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Pitiable state of health care system

There is little strength in health care delivery system in Pakistan like making health policies, participating in UN’s Sustainable Development Goals program, initiating vertical programs and introducing Public Private Partnership, improving human resource development and infrastructure by making Basic Health Unit and Rural Health Centers. However, all these programs are very limited in their scope and that is the reason that Pakistan’s healthcare system is still not very efficient. There are numerous weaknesses like poor governance, lack of access and unequal resources, poor quality of Health Information Management System, corruption in health system, lack of monitoring in health policy and health planning and lack of trained staff. Pakistan is improving very slowly in the health sector for the last five decades as is evident by its health indicators and above-mentioned strengths and weaknesses. Therefore, the government needs to take strong initiatives to change the current health care system.

One of the major difficulties faced by the healthcare policy makers, is the provision of health facilities to approx. 200 million population in Pakistan out of which majority do not have enough funds to buy the health care facilities they deserve. In order to assign expenditure on health care services, an impartial financing system should be implemented. Although there has been progressive increase in the government spending on health care over past years by government yet its ratio in terms of Gross Domestic Product (GDP) and Gross National Product (GNP) has remained stationary at almost 3% contrary to 5% of GDP expenditure on health as recommended by Wealth Health Organization (WHO).

Pakistan is attributed to the lack of access to basic health care services, poverty, lack of health infrastructure and personnel, illiteracy, women’s low status, inadequate water supplies and sanitation. In the urban areas, access to health care clinics and facilities is not a problem, though the general state and quality of public services is very poor. On the other hand, in the rural areas, people live far from hospitals and basic health care units. One of the main causes of illness in the rural areas of Pakistan is poor water and sanitation systems. Some studies indicate that a significant portion of the rural poor incomes is spent on preventable common diseases linked to contaminated water and unsanitary living conditions. Thus, the severity of health-related poverty is closely reflected in the country’s poor health indicators. Poverty is thus both a consequence and a cause of ill health.

 

In Pakistan, the health sector has been badly neglected and the policy makers have shown a callous lack of concern for educating the people and providing them with health care. No wonder, the quality of life of the people has remained low and the nation has not been able to achieve higher levels of economic progress due to underdeveloped human resources. The under-development of the health sector is manifested in Pakistan’s poor health-related key indicators. According to UNICEF, despite significant improvements over the past two decades, Pakistan ranks towards the bottom among other countries when it comes to infant and neonatal mortality. Pakistan’s ranking in the Maternal Mortality Ratio Index has slipped from 147 in 2014 to 149 in 2015, recording a staggering 276 deaths per 100,000 births.

In order to achieve overall improvement in health, fairness in risk distribution and financing and responsiveness to the non-medical needs of the clientele by the health system in Pakistan, it is imperative to create strong inter-sector agencies, norms and standard setting for health care delivery, quality assurance in the pharmaceutical industry and more collaboration with the private health care sector. To provide direction and proper oversight a strong stewardship function is necessary. Public private partnership may strengthen the stewardship role of the government in terms of bringing good governance and promote more responsiveness in Pakistan health system.

The writer is a Karachi based freelance columnist and is a banker by profession. He could be reached on Twitter @ReluctantAhsan

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