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Health and education – key issues confronting Balochistan

Balochistan is the country’s poorest province with standards of living and social indicators lagging substantially behind the rest of the country. There is a strong nexus of high illiteracy with high poverty in the province. A lethal combination of militancy and poverty continues to keep the province far behind the other provinces in performance improvement in the educational arena killing all efforts and frustrating any prospect to bring improvement in poor state of education. For obtaining health capital in Balochistan, there is a dire need to resolve basic and pressing issues related to the health sector.

Health distress

The health indicators in Balochistan are poorer than any other province. Major causes of water-related diseases include lack of water supply and sanitation facilities, absence of proper sewerage disposal, waste mismanagement and contaminated water. Malaria, typhoid, hepatitis, gastrointestinal and respiratory disorders are common in the province. These diseases can be prevented by facilitating the population with proper sewerage and sanitation disposal systems. In rural areas, the health status is relatively poor. Lack or absence of female health staff including female doctors in rural areas worsen the situation. In rural Balochistan, the health status is relatively poor. According to an estimate, there is only one doctor available for 7,300 persons in average. An amount of Rs18 billion had been allocated for health sector in the Balochistan budget 2017-18 which had a five percent increase than the past year.

Though health sector in Balochistan remained the focus of welfare programs launched by every government in the past, but the leakage, misuse of public funds and irregularities in this sector caused no relief to the people in the most backward province.

Balochistan Health Department is responsible for aims delivery of key health services to the people through hospitals, Basic Health Units (BHU) and Rural Health Centers (RHC). The Department operates more than 550 BHUs, 90 RHC’s and 89 Maternal Child Health Care Centers (MCH) to provide health services throughout to the province. The Provincial capital Quetta has five hospitals namely; Bolan Medical College (BMC), Civil Hospital, Fatima Jinnah Chest & General Hospital, Helper’s Eyes Hospital and Sheikh Khalifah Bin Zayed Hospital. The provincial health department has developed its Health Sector Strategy (2013-2018) to address challenges of service delivery, quality of care, lack of skilled health workforce, governance and regulation, and to ensure adequate health coverage for the poor and vulnerable populations in the province.

The key emphasis of the strategy is on integrating health services through a strong monitoring and evaluation system. The provincial government has committed funds from development partners, however, to ensure implementation, the strategy recommends an overall increase in health budget from 5 to 10 percent over the course of five years (2013-2018).

Both male and female medical staff always tend to live in Quetta, the provincial capital. Their concentration in Quetta and unwillingness to stay in rural areas affected the health status of rural population that have limited or no access to health services in their areas. The government must announce special and attractive packages for medical staff to serve in rural Balochistan. The non-availability of medical staff, medicines and necessary facilities is the tragedy of the government hospitals in Balochistan.

Most of the doctors serving in the government hospitals have their private clinics as part time job. They earn a handsome amount as checkup fee at their clinics. Most of these doctors do not pay due attention to the patients who come to them in hospitals for treatment. There have been public complaints about shortage of drugs in government hospitals, lack of public health facilities, questionable doctor’s behavior with poor patients, and duty dereliction and absence of staff.

A health insurance scheme for the people in different parts of the province should be launched in order to provide the people free healthcare facilities. The wider coverage of poor sections of society under health insurance scheme will be a great step towards making the country a welfare state.

 

Modification of poor education system

Balochistan’s education sector has suffered from years of neglect and under-funding. The province has a literacy rate of 39 percent, which is much lower than the national rate. Official statistics show a dismal state of education in the province, which constitutes 44 percent of the country’s total land mass. There are 12,600 primary, middle and high schools for more than 22,000 settlements in the province. The province will have yet to establish 10,000 schools on war-footings to ensure provision of education to children across the province. It has 57,000 government teachers, while it needs 60,000 teachers more. The province has only 1.3 million school-going children out of total 3.6 million children. The situation of educational facilities in all parts of the province excluding Quetta is worst. The major problem is lack of quality of instruction due to teacher absenteeism, poor facilities, and lack of school supplies.

With low participation in general education and low completion rates at primary and secondary levels, the unemployment and underemployment rates in the province are higher than the national rates. Education would be instrumental in combating backwardness in the province.

Quality of education is the major factor resulting in low enrolment and high dropout rates. Lack of access is a problem for certain remote population in Balochistan, as schools remain closed due to unavailability of teachers. Expansion of elementary and secondary schools may be required in certain locations to accommodate remote areas and increasing enrolment of students, especially girls. Special efforts are needed to rationalize resources and to improve the internal efficiency of the education system.

Income-based inequities are the main reason behind low access to school education in the province. Dropout rate of children is higher in the rural Balochistan where schools lack the physical infrastructure and educational facilities. Most of the schools lack basic amenities like drinking water, latrines, and electricity. Most of the schools are either single- or two-teacher schools. There is extreme shortage of female teachers in rural districts.

The literacy rate among the female is even less than 5 percent in most of the districts. The private sector has almost lost interest in providing education to the poor in rural Balochistan where the fragile public school infrastructure has failed to give better access to the poor and girls.

The government should consider the schooling of the mother as important as the family’s income in improving a child’s nutrition. Research studies have revealed that mothers’ illiteracy and lack of schooling directly harm their young children. Children under five are more likely to survive if their mothers have some primary schooling than if they have no schooling, and even more so if their mothers have some secondary schooling.

The provincial government must continue to increase its spending on education. It should encourage private sector but put checks on commoditization of education and ensure educational system free from discriminatory practices for all the citizens. Most of the private educational institutes have commercialized the professional education by charging high fees making it unaffordable for the common people. The government should provide both financial and technical support to improve primary enrolment and completion rates, reduce gender disparities, and encourage the private sector to participate in provision of education in the least developed province.

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