Pakistan faces numerous health problems due to factors like poverty, poor infrastructure, and climate change. The top health issues are intestinal infections, tuberculosis, hepatitis, typhoid, malaria, and diseases of the respiratory, digestive, and urinary systems. While Pakistan has primary health infrastructure like clinics and workers, challenges remain like lack of doctors, corruption, and poor standards of education. Addressing gender inequity, poverty, and improving water and sanitation could help improve Pakistan's health outcomes.

1. Submitted by:
Suman Sohail (15082)
Institute of Business Management

2. “Poor people and poor countries depend on the soil
for food, the rivers for water and the forests for
fuel…financial savings will not be sufficient for
sustainability if some natural resource required to
sustain life becomes seriously depleted…”
MahbubUl Haq,
Reflections on Human Development

3.  The health care system in Pakistan is beset with numerous
problems - structural fragmentation, gender insensitivity,
resource scarcity, inefficiency and lack of functional
specificity and accessibility. Faced with a precarious
economic situation characterized by heavy external debt and
faltering productivity, Pakistan’s room to maneuver with
health sector reform is quite limited. Both natural and man-
made factors contribute to these problems
 The government of Pakistan already recognizes the health
risks from climate change, and therefore, may more readily
embrace planetary health than other countries. One
important initial step that it can take is to begin a
conversation about health, beyond a focus on treatment
services.

4. Every year, Pakistan faces more health problems than it did in the
previous one, leading to new kinds of diseases and problems that are
difficult to treat due to the unfavorable financial, economic and
climatic conditions. According to the World Health Organization
(WHO), Pakistan ranks at 122 out of 190 countries in terms of
health care standards. There have been many interventions made in
health care but due to the poor standards of education, there is a
lack of doctors and health experts all over which does not create a
conducive atmosphere for hospitals to thrive in.

5.  Pakistan has a relatively large primary health care infrastructure. This includes 5000
basic health units, 600 rural health centers, 7500 other first-level care facilities and
over 100 000 lady health workers providing services across Pakistan.
 These primary health care services are supported by a network of 989 secondary care
hospitals, at tehsil and district levels, for referrals.
 The national program for family planning and primary health care, commonly
referred to as the lady health workers program was launched in 1994 to increase
access to basic preventive health care services, particularly in rural areas.

6. The10 most prevalent health problems existing in Pakistan:
1. Intestinal Infections
Intestinal infections include cholera, typhoid Fever, dysentery, food Poisoning and
diarrhea amongst others. The most common form of disease in Pakistan is infection
since infection occurs in the presence of co-infection. In a developing country like
Pakistan, there are many factors that contribute to infections, such as
contamination, poor sanitation, fewer resources and lack of medications.
2. Tuberculosis
TB is a lung disease that is contagious and spreads by coughing and sneezing.
Pakistan ranks 8 out of the 22 countries in the world that are most highly prone to
tuberculosis, according to WHO.
3. Bacterial and Viral Diseases
Viral diseases include viral hepatitis, typhoid, mumps, rabies, measles, chicken pox,
and many more. The most common and serious in Pakistan are Typhoid and
Hepatitis A and E.

7. 4. Hepatitis A
This viral disease spreads through contaminated water or unhealthy food, as a result
of poor sanitation and care of local produce. Its symptoms include fever, jaundice
and diarrhea and it deteriorates the liver functions.
5. Hepatitis E
This viral disease also affects the liver functions and is primarily spread through
contaminated water. It may disrupt the urinary tract as well as display other
symptoms such as jaundice or fatigue.
6. Typhoid fever
This is another bacterial disease caused by contaminated food or water and may
result in high fever if the victim is not treated so enough.
7. Malaria
Malaria is an anthropoid bone disease which is caused by single-cell plasmodium
parasite through a mosquito bite. to pollution, no climate control and poor drainage
systems, these mosquitoes find ideal nesting grounds on standing water all around
the country and there have been very few preventive measures that are being taken to
eradicate this problem.

8. 8. Dengue fever
Dengue fever is a severe form of virus that causes migraines, chills and loss of
strength and appetite. It is also due to the hostile climatic changes and an
environment that becomes perfect breeding ground for mosquitoes.
9. Yellow fever
Yellow fever is probably the most severe form of mosquito-borne diseases. It causes
viral infection of the respiratory passages causing fever and may even result in severe
hepatitis or hemorrhagic fever.
10. Disease of Nervous, Respiratory, Digestive and Urinary systems
These diseases may collectively include paralysis (stroke), epilepsy, Parkinson’s fever,
angina, heart failure (attack), pneumonia, asthma, influenza, bronchitis, ulcer
appendicitis, hernia, jaundice, and kidney failure.

9.  At present, different health programs target different health conditions in Pakistan.
Each program has an independent organizational structure at the federal, provincial,
district and first-level care facility levels. Having integrated primary health care
services will help to improve the health status of the people of Pakistan.
 In response to this situation, WHO commissioned the development of an essential
health services package in 2008–2009. Essential health services are those necessary
for provision of the minimal health services expected by the population from a
certain level of health care. An essential health package consists of a list of public
health and clinical services that will be provided at the primary and/or secondary
health care level.

