Health care system in Pakistan how to care health in Pakistan and what are the process and benefits.

1. Health Care systems
Pakistan

2. Leaning objectives
 The participants will be able to
 Know different partners in health.
 Levels of healthy care with differentiating points
 PHC with its functions
 Other sectors than Government in health care
 Summary of health structure and functions

3. Improving
Health
Individual /
Family
Community
Governments / NGOs / Private
Partners in Health

4. “Health is a state of complete
physical, mental, spiritual and
social well being, and not merely
the absence of disease or
infirmity”

5. Government systems in
Pakistan
 Federal Government
 Provincial Governments
 Local Governments (started in 2014)
Each government level has some health responsibility

6. June 2011
 18th Amendment in the constitution of Pakistan
 Health POLICY by Federal Government, implementation by Provincial
Government
 From July 2011 responsibilities and resources shifted to provincial
Government
 From 2014, Local Governments have an important role in health
delivery systems???

7. Province: Department of Health
 Minister and Secretary Health, Policy level decisions
 Additional and Deputy S H
 Section officer with support staff and D G Health
 (Planning and management)
 Teaching and training institutes
 (Medical colleges, nursing and paramedic training schools)
 Meedical Teaching Institutes (HMC, KTH, LRH, ATH, GMC, SMC, BMC)

8. The Local Government
(District Health System) in the
context of devolution after 2014
Very important
District Nazim / Deputy Commissioner.
(Planning, Implementation, Monitoring,
data collection, analysis, interpretation,
evaluation and planning)

9. Levels of health care
 Primary (BHU, RHC, LHWS ) 60-80 per district
 Secondary (THQ, DHQ hospitals) 1-4 per district
 Tertiary (Teaching hospitals) 1-3 per division

10.  L H W 1000 (Health hou)
 B H U 10000
 R H C 30-50 thous.
 TH Q 2 lacs.
 D H Q 10 lacs.

11. Divisions and districts in KP
 1 Peshawar
 1. Peshawar(Tertiary centres 4 in Govt, 4 in Private)
 2. Nowshehra
 3 Charsada
2 Mardan
4 Mardan (Tertiary)
5. Swabi
3. Kohat
6. Kohat (Tertiary centre)
7. Karak
8 Hangu

12. Divisions and Districts in
KPK
 4 Malakand
 9 Swat (Tertiary centre)
 10 Shangala
 11 Lower Dir
 12 Upper Dir
 13 Chitral
 14 Buneer
 15 Malakand
5 Bannu
16 Bannu (Tertiary Centre)
17 Lakki Marwat

13.  6 Hazara
 18 Abbotabad (1 Govt, 3-4 Private sector)
 19 Mansehra
 20 Battagram
 21 Haripur
 22 Kohistan
 23 Torgahar
7 D I Khan
24 D I Khan (Tertiary)
25 Tank

14. Functions of secondary
levels
(THQ and DHQ hospitals)
 Managing referrals from PHC
 Surgical / medical interventions (advanced)
 Training for Human Resource for Health (Nurses, paramedics,)

15. District
Comprehensive
Health Care
Services
District
NGDO’S
District Health
Care Budget
District Line
Departments
District CBOs
Evaluate Implement
Plan
Monitor
Provincial Comprehensive
Health Care Services

16. District Comprehensive
health Care Programme
Primary Health Care
Detect
Diagnose
Treatment
Ref
Diagnose
suspect
refer
Primary
Secondary
Health Care
Complex
Training some cadres
Tertiary Health Care
CENTRE OF EXCELLENCE
Community
Community Community
Service
Delivery
All the three
tiers are
important
• HRD (CME, CPD,
CED)
• Specialized Care
for referred cases
• Research and
Development
Health care System in Pakistan
Diagnose
&Treat

17. Health systems
A well-functioning health system working in harmony is built on
having
 trained and motivated health workers,
 a well-maintained infrastructure, and
 a reliable supply of medicines and technologies,
 backed by adequate funding, strong health plans and evidence-
based policies.
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18. THE DECLARATION OF
ALMA ATA 1978
Health for all

19. Health For All (1978)
“the attainment by all peoples of the world, a level of
health that will permit them to lead a socially and
economically productive life”.

