ARDL approach in Table 6 , results show that GRI has a more significant impact on recovered cases of COVID-19 in Table 6 . Table 7 demonstrates the Long and Short Run relationship of the COVID-19 indicators and GRI situation in Pakistan, which indicates that in the long-run overall impact of policy enforcement has a more substantial impact on Pakistan in its initial 6 months battle. However, in the short run, the policy was not effective at all, and the COVID-19 situation had worrisome.

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APPENDIX A: (ADDITIONAL DESCRIPTIVE STATISTICS OF HEALTHCARE AND COVID-19 FACILITIES IN PAKISTAN)

Abbreviation: HCE, health care expenditures

***Pakistan Nursing Council Statistics, 2019. ****A Special Administrative area under federal government

The authors declare no conflict of interest.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

https://orcid.org/0000-0002-8554-5485Atta Ullah https://orcid.org/0000-0002-0590-563X