Pakistan - Current Situation in Control Strategies and Health Systems in Asia

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Current Situation in Control Strategies and Health Systems in Asia by Prof. Dr. Jovaria Mannan, Professor of Paediatrics, Chairperson of the Medical Advisory Board, Thalassaemia Federation of Pakistan

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Pakistan - Current Situation in Control Strategies and Health Systems in Asia

  1. 1. 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
  2. 2. 24,280,000 1,000,000 4,340,0009,280,000 2,972,000 98,350,000 43,300,000
  3. 3. Healthcare in Pakistan Healthcare in Pakistan • Policy making  Federal  •N i National Programs lP Govt.  • Implementation of Provincial  y Healthcare System Govt. 
  4. 4. < 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
  5. 5. 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
  6. 6. 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
  7. 7. 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. 
  8. 8. 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
  9. 9. There are no current programs in the  following provinces• Azad Jammu and Kashmir• Balochistan• Federally Administered Tribal Areas• Gilgit & Baltistan 
  10. 10. 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.
  11. 11. 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
  12. 12. 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
  13. 13. Punjab Thalassaemia Prevention Program  (PTPP) •Genetic Counselling •Blood collection •Carrier Testing •CVS •DNA Lab •Result Feedback •Awareness Awareness •Trainings •Genetic Counselling •Blood collection District •Result Feedback DHQ  DHQ •Awareness Hosp.•Genetic Counselling•Blood collection•Carrier Testing Regional •CVS Office•Result Feedback•Awareness 74 Field Officers 
  14. 14. 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
  15. 15. 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
  16. 16. 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. 

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