HEALTH CARE IN PAKISTAN
DR S M ALAM
Apr 19 - 25, 2010
Health care is concerned with the analysis of inputs such as expenditure and employment and an appraisal of their impact on desired outcome - the health of society.
Clearly, many inputs may affect an individual's health. In a world of scarce resources, it is necessary to ensure that these resources are used efficiently-that the cost of producing care and the health is minimized and the benefits are maximized.
Health care needs proper education of masses, income, wealth, investment by the concerned quarters, proper nutrition, honesty, fear of Allah, fair mind, etiquettes, manners, fulfillment of promise, punctuality of time, truth, devotion, zeal and enthusiasm for serving others. If anyone posses these superior qualities then there will be no health care problems even with minimum expenditure in anywhere of the world.
The inefficient uses of health care resources are clearly unethical. It deprives patients of care from which they could benefit.
The health is a basic human right, should be processed honestly. The life saving profession of health service has been fraught with the inhumane commercial motives. The healthcare system in the country is plagued with numerous problems which are caused by factors like scarcity of resources, inefficiency and lack of health infrastructure, accessibility.
Some of the specific reasons are low spending in health sector, lack of access to health service, ineffective delivery of services, improper utilization of funds, illiteracy, women's low status, inadequate water supplies and sanitation, poverty, lack of resource, corruption, incidence of non-communicable diseases, high fertility levels and more in rural areas. Pakistan's overall population growth rate is much higher than elsewhere in South Asia (1.9 per cent per year).
Pakistan's health sectors with regard to health funding and sanitation infrastructures are generally poor, particularly in rural areas. According to one report about 19 per cent of the population is malnourished and 30 per cent of children under age of five are malnourished.
Due to improper utilization of funds and lack of attention by the authorities infectious diseases and fatal diseases are rampant throughout the countries. Also because of unhealthy sanitary conditions and wide spread contaminations in consumable products more or less everybody is sick.
After food items the drug is the most wanted commodity consuming 20 to 30 per cent of every household budget.
Leading causes of sickness and death include gastroenteritis, cholera, dengue fever, bird flu, typhoid fever, malaria, maternal and child health, respiratory infections, tuberculosis, human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), congenital abnormalities, vaginal diseases, breast cancers, diabetes, kidney diseases, and Hepatitis B,C. Health in the modern era is both a sensitive as well as a complex issue. The poor hardly have access to healthcare services.
According to official data, there are 127,859 doctors and 12, 804 health facilities in the country to cater for over 175 million people. In 2007, there were 85 physicians for every 100,000 persons in the country. Or in other words, one doctor is for 1,225 people. There are only over 62,000 nurses all over the country who are supplemented with a strong force of 96,000 lady health workers.
According one report, there are 13,937 health institutions in the country with the existing network of medical services of just 945 hospitals (with a total of 103,285 beds), 4755 dispensaries, 5,349 Basic Health Units (mostly in rural areas), 903 Mother and Child Care Centers, 562 rural health centers and 290 TB centers.
Pakistanis are spending nearly 77 per cent of their healthcare budgets on buying medicines. The country's total medicine market is about USD 1.9 billion with 386 Pharmaceutical companies i.e. National 356 (Punjab 204, Sindh 92, NWFP 50, Balochistan 7 & AJK 3), and multinational 30 (Punjab 5, Sindh 23, Balochistan 2) engaged in manufacturing varieties of medicines for the healthcare of millions of Pakistanis.
There are more than 70000 pharmacies selling different types of medicines to patients in the urban as well as rural areas of the country. To promote sale of their medicines, pharmaceutical companies or traders who import medicines from outside the country pleas doctors and make lucrative offers for prescribing their products to the patients. The favors that are normally given to medical practitioners include expensive gifts like watches, mobile phones, luxury vehicles, furnishing of clinics, foreign tours and share in sale products.
More than 50 per cent of the doctors are involved, knowingly or unknowingly with pharmaceutical companies in a manner that lacks ethics. Companies also spend lavishly on conferences, seminars and symposia in order to market their products renowned. Subsequently, all costs submerge in the end prices of medicines.
Doctors are equally responsible of surging medicines prices. The medical stores sell what the medical doctors write in the prescriptions for the patients. The spurious and fake medicines are being sold in the country with impunity.
The ministry of health should pay heed to suggestions which are in favor of masses and must put right required anomalies of price structure of pharmaceutical products. There should be more facilities for the patients instead of charging extra fees for the outdoors treatments.
To provide easily facility for the patients in the hospitals and clinics is a noble and act of kindness.
Pakistan has attained a high degree of self-sufficiency in the formulation and packaging of finished pharmaceutical products, but the basic manufacturing of ingredients is very small. About 95 per cent of basic raw materials are imported from various foreign countries such as China, India, Japan, the United Kingdom, Germany, Netherlands etc. However, a few firms are now engaged in producing the raw materials locally. China has long been a cost effective supplier of medical ingredients for pharmaceutical industry in the country.
Pakistan needs to develop capacity for the essential ingredients especially where local resources are available. The key action plans for the development sector include introduction of diploma course in pharmacy technology, establishment in each province of a fully equipped laboratory to undertake basic research in the field of pharmaceutical drugs and medicine for diseases prevention, establishment of research and development centres in pharmaceutical and drugs discovery and experimental therapeutics, establishment of testing/certifying laboratories for fabrication and manufacturing of basic equipment required in pharmaceutical industry.
The aim of health care organizations (health ministry, physicians, medicines manufacturers etc) are to generate information about the costs and benefits of getting ways for achieving health and health goals.