Dec 17 - 30, 2007

Pakistan is far behind in research in health sector when compared with other developing countries. The private sector is not paying due attention on research activities while public sector is lagging behind in research methodologies and related activities.

Health professionals told PAGE that health systems research is composed of two components: health systems and research. Health systems include the structure of all health outlets, programmes and projects engaged in providing health care to the population of a country.

These health outlets include: primary health care facilities such as basic health units and rural health centres; secondary health care facilities such as district hospitals; and tertiary health care facilities. Health systems research relates to health prevention, treatment and promotion within the national health system and is carried out by institutions based on socioeconomic, political and cultural aspects.

Under the constitution of Pakistan, they said health is a provincial issue, and most of the implementation takes place in the provinces through the respective health departments. However, the Federal Government deals with the decisions about health policy, formulation of plans and the main primary health care issues such as EPI, MCP, AIDS, drug policy, user charges and health insurance.

According to them, mother's health in Pakistan remains neglected due to a multiplicity of factors--social, economic, and political. Many women lose their lives in the process of giving births to their children and this means that, in Pakistan, pregnancy is not safe in its effects on the mother, newborn and household.

The overall development process also ignores of what is needed to improve the welfare of the vulnerable group such as the expecting mothers. Pakistan, therefore, represents an unacceptably high maternal mortality setting and needs an immediate attention for substantial and sustained reduction in the risk of dying during pregnancy. The need is to identify the problems through focused manner to improve maternal health, they asserted.

According to the health professionals, decision-making in the health sector takes place at the macro level whereas implementation takes place in the regions, going down to the village level through different stages. Health policy is the responsibility of the Federal Ministry of Health with the assistance of the attached health departments. There is a risk of neglect of community interest or a lack of understanding of the problems at the grass-roots level in the existing system of policy-making.

In order to achieve a balanced approach, access to the community is required so as to understand the basic problems and needs, and then to design the necessary strategy to solve the problems to be reflected in the health policy of the country. The problems should therefore be studied at the micro level in order to understand the real requirements of the entire population, they said.

In Pakistan, they said the research could be initiated based on the available data on the financial and physical position of the health sector. This requires identification of those factors, which are hurdles to the improvement of the health system. Although the total health sector budget has increased manifold in recent years, and has consequently led to an increase in the number of health facilities and health personnel, the quality of the care has not improved, nor has health care been provided to the entire population. All these factors, once identified, will be helpful in meeting the shortcomings in the future, and will enhance the effectiveness and efficiency of the health systems through improved allocation of resources and equal distribution among preventive, primitive and curative health care, they added.

They further said improvement of the health care system of the country through health systems research involves a variety of disciplines so that adequate information can be given to decision-makers in a systematic way before they make their decisions. Social, cultural, demographic, economic and political aspects of the issues to be resolved must be considered. The actual research will depend upon the precise nature of the problems, and will require the skills of biomedical scientists, sociologists, epidemiologists, demographers, economists, and political, organization and management scientists, they added.

JICA SUPPORT: A delegation of JICA led by Mr. Takao KAIBARA visited Pakistan and offered to enhance assistance to Pakistan for National Health Management Information system.

JICA is also funding various ongoing health projects apart from conducting research for improvement of National Health Management Information system in Pakistan, which had been submitted to the Ministry of health for implementation. JICA intends to increase assistance to Pakistan for the same if implementation on the plan is expedited, sources in the Ministry of Health told PAGE.

UHS RESEARCH EFFORTS: University of Health Sciences Lahore offers Postgraduate courses in Basic Medical Sciences leading to the award of M.Phil and Ph.D. degrees. The courses in Anatomy are designed to equip the participants with state-of-the-art knowledge, skills and behaviour necessary to understand and positively influence factors that affect the teaching standards in affiliated Medical Colleges of Punjab. It is envisaged that these efforts will go a long way to produce Medical Teachers of high quality with strong hands on experience and necessary skills to initiate and carry out teaching as well as research of internationally accepted standards. In this pursuit, UHS is establishing contacts with highly respected foreign universities (such as the University of Texas, USA and Manchester University in U.K) for mutually beneficial cooperation in terms of faculty/students visits for training and research activities, a spokesman of the University said.

The UHS's department of Anatomy offers full time 2 years course for M.Phil programme in Microscopic Anatomy, Gross Anatomy, Neuroanatomy and Embryology. The course in Microscopic Anatomy is designed to acquaint students with the structure & function of cells with the help of light & electron microscopy, current concepts of the cell division, cell membrane, cell organelles, cell metabolism, cell transport and cell aging / specialization. Moreover, the course in Embryology deals with the formation, growth and differentiation of the fertilized ovum, and the normal as well as the abnormal changes (Teratogenesis) that occur during the periods of human development. The course in Gross and Neuroanatomy covers the relationship of structure to function in human organ systems and the mechanism of their control by the nervous system.