Govt use mere 0.9pc of its GDP on health
Health aspect of well-being of common people is mostly neglected. Pakistan’s successive governments whether civil or military in its 70 years have not made health a preference while health well being in Pakistan receive little to no space in the agenda of political parties.
Pakistan does not show any interest in the well being of the poverty stricken people. This is reflected in the fact that Pakistan spends a mere 0.9 percent of its GDP on health.
The public expenditure on health accounts for a little over one-third of Pakistan’s total health expenditure. Therefore common citizen of Pakistan rely mostly on private healthcare, which they avail primarily through out-of-pocket payments.
The poor quality health services by the government institutions is the key reason behind inviting massive role played by the private sector in healthcare. The absence of accessible healthcare not terrorism, drones or the energy crisis is the greatest setback facing Pakistan. Although healthcare is truly connected to problems of corruption and security, there is no reason why healthcare should not be made an instant attention.
The media no doubt tends to report heavily on specific heath-related crises such as the spread of polio and child deaths in Thar, even then the low health services are virtually absent.
LESSON TO LEARN
Look at other low-income countries that have made great progress in healthcare in the last thirty years. The examples of these countries provide brightening lessons that should be applied in Pakistan.
The infant mortality rate in Pakistan is 66 per 1,000 births, compared to 38 in India and eight in Sri Lanka. Life expectancy in Pakistan for women is 67 years, as compared to 73 in Bangladesh and 78 in Thailand.
The maternal mortality rate in Pakistan is 170 per 100,000 live births, in contrast to 30 in Sri Lanka and 20 in Thailand.
The Democratic Republic of Congo and Bangladesh have a lower ratio of GDP to health spending. Developing countries such as Thailand and Sri Lanka, where public expenditure accounts for most of health spending.
Thailand and Mexico are examples of two developing countries that have made progress in economics and social commitments towards universal healthcare with very encouraging results. The Thai government introduced a ‘30-baht universal coverage scheme’ that covered the entire population with a guarantee that a patient would not have to pay more than 30 baht per visit for medical care. It adopted a scientific measure to promote public accountability through the creation of the ‘Health Assembly’, a regular meeting where citizens voice feedback and complaints on the health system.
Mexico established a ‘System of Social Protection in Health’ which includes a public health insurance scheme that has steadily expanded insurance coverage with a package of comprehensive health services to millions Mexicans.
In India’s Tamil Nadu performance is remarkably well. Its infant mortality rate is 22 per 1,000 births and maternal mortality is 97 per 100,000 births, substantially better than many other states in India.
Countries have met the healthcare needs of large number of their populations by improving public health services and providing public insurance schemes. If there is accountability in the health care systems then it can attain positive results.
The execution of health policies devolved to the provinces should create new opportunities for public engagement and local government officials for the provision of public health services.
In Sindh for example, public health facilities are in critical condition, combined with staff absenteeism and shortage of essential medicines and equipment.
Our public officials and elected representatives must be pushed to make health the central political issue of our time.
For instance, the average life expectancy in 2000 was nearly the same in both India and Pakistan (62.63 years vs. 62.77 years). But by 2014, the indicator for India had improved to 68.01 years whereas it only reached 66.18 years for Pakistan. Life expectancy in Bangladesh has risen to 72 years, in Nepal to 70 years and in Sri Lanka to 75 years.
These nations also spend more money on the social sector than Pakistan. India, Sri Lanka and Nepal, for instance, spend 1.4 percent, 2.6 percent and 2.3 percent of their GDP (gross domestic product) on healthcare. Similarly, India allocates 3.8 percent of its GDP on education compared with 2.2 percent in Pakistan.
FACTORS TO BLAME
Several factors are responsible for the country’s poor performance in the social sector compared with its regional peers.
The expensive, prolonged war on terror that has cost it over $118 billion; floods and other natural disasters; increased policy focus on economic stabilization because of a recurring balance of payments crises; and more significantly inadequate budgetary resources owing to a low tax-to-GDP ratio, as well as a higher defence spending and debt servicing obligation along with poor capacity of public institutions to formulate and implement internally consistent policies for social service delivery.
The rapid population growth and the exclusion of the female population from the national, economic and social uplift policy framework as a major constraint to health sector development.
The state’s failure to deliver quality public services to the vast majority of the population has led the private sector to penetrate in the education and healthcare sectors over the past few years. But private services remain too expensive to be availed by larger parts of the population.
PM ‘S INITIATIVE
Prime Minister Muhammad Nawaz Sharif termed the healthcare sector as one of his top priorities and said the government was taking initiatives for the uplift of poorest of the poor patients. He said the government was committed to uplift of healthcare sector.
Under Prime Minister’s National Health Program launched in 2015, fifty new hospitals would be constructed across the country. This program would also provide free primary and tertiary healthcare to patients and being carried out on periodic basis provided it eventually benefit 100 million persons.
Under the Prime Minister plan, free of cost immunization for infants and pregnant mothers besides continuity of anti polio campaign make available.
Moreover, at 237 canals of land, the nursing university would cater 2,000 students with 500 admissions annually. Besides, residential services to 1,000 male and female students would be provided.