HEALTH SECTOR WOES

SHAMSUL GHANI
(feedback@pgeconomist.com)
Apr 19 - 25, 2010

High population growth rate and a slowed economic development have put immense pressure on country's health sector. Poor and corrupt governance have further added to health sector woes. What this sector has to offer is just one doctor for every 1200 people and just one hospital bed for 1600 patients. Even after the passage of 63 years, we have not been able to spend at least one percent of GDP on this highly important sector which is responsible for keeping our talented labor force and the general populace physically fit to be able to perform their socioeconomic duties. The Pakistan Economic Survey 2008-09 summarizes the inadequacies of this sector in the following words: "The health development activities contrast sharply in relation to other countries at similar level of development and per capita income and reflects a backlog of many unmet needs. These concerns are overdue and require an urgent attention"

HEALTH SECTOR INDICATORS FOR THE LAST EIGHT YEARS

. 2001-02 02-03 03-04 04-05 05-06 06-07 07-08 08-09-p
Regd Doctors (000 Nos) 97 103 108 113 118 123 128 134
Regd Nurses 40 45 46 48 51 58 63 65
Regd. Dentists 4.6 5 5.5 6.1 6.7 7.4 8.1 9
Hospitals (Nos) 907 906 906 916 919 924 945 948
Dispensaries (000 Nos) 4.6 4.6 4.6 4.6 4.6 4.7 4.7 4.8
Beds in Hospitals/Disp. 98 98 99 100 102 102 103 103
Rural Health Centers. (Nos) 500 600 600 600 600 600 600 600
TB. Centers (Nos) 272 285 289 289 289 288 290 293
Health Expenditure% of GDP 0.7 0.7 0.6 0.6 0.5 0.6 0.6 0.5
p = provisional

Low per capita income leading to mass malnutrition, deteriorating health and sanitary conditions, general lack of hygienic water supply, and poor living conditions, all contribute to a growing incidence of diseases that, if remain untreated for a longer period of time, result in permanent disability or even death. A properly designed and efficiently operating national medical system can alleviate the sufferings of the poor masses to a great extent. Unfortunately, any such system hardly exists and the masses are left to fight disease and health hazards on their own, and of course at their own expense. The ever rising cost of health services and frequent medicine price hikes render a major segment of our population quite helpless compelling it to resort to the use of cheaper, substandard - in some cases hazardous- alternate medical remedies exposing their lives and those of their family members to irreparable damage. Lack of proper and timely medical treatment diminishes the working capacity of a household which in turn destroys whatever economic balance it had been able to strike in the face of adversity.

Woman gender perhaps suffers more from the existing conditions. Being treated since centuries as an instrument of limitless fertility, she never gets medical attention to match her role of the prime mover of this world. This criminal negligence on the part of our society and the government has given us the dubious distinction of recording the highest infant mortality and under-5 mortality rates in the region. Lack of education, especially on the rural side, makes women and girls more susceptible to the onslaught of diseases that mostly go unattended in the initial stage to become more threatening and expensive to treat at a later stage. The economic pressure in many cases forces women folk to hide their diseases from the family head who, for a short period of time, gets benefited from this 'blissful ignorance' just to incur a heavier loss later on.

SOCIAL INDICATORS OF SOME OF THE ASIAN COUNTRIES

. COUNTRY LIFE EXPECTANCY,
2007
INFANT MORTALITY RATE PER 1000, 2007 UNDER-5 MORTALITY RATE PER 1000, 2007 POPULATION % AVERAGE ANNUAL GROWTH 2008
Bangladesh 64 47 61 2.0
China 73 19 22 0.6
India 65 54 72 1.5
Indonesia 71 25 31 1.2
Malaysia 74 10 11 1.7
Nepal 64 43 55 2.1
Pakistan 65 73 90 1.8
Philippines 72 23 28 1.7
Sri Lanka 72 17 21 0.9
Thailand 71 6 7 0.6

After women on the household side, labor force numbering around 52 million is the next victim of non-existent-medical-care culture. Labor is an important factor of production especially for an economy like Pakistan's. The economic loss, in terms of both cost and output levels, accrued by the system's inability to provide cheap and timely health care to labor needs to be measured and avoided through some efficient and cost effective social program that may be based on a partnership with the two dominating forces of financial sector, insurance companies and banks. Health insurance concept for low income and middle income groups of the economy can be borrowed from the western developed economies wherefrom we have imported the idea of democracy. But that perhaps doesn't suit our feudalistic democrats who have now started to openly demonstrate their inborn indifference to the issues of common man. Decades-long failure to provide free basic medical care to the masses in the shape of mandatory health insurance cover is a manifestation of this draconian attitude.

We spend on an average just 2 per cent of GDP cumulatively on education and health sectors. The picayune health sector expenditure allocates less than $4 to each individual of this 170-million- people country. World Health Organization sets a benchmark of $34 for per capita expenditure on health care. Do we have any future hope of matching this minimum standard?