community health community health nursing health research by nurses

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2. Compare changes in Pakistan’s Health care
System
Complied by :
Yasmeen
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3. Objectives
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By the end of the session, participant will be able to:
 Changing Concept in Health
 Define what is system and what is health care
system
 Describe health care system of Pakistan
 Discuss health initiatives to improve the health
status of people
 Discuss the issues, as well as strengths and
weaknesses existing within the health system

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What is System & Health system
System:
“An organized, purposeful structure that consist of
interrelated and interdependent elements (components,
entities, factors, members, parts etc). These elements
continually influence one another (directly or indirectly) to
maintain their activity and the existence of the system, in
order to achieve the goal of the system”.
Health System:
“ A health system consists of all organizations, people and
actions, whose purpose is to promote, restore and
maintain health. The domain of health system should be
broaden and include inter-sectoral action” (WHO)

5. Health care delivery system
The health care delivery system in
Pakistan consists of public and private sectors.
...
The state provides healthcare through a three-
tiered healthcare delivery system and a range of
public health interventions.
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6. 6
Components of Health Care System
Leadership and
Governance
Health Financing
Health Information
systems
Human Resource for
Health
Logistics and
Technology
Service delivery

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Goal of Health Care System

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Pakistan: an overview
Total population: 184.5 million (193.2 million in 2016)
Pakistan is now sixth most populous country
Life expectancy is for male: 64.6y and female: 66.5y
Estimate as per census of 2017- 220 million

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Pakistan: an overview
Health Indices
• Maternal Mortality rate: 170/100,000 live births
• Neonatal mortality rate: 42/1000 live births
• Infant Mortality rate: 62/1000 live births

10. Patient
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Health Professional
Healthcare
Delivery
Doctor Pharmacis
t
Health Worker
Health Providers Don’t Just
Appear From Nowhere, Ready
To Heal
Patients Don’t Magically Find
Themselves In Hospitals

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Health
System
A Mother Caring For
A Sick Child At Home
Private
Providers
Behavior Change Programmes
Vector-control
Campaigns
Health Insurance
Organizations
Occupational Health And Safety Legislation
Within Health Sector

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Health
System
Education
Finance
Safety
Law
Transport
Communication
Information
Technology
Other Sectors

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Health care system is the
organization of people,
institutions, and resources
that deliver health
care services to meet
the health needs of target
populations.
What is Health Care System

14. Health Care System in Pakistan
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Pakistan’s Health Care System is
three- tiered

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PRIMARY
Dispensaries
MCHC/BHU/RHC
NGO/Community Groups
General practitioners
Non-formal health providers
SECONDARY
Clinics/Maternity homes
Tehsil Hospitals
Privately run clinics/hospitals
Non-formal health providers
TERTIARY
District Hospitals
Large urban private hospitals
T
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D
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N
A
L
M
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D
E
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N
P
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V
A
T
E
P
U
B
L
I
C
Health Care Services in Pakistan

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 Health care system is primarily the responsibility of provincial
government
 Each provincial government has department of health, which also
regulate private health care providers
 Survey 2005-06 indicates that 67.4% households in Pakistan consult
health providers in private sector when they have health problem
 Other providers are: hakim, homeopath, pharmaceutical, tabibs
 Government sector is low cost. Outpatient department have no
consultant fee but patient has to pay for medicine
Composition of Health Care System

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Health Care spending in Pakistan
27%
73%
• Only 27 % of population enjoys full health care coverage
• 73% depend on out of pocket payments
• Government spend $246.9 billion on health care (WB)

18. Health delivery
services
1 - 2 Million population
50,000 – 1 Million
Population
25 – 50,000 Population
10 – 25,000 Population
DISTRICT HQ HOSPITAL
(80-100 Beds)
TEHSIL HQ HOSPITAL
(40-50 Beds)
RURAL HEALTH
CLINICS (Extensive OPD;
10-20 Beds)
BASIC HEALTH UNITS
(Preventive & Curative;
mostly OPD)
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Pakistan has relatively large health care infrastructure
Primary & Secondary Health Care
Services in Pakistan
Basic Health Units 5000
Rural Health Clinics 600
Other FLC facilities 7500
Primary health care services are supported by the
network of 989 secondary care hospitals at district
and tehsil level

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• 919 hospitals
• 560 RHCs
• 5334 BHUs
• 4712 Dispensaries
• 905 MCH centers
• 288 TB centers
• 1,16,189 GPs
• 22,799 Specialists
• 9,193 Dental Surgeons
• 33,427 Nurses
• 7,073 LHVs
• 23,897 Midwives
• 95,000 LHWs
Pakistan Health System Profile, WHO EMRO Observatory 2007
Pakistan Medical and Dental Council, 31st Oct 2009.
National Programme for FP & PHC, 2008.
Services and human resource

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22. Ultimate Destination of pakistan
 Our is to see Pakistan among the ten largest
economies of the world by 2047 – the centennial
year of our independence.
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24. WHO support
 WHO supports the national health authorities vision
and aim of reaching universal health coverage
through the delivery of equitable and sustainable
health services.
 Support to the delivery of an identified package of
essential services that is based on integration of
service delivery.
 Introduction of Family Practice and promotion of
Public-Private Partnerships models in service
delivery
 Quality of services and patient safety as one of the
main components of service delivery
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Thank
you!