Health issues in pakistan

HealthIssues In Pakistan
PPT by Jaweria Nazir

Introduction

+ The maintenance and promotion of health is achieved through different
combinations of physical, mental, and social well-being, together sometimes
referred to as the “health triangle”.
+ Health is not just a state, but also a resource for everyday life Health is a positive
concept emphasizing social and personal resources, as well as physical capacities.
+ Good health is identified as a vital component of a good quality of life. Access to
good health is recognized as a basic human need and a fundamental human
right
“a state of complete physical, mental, and social well-being and not
merely the absence of disease or infirmity”
(WHO 1946)
• PPT by Jaweria Nazir

HealthCare
The diagnosis, treatment, and prevention of disease, illness, injury, and other p
hysical and mental impairments in humans delivered by practitioners in medic
ine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care pr
oviders refers to the work done in providing primary care, secondary care and t
ertiary care, as well as in public health.

Determinants of Health

Income
and social status
Healthy child
development
Education
and literacy
Health care
service

Social
environment
Physical
environment
Personal
health care
and coping
skills
Social support net
work

Biological
genetic
Employment
and working
conditions
Gender Culture

Politico-Administrative Aspects
of Health

+ After 18th amendment in constitution of Pakistan, health is now subject of
provincial government.
+ There is a window of opportunity to make drastic improvements in the
health sector after its devolution to provinces.
+ Still there are different administrative issues regarding pay structure and
working conditions of medical staff
+ Health issues have become highly sensitized due to globalization and mass
media faced with precarious economic situation characterized by heavy
external debt and faltering productivity,
+ Pakistan’s room to maneuver with health sector reform is quite limited.

Health Situation of Pakistan

+ hepatitis B and C with 7.6% affected individuals
+ 5th highest tuberculosis burden in the world
+ HIV prevalence of 21.0%
+ high rates of unscreened blood transfusions
+ Pakistan is ranked 10th in the world for diabetes
+ One in four adults over 18 years of age is hypertensive
+ Disability due to blindness or other causes is also high
+ Infant Mortality Rate per 1000 is 63.3
+ Mortality Rate under 5 per 1000 is 89
+ Half of women of reproductive age are anemic (50.4%)
+ In young children, diarrhea and respiratory illness remain
as the major killers
Pakistan is facing a double burden of disease (BoD)
The health system functions and operations are frequently disrupted by acu
te crises such as floods, droughts, earthquakes, manmade emergencies as w
ell as disease outbreaks such as Dengue and Measles. PPT by Jaweria Nazir

Health Indicators Comparison

+ Despite the fact that Pakistan has made progress during last couple of years towards achieving these health targets yet t
he pace has been sluggish.
+ Pakistan still suffers from a high infant and maternal mortality, a double burden of diseases, and inadequate health car
e facilities with high population growth.
+ Mortality, morbidity and slow progress of indicators in the maternal and child health are major concerns in the progress
towards achieving Millennium Development Goals.
+ However, life expectancy at birth is a good indicator of health and here Pakistan has done better.
+ The average life expectancy at 67.2 years estimated for 2010 well comparable with Bangladesh, Nepal and Thailand the m
ortality rate for children under age five and infant mortality still remains high due to birth related problems, immuniza
ble diseases, malnutrition and unhealthy dietary habits and low female literacy rate

Health Expenditures

+ The government’s health budget has been progressively increasing over the last several years.
+ The share of health expenditure in total expenditures/GDP is the most significant variable affecting health s
tatus in a country.
+ Its ratio to GNP/GDP remained more or less static at around 0.5-0.7 percent comparison of last several year
s shows a major dominance of non-development budget.

