Apr 19 - 25, 2010

Despite various measures taken by the PML-N led Punjab Government to provide quality healthcare facilities to the masses, provision of equal access to primary healthcare is still a mammoth task mainly due to resource constraints.

Punjab has a network of 2,748 primary healthcare (PHC) facilities spread over an area of 205,345km. The Punjab government had initiated a two-year Health Sector Reforms Programme (HSRP) to make the primary healthcare network of 2,456 basic health units and 292 rural health centres fully operational.

Benefits of the programme for medical staff include a substantial salary and an incentive package combined with improved working and living conditions, a pre-service orientation programme and regular in-service training, a supportive monitoring and supervisory mechanism, and periodic third party inspections.

The strong political and administrative will to harness all available resources is the key to the success of the HSRP. All of the 35 district governments have signed terms of partnership with the provincial government to execute the programme.

In Punjab, the total fertility rate is 4.7 births per woman, and the infant mortality rate is 77 per thousand live births. The maternal mortality rate in Punjab is estimated to range from 300 to 533 per 100,000 live births, as only 32 per cent of births involved skilled birth attendants. At the top of the pyramid are a relatively small number of large hospitals each with around 1,500-2,000 beds. At the next level is a network of district headquarter and Tehsil (an administrative sub-division of a district) headquarter hospitals.

The base of the healthcare pyramid is made up of primary healthcare facilities and 'health houses' (a room in the lady health worker's residence used to display health education material).

There are 2,748 primary healthcare facilities spread across Punjab, but access to quality healthcare is still a dream for many. Although the reported maternal mortality rate in 11 districts of Punjab is lower than 200, against the national estimate of 533, much work is still needed to improve the health of the population of Punjab.

Health sector investment in Pakistan is part of the government's Poverty Alleviation Plan, and health sector development targets are fixed by the Millennium Development Goals (MDGs) agreed by the international community. Basic health units provide mother and child health services, offering antenatal, parental and postnatal care, child growth monitoring, education about health and nutrition, sanitation and control of communicable diseases, family planning, immunization, and treatment of common ailments. The units also provide services directed by government initiatives such as control of diarrhea diseases, acute respiratory tract infections and tuberculosis (TB), and assist patients with day-to-day management of long-term illnesses such as diabetes and hypertension.

A sum of Rs12 billion has been apportioned in budget 2009-10 for the health sector and strategic interventions including Punjab safe motherhood initiative, national blood transfusion service programme, HIV/AIDS control, TB control, malaria rollback, dengue control and thalassemia prevention programmes.

In view of rising trend of water borne diseases and resultant load on health facilities, the government has allocated Rs8.5 billion in the budget to expand the facilities of potable drinking water and sanitation coverage for rural and urban populations.

Health professionals told Page that healthy environment is essential for a healthy society and an efficient solid waste management system in the cities can help save the people from diseases, which are on rise.

Punjab Chief Minister Mian Shahbaz Sharif chaired a conference of Chief Executive Officers of various international companies of Islamic and European countries in Lahore in which representatives of the companies gave a detailed briefing regarding solid waste management and improvement of health sector in the province.

Addressing the moot, Chief Minister Mian Shahbaz Sharif said that he is determined to provide modern health facilities to the masses and unprecedented measures have been taken for this purpose. He said that provision of a healthy environment to the people through effective solid waste management in the cities is the priority of the government and comprehensive measures are being taken for this purpose. He said that huge funds are being spent for the uplift of health sector for providing modern treatment facilities to the masses. He said that he wants such a vibrant and efficient system in health sector, which could provide relief to the people of the cities as well as far-flung and backward areas and also has an in built mechanism of accountability.

He said that holding of the conference of chief executive officers of international companies for solid waste management and improvement of health sector is a good omen and will help in benefiting from their skill and experience as well as promotion of public-private partnership.

He said that the visit of chief executive officers of different international companies for the improvement of solid waste management system in Lahore as well as uplift of health sector is encouraging and also reflects that Pakistan is a peaceful country and there are vast opportunities of foreign investment in the country.

Referring to solid waste management and health sector in Punjab, the Chief Minister said that sanitary conditions in the cities are pathetic and even in the provincial metropolis, which is the second biggest city of the country, the situation is highly unsatisfactory. He said that there is no proper system of solid waste management or of monitoring. He said that he wants such a system of solid waste management which could help clear the cities as well as towns of filth and garbage and shifting of the waste to specific land fills for the generation of energy with the help of modern technology.

He said that Ecoss International has a vast experience in solid waste management and it should cooperate with Punjab for the improvement of this sector. He said that public-private partnership would be encouraged in this regard. He said that Pakistan is a poor country and has limited resources. He said that rich countries like Europe and Kuwait can afford huge expenses on modern technology but Pakistan needs such a technology, which is low cost and can fulfill the local needs.

During the briefing given by Shankland Cox Limited for the improvement of health sector, the Chief Minister said that Punjab government is utilizing maximum resources for the uplift of health sector while in addition to provision of free of cost dialysis facility and medicines, air-conditioners and generators have also been provided to all hospitals first time in the history of the country. However, he said, despite all out efforts and spending of heavy resources, the desired results have not yet been achieved. He said that there is a need for an effective management and monitoring system in hospitals, improvement of the efficiency of doctors and paramedical staff as well as ensuring proper sanitary conditions.

He said that performance audit of four major hospitals has been conducted and a health commission will also be set up for the improvement of health sector. He said that use of IT technology is of paramount importance for improving performance of hospitals as well as other sectors and the government is also paying attention in this regard. He said that new hospitals are also been set up and BoT system is being adopted for this purpose. He said that Punjab government needs cooperation of international companies for dealing with these matters. The Chief Minister also issued instructions for setting up working groups comprising senior officers of Punjab government for negotiating with international companies for seeking their cooperation for solid waste management and improvement of health sector and evolving a strategy in this regard. He described the briefing given by international companies regarding solid waste management and improvement of health sector as comprehensive and thanked them for their arrival in Lahore.

Earlier, Vice Chairman Punjab Investment Board apprised the representatives of international companies of the prospects of investment in different sectors in Punjab. Ecoss International, National Cleaning Company and Thyssen Krupp gave briefing regarding solid waste management and Shankland Cox Limited about hospitals and medical centers.