OUTLINE
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Indicators
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Health System
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Importance of Healthcare in Economy
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Pakistan health system
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Public sector
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Private sector
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WHO support
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Pakistan’s Healthcare Crisis
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Strategies to improve Pakistan Health
system
Indicators
o Total Polio Cases
§ 8 in 2017
§ 12 in 2018
§ 9 in 2019
Source: End Polio Pakistan (www.endpolio.com.pk)
Health System
A health system, also sometimes referred
to as health care system or as healthcare system, is the
organization of people, institutions, and resources that deliver health
care services to meet the health needs of target populations.
Importance of Healthcare in Economy
Access to comprehensive, quality health
care services is important for promoting and
maintaining health, preventing and managing disease, reducing unnecessary
disability and premature death, and achieving health equity for
all country.
It also makes an important contribution
to economic progress, as healthy populations live longer, are
more productive, and save more. It is concerned with the impact of
better health on development and poverty reduction, and
conversely, with the impact of development policies on the
achievement of health goals.
Pakistan health system
Pakistan has a mixed health
system that includes public, parastatal, private, civil society,
philanthropic contributors, and donor agencies. In Pakistan, health
care delivery to the consumers is systematized through four modes of
preventive, promotive, curative, and rehabilitative services.
Under the constitution, health is primarily
responsibility of the provincial government, except in the federally
administrated areas. Health care delivery has traditionally been jointly
administered by the federal and provincial governments with districts mainly
responsible for implementation.
The state provides healthcare through a
three-tiered healthcare delivery system and a range of public health
interventions.
Some government/ semi government
organizations like the armed forces, parastatals such as Sui Gas, WAPDA,
Railways, Fauji Foundation and the Employees Social Security Institution
provide health service to their employees and their dependents through their
own system, however, these collectively cover about 10% of the
population.
The private health sector constitutes a
diverse group of doctors, nurses, pharmacists, traditional healers, drug
vendors, as well as laboratory technicians, shopkeepers and unqualified
practitioners.
Public sector
Public sector health care system endeavors to
deliver healthcare through a three level healthcare delivery system and a range
of public health interventions. The first level includes Basic Health Units
(BHUs) and Rural Health Centers (RHCs) founding the fundamental of the
primary healthcare model, secondary care encompassed first and second referral
facilities providing acute, ambulatory and inpatient care through Tehsil
Headquarter Hospitals (THQs) and District Headquarter Hospitals (DHQs) and
tertiary care including teaching hospitals.
The national health infrastructure comprises
of 1201 hospitals, 5518 Basic Health Units, 683 Rural Health Centers, 5802
Dispensaries, 731 Maternity & Child Health Centers and 347 TB centers, and
the total availability of beds in these health facilities is estimated at
123394. In addition more than 95000 Lady Health Workers are providing primary
health care services to the community through the health houses.
Private sector
The rising population pressure on state
health institutions has allowed the private sector to bridge the gap of rising
demand and limited public health facilities. A number of private hospitals,
clinics and diagnostic labs has increased considerably and is contributing
health services in the country. Majority of private sector hospitals has
sole proprietorship or a partnership model of organization. Stand-alone clinics
across Pakistan are the major providers of out-patient care majority of these
clinics falls in the sole proprietorship category.
WHO support
1. WHO supports the national health
authorities vision and aim of reaching universal health coverage through the
delivery of equitable and sustainable health services.
2. Support to the delivery of an identified
package of essential services that is based on integration of service
delivery.
3. Introduction of Family Practice and promotion
of Public-Private Partnerships models in service delivery
4. Quality of services and patient safety as
one of the main components of service delivery
Pakistan’s Healthcare Crisis
IN Pakistan, the most important aspect of
well-being is also the most neglected. In its 70-year history, Pakistan’s
successive governments — civil and military — have not made health a priority.
The Pakistan’s government to health is
reflected in the fact that Pakistan spends a mere 0.9pc of its GDP on health.
Only two countries, the Democratic Republic of Congo and Bangladesh, have a
lower ratio of GDP to health spending.
Major CHALLENGES OF PAKISTAN HEALTH CARE SYSTEM are
· Pakistan health care system has poor infrastructure of health
care centers like BHUs and RHCs.
