HEALTHCARE SERVICES IN PAKISTAN
DR. S.M. ALAM
Aug 15 - 21, 2011
All over the world, the healthcare is fully concerned with the analysis of inputs such as expenditures and an appraisal of their impact on the desired outcome - the health of society.
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.
In the present world's scenario, the evaluation of healthcare is seriously deficient.
Healthcare needs proper education of masses, income, wealth, investments, proper nutrition, honesty, fear of Allah, fair mind, and zeal and enthusiasm for serving others. If anyone possesses these superior qualities then there will be no healthcare problems even with minimum expenditures in anywhere of the world.
The health is a basic human right, which should be delivered honestly. The life saving profession of health service has been fraught with the inhumane commercial motives. The healthcare system is plagued with numerous problems, which are caused by factors like scarcity of resources, inefficiency, and lack of health infrastructure and accessibility.
Some of the specific reasons are low spending in health sector, inadequate health services, ineffective delivery of services, improper utilization of funds, illiteracy, inadequate water supplies and sanitation, poverty, corruption, and high fertility levels mainly in rural areas.
Pakistan's health sectors with regard to health funding and sanitation infrastructures are not enough, particularly in rural areas.
According to a 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 and fatal diseases are rampant throughout the country.
In general, the cases of human sickness include cancer, bone marrow biopsy, bleeding tendency, hemolytic anemia, other anemia), bone cancer, arthritis, bone tumors, fractures, muscle pain, blood-streaked stool, gallbladder disease, hemorrhoids, tarry stools, colon tumors, rectum tumor, stomach tumor, ulcers, deafness, dizziness, instability, shivering, sweaty, hungry, drainage from ears, ringing in ears, hearing loss, blurred vision, cataracts, double vision, eye infection, glaucoma, sudden blindness, bloody urination, excessive urination, kidney stone, losing urine when coughing, urination at night, diabetes, diabetic foot infection, hyperglycemia, disturbance in tight glucose control, abnormal waist hip ratio, abnormal heart beat, disturbances in serum cholesterol, high density lipoprotein or HDL (the good cholesterol), low-density lipoprotein or LDL, persistent fever, protruding eyeballs, sugar in urine, thyroid tumors, unusual thirst, weakness and general tiredness, abnormal electrocardiogram, ankle and leg swelling, asthma, blueness of lips and fingers, bronchitis, chest pain, chronic cough, heart attack, hypertension, heart enlargement, heart murmur, blood pressure, irregular heartbeats, atherosclerosis, osteoporosis, leg cramps, low blood pressure, lung tumors, night sweats, pneumonia, shortness of breath at night, shortness of breath at lying down, tuberculosis, chicken pox, measles, polio, mumps, syphilis, prostate tumor, sexual dissatisfaction, sexual impotency, sore on penis, urethral infection, convulsive disorder, difficulty in limb control, head trauma, headache, memory problem, muscle weakness, speech problem, stroke, tremor (shaking), walking disorder, deviated septum, nosebleeds, polyps, running nose, sinusitis, abnormal pap smear, abnormal breast exam, abnormal pelvic exam, menopause, miscarriages, painful intercourse, chronic skin infection/lesions, psoriasis, skin rash, skin tumors, throat infections, sore tongue, schizophrenia, polycystic kidney, voice change, allergies, hearing loss, malaria, polio, typhoid, dialysis, meningitis, insomnia, hepatitis-C, excess vomiting, palpitations, constipation, anorexia, dream abnormality, diaphoresis, rhythm disturbance, cirrhosis, tetanus, gastroenteritis, cholera, dengue fever, flu, typhoid fever, maternal and child health, respiratory infections, human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), congenital abnormalities, vaginal diseases, breast cancers, and Hepatitis B.
The human resource available for health care registered till December 2009 in the country included 139,555 doctors, 9,822 dentists and 69,313 nurses, who were supplemented with a strong force of 96,000 lady health workers.
The current population doctor ratio is 1,183 persons per doctor and 16,914 persons per dentist. According to a report, there are 13,937 health institutions with the existing network of medical services of 968 hospitals, 4755 dispensaries, 5,349 basic health units, 903 mother and child care centers, 572 rural health centers and 293 TB centers. There are 108 medical colleges in the country which produces 150,00 MBBS doctors every year and out of which 85 per cent are girls.
The infant mortality rate per 1000 for the year 2009 was about 65.1. The population average growth rate for the year 2009 was 2.1 per cent. The budgetary allocation for health is not sufficient.
To promote sale of their medicines, pharmaceutical companies or traders who import medicines from outside the country please doctors and make lucrative offers for prescribing their products to the patients. The favors that are normally doled out to medical practitioners in the shape of expensive gifts include in some cases gifts like watches, mobile phones, luxury vehicles, furnishing of clinics, foreign tours and share in sale products.
Many doctors are involved, knowingly or unknowingly with pharmaceutical companies in a manner that lacks proprietary through commissions and other payoffs.
Besides, 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 increase in the cost of medicines. The medical stores sell what the medical doctors write in the prescriptions for the patients. The spurious and fake medicines are 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 anomalies of price structure of pharmaceutical products. There should be more facilities for the patients instead of charging extra fees for the outdoors treatments.
Providing easy 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. However, a few firms are now engaged in producing the raw materials locally.
There is need to develop capacity for the essential ingredients especially where local resources are available.
The key elements action plans for the development sector include introduction of diploma course in pharmacy technology in the faculties of pharmacy, 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 centers in pharmaceutical and drugs discovery and experimental therapeutics, and 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.