Basic health issues and role of private healthcare System in Pakistan

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Basic health issues and role of private healthcare System in Pakistan

  1. 1. Basic Health issues and Role of Private Health Care System in Pakistan DR.ABDUL.GHAFOOR SHORO MBBS,MAS in HSA ,PGDPA,DPHC Secretary General Sindh Private Hospitals and Clinics welfare Association(SPHCA)
  2. 2. Structure of Modern Health Care System Internationally Recognized Health system / Levels of health care: An internationally recognized health care delivery system which includes four tiers. 1. Preventive care: The specialists in preventive care plan at Governmental, institutional or community level for controlling preventable diseases. They have special role in maintaining hygiene and sanitation of a community as well as inculcating awareness regarding health and disease in masses. 2. Primary Care: The Doctors working at Primary care level (Family Medicine Specialists / Qualified Specialist GPs / Simple GPs) treat all the members of a family for most of the common illnesses. They also provide necessary Health advice and arrange referrals to different specialists at secondary or tertiary health care levels when required. The key element of a primary health care set up is Family Physician. 3. Secondary Care: Doctors working in bigger hospitals including medical specialists, surgeons, pediatricians, gynecologists, dermatologists, psychiatrists, ENT specialists , ophthalmologists and other sub specialties provide secondary care. 4. Tertiary Care: Special Hospitals dealing with certain subspecialties covering single organ or organ system related diseases provide the tertiary care like Cardiac centers, Burn units, orthopedic units, Kidney centers etc.
  3. 3. Basic Health Issues in Pakistan • Health system has been designed developed and maintained by politicians rather than physicians/ Health professionals. • We have a poorly organized health structure. We need to clearly define the four tier health care system. • Our health priorities are not properly defined. • Lacking of experts in the field of primary health care. • To spend more on secondary and tertiary care centers. • Neglecting Primary and Preventive Health care system. • High cost of Medicines and Procedures. • Lack of Promotion of Research in Medical Field . • Circulation of Fake Medicine. • Lack of Health education in Community .
  4. 4. Health Issues Cont: • Un Controlled quackery(un authorized healthcare giving) all over the country. • Gap between our medical training and on ground health issues. • difference between demand and supply of health professionals for different services. • We neither have insight nor physical existence of a properly functioning preventive health care system. • Political Interference.
  5. 5. Role of Private Health care system • 70-80% health care providers in Pakistan. • The Private sector specially in urban areas has become main health provider in Pakistan. • In Sindh private providers act on the front line and are often the only form of healthcare available . • Although the private sector plays an increasingly important role in health care in Pakistan, it remains anew area of study and innovation. • As government fall short of providing widespread access to care ,the private sector presents an opportunity for sustainable scale-up of health care services along side social and economic development. • Included the scope of private sector agencies are both for profit private providers and NGOs that apply market based approaches to service delivery. • Un fortunately Private sector’s true role was never understood in Pakistan.
  6. 6. Cont: • To introduce such a health care infrastructure model where all citizens can get better health care facilities in Sindh. • Only access to health care, even if universal, will have no meaning unless the larger social determinants of health are squarely addressed and issues of ethnicity, caste, class and gender are engaged-with as a society. • With regards to health, we also believe that the private sector should play only a supplementary and never a complementary or competitive role.
  7. 7. Private Healthcare system in Sindh • The Private sector in Sindh is varied with no defined structure, weak regulations exists in this sector. Descriptive situation of the Private Health care sector in Sindh. 1. Health infrastructure 2. Types of Health facilities 3. Informal Structures 4. Allopathic Service Providers 5 . Non Allopathic Service providers 6. Traditional.
  8. 8. Health Infra structure • The private Health Infrastructure is not well organized . • The wide range of disparity in health care provision in the private sector. • Ranging from Hi Tech regular Hospitals with all necessary provisions to a general store providing healthcare.
  9. 9. Types of Health Facilities • Regular hospitals: Fully equipped with necessary staff ,supplies, equipment, transportation, skilled staff and can be compared to any teaching hospital of the public sector.
  10. 10. Nursing Homes in Sindh • Nursing homes are mostly acting as maternity homes and generally are not well versed in providing most of the primary health care services and even not equipped for new born care.
  11. 11. Clinical Set up in Sindh • Clinics are generally owned by a single person who is sole proprietor of this healthcare providing structure. • There are some very good clinics run by specialists well equipped and providing quality services but these are in limited number . • Mostly situated in Metropolitan areas where people are well aware of the quality of the health services. • But the Conditions of the most of the clinics is pathetic due to weak regulatory system.
  12. 12. Informal structure • Informal structure don’t act primarily as health care provider and even are not legally authorized for this ,but even then this practice exist. • These are general store, Karyana merchants, and Pan wala also providing medicines for minor diseases .
  13. 13. Allopathic Service Providers • Allopathic service providers are divide into three groups : • Qualified • Semi- qualified • Non- qualified
  14. 14. Qualified • Qualified Services Providers include MBBS and Specialists. • They are mostly providing services at private hospitals Medical centers /nursing homes and at their Clinics .
  15. 15. Semi Qualified • The semi Qualified health care providers include LHVs, LHWs etc. • They are having some training and diploma as recognition. • The y are trained for specific purpose and have their limitations with respect to health care service provision. • But mostly performing the functions of qualified doctors with out enough knowledge.
  16. 16. Non-Qualified • Non qualified ser vice providers include dispensers, Ward boys and peon etc. • Any other person having some experience working with qualified health care provider for a short time. • The pharmacist lying in this category providing consultancy and dispensing are also non qualified persons.
  17. 17. Non- qualified in Action
  18. 18. ENT Specialist- Ophthalmologist and Dental surgeon
  19. 19. In the name of herbal treatment
  20. 20. Non-Allopathic Service providers • Homeopaths, Hakims, Pehlwans and Jirhas. • Acupuncture and Chinese Medicine treatment Provider.
  21. 21. Traditional Health Care providers • About 70% of the population , particularly in rural areas use traditional and complementary /alternate Medicine. • The Govt: of Pakistan has issued the Unani, Ayurvedic and Homeopathic System of Medicine Rules of 1965. • Under this Act courses in homeopathy provided by recognized institutions must be four years in duration ,culminating in a qualifying examination.
  22. 22. Governmental Responsibility • The Private sector’s dominance in the health sector needs to be recognized by policy makers. • Private Provision could be financed through Government sources to provide subsidized care to low income groups. • Vertical programs such as EPI , Family Planning, TB control etc need to be expanded to include Private Sector. • The field of Family Medicine needs to be properly high lighted promoted and utilized by Government to the best of its advantage to public • Quackery and Un- authorized health care giving should be penalized under the law.
  23. 23. Responsibility of Private Healthcare Sector • Must properly analyze the ethical and Professional Competency standards of our private healthcare sector. • Must make a full audit of all the existing private practice outlets. • Must also look into the possibilities of govt: and Private partnership. • Should clearly define our health issues ,Health priorities and health policy. • Must have full Time properly functioning Public Health Department at all levels . • Must eliminate quackery in all forms. • Should adopt the concept of affordable treatment for all.
  24. 24. House Hold Hakeem's

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