· There is
an inadequate allocation of health care resources like finance, transport etc.
· There is a severe shortage of adequate number of health care
professionals like nurses, doctors and lady health workers.
· There is lack of technology advancement and research
opportunities for health professional at national level.
· Pakistan has double burden of communicable and noncommunicable
diseases.
· There is a poor accessibility and affordability to health care
services especially for rural population of the country.
Strategies to improve Pakistan health system
A series of programs and projects are on
track in Pakistan to improve health status of the people and to reduce burden
of communicable and non-communicable diseases while vertical programs have been
devolved to the provinces.
The present government is committed to
further uplift health and nutrition status of population. The Ministry of
National Health Services, Regulations and Coordination (NHSRC) during 2nd and
3rd quarter of FY2019 has made significant progress by devising comprehensive
strategies to improve health for all Pakistani people. In this context two
strategic documents were produced and approved which are as follows
Action Plan - National Health Services, Regulations and
Coordination Division 2019-2023:
The ‘Action Plan’ sets out the prioritized
strategic actions of the new government to transform the health sector of
Pakistan by addressing the challenges, health sector reforms and thus improving
the health outcomes of people of Pakistan
Islamabad Capital Territory – Health Strategy (2019-23)-
The
first ever ‘Islamabad health strategy’ to ensure provision of integrated
quality health care services in the capital area
Sehat Sahulat Program(SSP)
Ministry of National Health Services,
Regulations and Coordination (NHSRC) in collaboration with provincial
governments, started a landmark and flagship health care and social protection
initiative, the Sehat Sahulat Program The program is being implemented in a
phased manner. In the first phase, the program is being implemented in 38
districts of Pakistan covering 3.2 million families.
Civil Registration and Vital Statistics
Given
the significance and relationship that an efficient Civil Registration and
Vital Statistics (CRVS) has towards the development of a country, the
government is making serious efforts and has gained momentum to strengthen and
revamp its CRVS in the country.
Reduction in Prevalence of Tobacco Use in Pakistan
Ministry of National Health Services
Regulations & Coordination has initiated a strategy in January, 2019 to
enhance efforts to reduce the prevalence of tobacco use in any form in the
country by urging all tobacco manufacturers to print new Pictorial Health
Warning (PHW) on cigarette packs and outers. The size of new warning has been
increased from 50 percent to 60 percent and it will be printed on both sides of
the cigarette packs and outers.
Tobacco use is a cause of death of around
160,100 Pakistan every year. Around 24 million adults currently use tobacco in
any form in Pakistan. The youth of Pakistan is being targeted with this
strategy of implementing Pictorial Health Warning
National Nutrition Program
The Nutrition Wing that was established in
2001, has been playing a major role in targeting malnutrition in the country
through development of policies, strategies, guidelines and standards for
nutrition and fortification, building provincial capacity, oversight,
monitoring and evaluation of program implementation in the provinces as well
research and evidence generation for policy review and planning.
Prime Minister’s National Health Insurance Program
Prime Minister's National Health Program (PMNHP)
is a milestone towards reaching the goal of attaining Universal Health Coverage
through recently introduced healthcare financing system ensuring access to
medical health care in aswiftand dignified manner without any financial
obligations
Polio Eradication Initiative Program
Pakistan has made important progress towards
eradications polio in the country. Case numbers are at the lowest and the
immunity gaps continued to decline.
According to Planning and Development
Division, during 2019-2021 Pakistan will invest US $ 347.22 million (PKR 46.8
billion) for polio eradication activities. Vaccine procurement and social
mobilization is undertaken by UNICEF while WHO incurs expenditures on
operational activities and environmental surveillance.
Nutrition Security
Global Nutrition Report (GNR) 2018 revealed
unacceptably high level of malnutrition and every country is affected in one
way or the other.
Improving nutrition can have a powerful and
positive multiplier effect across multiple aspects of development, including
poverty, environmental sustainability, peace and stability. The government has
shown its commitment to overcome vicious cycle of malnutrition and has
pin-pointed stunting as the major setback in the development of the nation.
Pakistan Multi-sectoral Nutrition Strategy (PMNS) has been formulated following
the bottom up approach to fill gaps in planning and implementation.
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