10.  The National Health Policy (Ministry of Health, Islamabad), 2001,
act as a collective framework and provides guidelines to the
provinces while 10 implementing plans in the health sector in
accordance with their requirements and priorities.
 The present policy document is a blueprint of planned
improvements in the overall national health scenario. It will require
commensurate investments and interventions by the provincial
governments for improving health infrastructure and healthcare
services. The federal government will continue to play a supportive
and coordinative role in key areas like communicable disease
control programs.

11.  The strategy of the health sector reform is to achieve accessible
quality health care for all. The policy document identifies ten key
areas:
1. Reducing widespread prevalence of communicable diseases;
2. Addressing inadequacies in primary/secondary health care
services;
3. Removing professional/managerial deficiencies in the district
health system;
4. Promoting greater gender equity;
5. Bridging basic nutrition gaps in the target-population;
6. Correcting urban bias in health sector;
7. Introducing required regulation in private medical sector;
8. Creating Mass Awareness in Public Health;
9. Effecting Improvements in the Drug Sector; and
10. Capacity-building for Health Policy Monitoring.

12.  In each of these areas, strategic objectives have been
identified and implementation modalities determined
with an appropriate time frame for implementation
and indication of targets wherever possible. The key to
success of the health policy lies in its implementation
at all levels with the collaboration of public and private
sector, and assistance from international development
partners. Within the public sector collaboration
between ministry of health and provincial health
departments and district and local governments would
help in effective implementation of the health policy.

13.  Another successful program was the recognition of
tuberculosis as a national emergency in 2001 and
providing DOTS to the population suffering from
tuberculosis. In order to combat malaria epidemics,
Roll back malaria initiative was launched in 1998.
WHO has also contributed majorly to the area of
nutrition; under this banner, nutrition education and
promotion programs were introduced at the PHC
level.
 Secondly, food fortifications with vitamin A, iron and
other micronutrients were also introduced. The
government of Pakistan also endorsed the
WHO/UNICEF strategy that protects exclusive breast
feeding for six months of life.

14.  Our country’s health sector is facing manifold challenges and
hindrances. According to a report published in Dawn (2003), there are
5,308 basic health units (BHU) in our country, but mostly they are
nonfunctional due to absenteeism of health personnel and doctors.
Therefore, a major challenge faced by our health sector is corruption
which includes unethical behavior and malpractices with patients,
illegal fees, corruption in the drug supply, scarceness and misallocation
of resources, political influence, absence of concrete health policies,
leaking of equipment and supplies, centralized financial, administrative
and management authorities.
 Moreover, our country is suffering from the increased burden of chronic
diseases and disease stricken people. In addition to this, there is a
shortage of health care professionals including nurses and doctors at all
levels. However, it needs to be understood that PHC is not solely
responsible for the lack of success in achieving health, but there is also a
lack of commitment and dedication by health care personnel.

15. o There is a need of recognition at the national level of the issue. Though
government of Pakistan has considered this issue but, consistent follow-up
is mandatory.
o There should be enough educational programs in all societies and cultures,
both for women and men at the same levels.
o There should be enough opportunities of employments and participation in
political parties along with security and safety for women and the seat
allocation for recruitments of both genders should be considered on
equality grounds. More funds should be allocated to women's development
in the country.
o Government should make it compulsory to incorporate the programme in
all health care facilities of Pakistan for proper screening of all types of
domestic violence and abuse. Adequate emergency treatments with
rehabilitative measures should be provided. All health professionals should
be made aware of domestic violence, its factors, possible treatment and
moreover the preventive measures. Along with medical facility, government
also can have crisis centers for violated women in the main health care
centers like Rural Health Centers (RHC), Basic Health Unites (BHU) and
tertiary hospitals throughout the country. Furthermore, specialized health

16. o Awareness programs should be conducted for both women and men. It should be
done by using the resources like nurses, doctors and psychologists, working under
governmental and non-governmental organizations (NGOs). This could easily be
done either by direct or indirect teaching. The direct methods would include one to
one teaching, counseling, or group based teaching. Indirect methods would involve
the use of media, pamphlets, role plays, drama and talk shows.
o There should be religious definitions of the basic rights of women like autonomy and
freedom in Pakistan on federal levels and the government needs to evaluate all of the
basic rights of women. For this a central committee can be made which should
include religious leaders, Ulema, and scholars who can consensually define the rights
of women in the lights of Islamic teaching and literature. But, for this the other ethnic
and minority religious groups should be considered when finalizing any package for
basic rights of women. Government should also ensure that every citizen of the
country is following the main themes defined by the religious committee.
o Government should to make sure that women have enough access to reach any
political opportunity and there should be a training program available for their
capacity building on politics.

17. o There is also a need of reforms in the police departments and judicial processes
which place constraints on women from accessing justice. Women police should be
trained to deal with women facing domestic violence so that women could feel safe
and protected. Indeed the presence of a nurse or doctor in the police department
team would facilitate a pleasant environment for the sufferers.
o Alcohol production, transport and drinking should be banned as Pakistan is an
Islamic country and in Islam alcohol is strictly prohibited. Government can take help
from social groups, religious leaders and even they can strengthen their law and
order situation to decrease alcohol and other addictive material usage in the country.
o Exclusive celebrations of marriages were banned in the country some years ago and
that worked very effectively through the country. Similarly government can also ban
weighty dowry systems in different cultures, and fix certain amount in the lights of
Islamic religious teachings which should be followed in any culture and in any region
of the country.
o Government should develop recreational programs like family parks, and other
entertaining places where women along with their family can enjoy and relax.