Healthcare Facilities In Pakistan

The health care personnel-doctors, dentist, nurses and paramedics etc. In p
ublic sector have also increasing considerably over time in the country. Till 2
010, there were
+ 144,901 Physicians,
+ 10,508 Dentists
+ 73,244 Nurses
+ 27,153 Midwives
+ 972 Hospitals
+ 104,137 Hospital Beds
+ 4,842 Dispensaries
+ 5,344 Basic Health Units(bhus)
The population versus health facilities ratio works out 1,222 person per doct
or and availability of one dentist for 16,854 people and one hospital bed for
1,701 people

Health Performance 2010-2011

+ Targets for the health sector during 2010-11 included establishment of 15 Rural Health Centers (RHC),
40 Basic Health Units (BHUs) and up-gradation of 45 existing RHCs and 900 BHUs.
+ The manpower target included the addition of 5000 new doctors, 450 dentists, 3500 Nurses, 5500 para
medics and 500 traditional birth attendants. Under the preventive program, about 8.5 million children
were targeted to be immunized and 25 million packets of ORS were to be distributed during 2010-11.
+ Till date 4500 HIV positive cases have been reported to the National and Provincial AIDS Control Progr
ams including 3050 full blown AIDS cases.
+ Around 1030 are receiving free treatment through 12 AIDS Treatment Centers. Total number of TB case
s reported are 62,321.
+ Whereas the absolute number of cases is 209,714 up to the third quarter of 2010 and the treatment succ
ess rate remained 91 percent.
+ The percentage of TB case-detection rate is 81 percent and cure rate is 74 percent.

Major Health Programmes

+ Expanded Programme on Immunization (EPI)
+ National AIDS Control Programme (NACP)
+ Malaria Control Programme
+ National T.B. Control Programme (NTCP)
+ National Programme for Prevention and Control of Blindness
+ National Programme for Family Planning (FP) & Primary Health
Care (PHC)
+ National Maternal, Newborn and Child Health Programme (MN
CH Programme)
+ Cancer Treatment Programme
+ Drug Abuse Control

Cooperation For Health

+ The overall investment in the health services sector during 2009 wa
s US$ 4.853 billion, with the government providing 24%, donors 6
%, the military 4%, and 1% through social security.
+ The remaining 65% was paid by individuals as out-of-pocket medi
cal expenses. The UNCT coordinates all external support from bilat
eral and multilateral donors that support the One UN joint progra
mmes including that on health and population. OCHA is the key a
gency for coordination of humanitarian support.

WHO Cooperation

In 2017, WHO has taken the chairmanship
of the Health, Population and Nutrition Pa
rtners Group, a quarterly coordination plat
form that aims to streamline donor suppor
t in Pakistan.

