This Power point informs information regarding delivery system of health in pakistan

1. Health Care Delivery
System in Pakistan
Muhammad Amjad

2. What is Health and Health System
Health:
A state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity.
Health System:
A health system consists of all organizations, people and actions, whose purpose is
to promote, restore and maintain health.

3. Services in Health care system
Service delivery is being organized through
 Preventive
 Promotive
 Curative
 Rehabilitative services

4. Services in Health care system
The curative and rehabilitative services are being provided mainly at the
secondary and tertiary care facilities.
The Preventive and promotive services are mainly provided through various
national programs; and community health workers’ interfacing with the
communities through primary healthcare facilities and outreach activities.

5. Government systems in Pakistan
 Federal Government
 Provincial Governments
 Local Governments (started in 2014)

6. Federal Government
 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
 Section officer with support staff and D G Health
(Planning and management)
 Teaching and training institutes
(Medical colleges, nursing and paramedic training schools)
 Medical Teaching Institutes

8. The Local Government
 District Nazim / Deputy Commissioner.
(Planning, Implementation, Monitoring, data collection, analysis,
interpretation, evaluation and planning)

9. Composition of Health Care System
 Health care system is primarily the responsibility of provincial government
 Each provincial government has department of health, which also regulate
private health care providers
 Survey 2005-06 indicates that 67.4% households in Pakistan consult health
providers in private sector when they have health problem
 Other providers are: hakim, homeopath, pharmaceutical, tabibs
 Government sector is low cost. Outpatient department have no consultant fee
but patient has to pay for medicine

10. Public sector
Public sector health care system endeavors to deliver healthcare through a three
level healthcare delivery system and a range of public health interventions.
Levels of health care
 Primary Health Care
 Secondary Health care
 Tertiary Health care

11. Public sector
 PRIMARY
Dispensaries, MCHC/BHU/RHC, NGO/Community Groups, General
practitioners, Non-formal health providers
 SECONDARY
Clinics/Maternity homes, Tehsil Hospitals, Privately run clinics/hospitals,
Non-formal health providers
 TERTIARY
District Hospitals, Large urban private hospitals

12. Public sector
 The public health activities have persistently increased in terms of physical
infrastructure and workforce.
 The national health infrastructure comprises of 1201 hospitals, 5518 Basic
Health Units, 683 Rural Health Centers, 5802 Dispensaries, 731 Maternity &
Child Health Centers and 347 TB centers.
 The total availability of beds in these health facilities is estimated at 123394.
 In addition more than 95000 Lady Health Workers are providing primary
health care services to the community through the health houses.

13. Private sector
The rising population pressure on state health institutions has allowed the private
sector to bridge the gap of rising demand and limited public health facilities.
A number of private hospitals, clinics and diagnostic labs has increased
considerably and is contributing health services in the country.
Majority of private sector hospitals has sole partnership model of organization.

14. Health Care spending in Pakistan
 Cumulative health expenditures of federal and the provinces are estimated at
Rs 384.57 billion for fiscal year 2017-18
 The major share of spending on health has been observed in Punjab (84.8
percent) followed by Sindh (41.4), Khyber Pakhtunkhwa (17.6 percent) and
Balochistan (11.3 percent).

15. Issues in health care delivery system
The health care delivery suffer from some key issues like;
 High population growth
 Uneven distribution of health professionals
 Deficient workforce
 Insufficient funding and limited access to quality health care services.