Pakistan - Current Situation in Control Strategies and Health Systems in Asia
Current Situation in Control Strategies Current Situation in Control Strategiesand Health Systems in Asia ‐ Pakistan Prof. Dr. Jovaria Prof. Dr. Jovaria Mannan Prof. of Paediatrics, Chairperson, Medical Advisory Board, Thalassaemia Federation of Pakistan
Healthcare in Pakistan Healthcare in Pakistan • Policy making Federal •N i National Programs lP Govt. • Implementation of Provincial y Healthcare System Govt.
< 1% GNP spent < 1% GNP spent Allopathic All thi Homeopaths H th on Health Private (70%) Non‐allopathic Hakims Accupuncture & Traditional Chinese Herbal MedicineHealthcare in Pakistan Tertiary Care Hospitals (22) District Public (30%) Headquarter Hospitals Primary Health Care Basic & Rural Estimated that a Estimated that a Health Unit H l hU i person visits this center once a year
Healthcare Infrastructure in Pakistan Healthcare Infrastructure in PakistanType of Healthcare No. (according to Health No. No. of bedsprofessional 2009 statistics) FacilitiesDoctors 139,555 Total 13,937 103,708Dentists 9,822 9 822 Healthcare FacilitesNurses 69,313 Hospitals 968 84,257Midwifes 26,225 Dispensaries Di i 4,813 4 813 2,845 2 845Health visitors 10,731 Rural Health 572 9,612 Centers Tuberculosis 293 184 Clinics Basic Health Basic Health 5,345 5 345 6,555 6 555 Units M. C. H. 906 256
Thalassaemia in Pakistan Thalassaemia in Pakistan• Beta Thalassaemia is the commonest inherited disorder in Pakistan• 5 ‐ 8% Pakistanis are 5 ‐ 8% Pakistanis arecarriers of Thalassaemia Gene h l i5000 new thalassaemicsborn every dayborn every day
Thalassaemia Care in Pakistan Thalassaemia Care in Pakistan• Private sector – 95% care based on outpatient diagnostic, clinical, p g , , transfusional, BMT and preventative services.• Public sector Public sector – 5% care based on diagnostic, critical care and transfusional services. f i l i• Privately 36 NGO’s knitted together by the y g y Thalassaemia Federation of Pakistan.
Thalassaemia Federation of Pakistan: Federation of Pakistan:• Provides support in government policy making – sets standards of care of thalassaemia patients in p Pakistan – Training of healthcare providers Training of healthcare providers – Conducts awareness Programmes across the country – Publishes books, pamphlets and handouts for healthcare providers and the general population. h lh id d h l l i
There are no current programs in the following provinces• Azad Jammu and Kashmir• Balochistan• Federally Administered Tribal Areas• Gilgit & Baltistan
KhyberPakhtunkhwa (2006 –KhyberPakhtunkhwa (2006 2007) – Ph Phase‐II: II • Public awareness campaign through media and community institutions. • Screening of the family members of the Index Cases at Peshawar. • Screening of the family members of the index cases in the districts of high prevalence of Thalassaemia major. • Screening of the family members of the index cases in the Screening of the family members of the index cases in the districts of high prevalence of Thalassaemia major. • Compilation of Thalassaemia trait directory in the settled area of KP. f KP • Establishment of genetic counseling services.
Punjab Thalassaemia Prevention Program (PTPP) ( )ADP Scheme No 531 Grant No 36 DevelopmentADP Scheme No. 531 Grant No. 36 DevelopmentLaunched July 2009 July 2009Revised Sept 2010Duration Duration 04 years 04 yearsBudget Rs. 162.358 m Lady Willingdon Hospital, Lahore
PROJECT NETWORK DHQ Hospitals Southern Punjab Regional Center 1 Children Hospital, Multan Mobile Teams Southern Punjab DHQ Hospitals Regional Center 2 Victoria Hospital, Bahawalpur Mobile Teams Mobile TeamsPIMU DHQ Hospitals Central Punjab Central Punjab Regional Center Sir Ganga Ram Hospital, Lahore Mobile Teams DHQ Hospitals Northern Punjab Regional Center Regional Center Holy Family Hospital, Rawalpindi Mobile Teams
Sindh• NGO based prevention programmes are g running in Sindh • a resolution was approved in 2010 for mandatory thalassaemia screening prior to mandatory thalassaemia screening prior to marriage in 2010 • A formal bill has yet to be presented in the Sindh Assembly Sindh Assembly
2. Screening 2 Screening• Target screeningMost cost effective method advised by WHO in countries with gene frequency less than 10 % in general population f l th 10 % i l l ti• CBC• Hb Electrophoresis p• DNA Analysis
Conclusion• The health budget of Pakistan needs revision pp p for appropiate health care delivery y•• Th l Thalassaemia Federation has done a lot of i F d i h d l f awareness in Pakistan but a prevention programme cannot run effectively without the political will and financial support of the the political will and financial support of the government.