StrategicPriorities MainFocusAreasforWHOCooperation
STRATEGICPRIORITY1:
Healthpolicyand systemdevelopment
WHO will support improvements in policy-making and governance through policy assessment and analysis and review the health system with a view to outline gaps and propose
solutions as part of the national health policy/strategy. Pakistan will also assist to improve service delivery, access and equity through development of an integrated framework for
the
provision of comprehensive quality and equitable health care to the population. In addition WHO will support Prime Minister Health Insurance Programme and advocate for mo
re adequate budget allocations for health (aiming at a
minimum of 4% of GDP by 2017). Pakistan should be given opportunity to increase external resources (ODA) to support critical aspects of health sector reform at provincial level
and promote coordinated approaches and effective use in view of the devolution process. Developing public–private partnership and managing human resources for health, deve
loping an integrated health information system and promoting and supporting applied research are other components to enhance Health policy and system development in Paki
stan.
STRATEGICPRIORITY2:
Communicablediseasecontrol
Disease surveillance and early warning systems will be supported for the detection and timely control of communicable diseases including polio, tuberculosis, malaria, HIV/AIDS,
leishmaniasis, hepatitis, acute watery diarrhoea, acute respiratory infection, malaria, dengue fever, Crimean–Congo haemorrhagic fever among others. Support will also be provi
ded for improving routine immunization through collaboration with partners specifically GAVI.
STRATEGICPRIORITY3:
Improvingthehealthof womenandchildren
WHO will support the provincial health departments in improving mother, newborn and child health/reproductive health in collaboration with other stakeholders and UN sister
agencies. Promoting safe motherhood, family planning, prevention and control of sexually transmitted infections and reduction of neonatal and peri-natal mortality and implem
entation of provincial plan on reducing Maternal and neonatal heath are among major interventions that will be supported by WHO.
STRATEGICPRIORITY4:
Noncommunicablediseasesand mentalhealth
Support development of national noncommunicable strategy addressing minimizing negative impacts of risk factors and advocating multisectoral public policies and strengtheni
ng partnership, public private partnership and accelerate implementation of the provisions of the WHO Framework Convention on Tobacco Control. Efforts will be made to integ
rate mental health and substance abuse into primary health care services.
STRATEGICPRIORITY5:
Addressingthe socialdeterminantsof health
WHO will assist Government on SDH through promoting healthy environments with priority given to access to safe water and sanitation and filed testing healthy city programm
e initiative.WHO will also advocate for gender equity and equality includingsex-disaggregated health data and information.
STRATEGICPRIORITY6:
Emergency preparedness and response and disaster risk
management
WHO support national and provincial governments for implementation of emergency preparedness and response plans, guidelines and relevant standard operating procedures.
Strengthening partnership and harmonization with interested and potential partners and donors, conduct hazard mapping and vulnerability health assessments at district and
selected health facilities, develop and regularly update the health emergency management information system and assist to update the health sector contingency plan are among
WHO contribution in the coming years.
STRATEGICPRIORITY7:
Partnerships,resourcemobilizationand coordination
WHO will develop a resource mobilization strategy for WHO Pakistan, support the health sector in resource mobilization and develop and regularly update an information syste
m for donors and health partners with the aim of supporting external assistance in form of data, surveys, studies and reports. Partnership with the donors will be improved thro
ugh better coordination process and as lead the health cluster use the health cluster approach to improve the coordination system within the health sector.

Factors Causing Poor Health in
Pakistan

+ Poverty
+ Pollutionexplosion
+ Illiteracy
+ Unhealthyhealthpolicies
+ Lackof awarenessamongmass
+ Genderdiscrimination
+ Naturalcatastrophesandcalamities
+ Genderdiscrimination
+ Lackof medicalresearch
+ Uncleandrinkingwater
+ Unhygienichabits
+ Inadequatemedicalfacilities
+ Uncontrolledurbanization
+ Poorsanitationandsewage

How To Cope With The Health
Issues

+ Paradigm shift: from providing health care to producing health
+ Regionalization of Health Care Services
+ Control population
+ Increase literacy rate
+ Increase in budget spending on health
+ Corruption control in the public health projects
+ Public-private partnership for provision of medical facilities to the people
+ Take measures to spread awareness regarding importance of health among the mas
ses
+ Implement environment-friendly measures to curb pollution

+ promote health education and awareness
+ Encourage medical research and development at public and private level
+ Check growth of substandard private hospitals and clinics
+ Bring health reforms and ensure their successful implementation
+ Make drug control department efficient and effective
+ Facilitate existing brains in the medical field by providing them adequate pay struc
ture with incentives
+ Use information technology to facilitate far areas and a large portion of the populat
ion
+ Contracts with the developed countries to exchange human resource and knowledg
e
+ Promote hygienic and simple lifestyle and cleanliness PPT by Jaweria Nazir

Health needs devotion at both government and public level. A single s
ided attempt by the government is not sufficient until people themsel
ves do not have awareness regarding significance and value of health.
Although performance in the health sector is very disappointing but a
combined effort by all actors of society could accelerate progress in he
alth and could result into a safe and healthy Pakistan
Conclusion

“There can be no real growth without healthy populations. No sus
tainable development without tackling disease and malnutrition.
No international security without assisting crisis-ridden countries
. And no hope for the spread of freedom, democracy and human
dignity unless we treat health as a basic human right.”
- Gro Brundtland –

Thank you!!

Health issues in pakistan

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