20. PRIMARY HEALTH CARE (PHC)
‘Primary Health Care is essential health care
based on practical, scientifically sound and
socially acceptable methods and technology,
made universally accessible to individuals
and families in the community through their
full participation and at a cost that the
community and country can afford to
maintain at every stage of their development
in the spirit of self-reliance and self-
determination.

21. Functions or elements of PHC
1. Education on health problems and how to prevent and control them. P
2. Development of effective food supply and proper nutrition. P
3. Maternal and child healthcare, including family planning. P
4. Adequate and safe water supply and basic sanitation. P
5. Immunization against major infectious diseases. P
6. Local endemic diseases control. P
7. Appropriate treatment of common diseases and injuries. C
8. Provision of essential basic medication. C

22. Elements of P H C
 1. EDUCATION
 Education regarding common diseases in the catchment
population may reduce the occurrence of disease.
 (measles, polio, malnutrition, taking medicine of hypertension
preventing stroke / heart attack etc)

23. 2. PROPER NUTRITION :
Nutrition is another essential component of
health care. WHO works to prevent
malnutrition and starvation and to prevent
many diseases and afflictions.
(Nutrition during pregnancy, breast feeding,
young children supplementary balanced diet,
low salt diet)

24. Mother’s Education : More common in
illiterate mothers
Socioeconomic conditions:More common in
poor (Clustering) land less laborers
Malnourished mother at young age
Baby Girl
malnourished children
Malnutrition; Predisposing Factors

25. 3. CLEAN WATER & SANITATION :
Clean water and basic sanitation can reduce the
spread of disease .
A supply of clean, safe drinking water, and basic
sanitation measures regarding trash, sewage and
water cleanliness can significantly improve the
health of a population, reducing and even
eliminating many preventable diseases.

26. 4. MATERNAL & CHILD HEALTH CARE (MCH)
Ensuring comprehensive and adequate health care
to children and to mothers, both expecting and
otherwise, is another essential element of primary
health care.
By caring for those who are at the greatest risk of
health problems, WHO helps future generations
have a chance to thrive and contribute globally.
Sometimes, care for these individuals involves
adequate counseling on family planning.

27. 5. IMMUNIZATION :
By administering global immunizations,
WHO works to wipe out major infectious
diseases, greatly improving overall health
globally.

28. 6. LOCAL DISEASE CONTROL :
Prevention and control of local diseases is
critical to promoting primary health care in a
population.
Many diseases vary based on location.
Taking these diseases into account and
initiating measures to prevent them are key
factors in efforts to reduce infection rates.

29. 7. ACCESSIBLE TREATMENT :
Getting health care quickly is important
Another important component of primary health care
is access to appropriate medical care for the
treatment of diseases and injuries.
By treating disease and injury right away, caregivers
can help avoid complications and the expense of
later, more extensive, medical treatment.

30. 8. DRUG PROVISION :
Proper medication
By providing essential drugs to those who need them,
such as antibiotics to those with infections, caregivers
can help prevent disease from escalating.
This makes the community safer, as there is less
chance for diseases to be passed along.

31. What is Universal Health Coverage
(UHC)?
 UHC means that all individuals and communities receive the health
services they need without suffering financial hardship.
 It includes the full spectrum of essential, quality health services, from
health promotion to prevention, treatment, rehabilitation, and palliative
care.

32.  UHC enables everyone to access the services that address the
most important causes of disease and death,
 and ensures that the quality of those services is good enough
to improve the health of the people who receive them.

33. Protecting from poverty
 Protecting people from the financial consequences of paying for
health services out of their own pockets reduces the risk that
people will be pushed into poverty because unexpected illness
requires them to use up their life savings, sell assets, or borrow –
destroying their futures and often those of their children.

34. Good health allows
children to learn and
adults to earn,
 helps people escape from poverty, and provides
the basis for long-term economic development.

35. References
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36. Thank you