- Need to change infrastructure, governance and adopt new technologies
- Govt must implement the policies outlined in NSP-2022-2026
Pakistan has a long history of providing healthcare through the public sector. However, in recent years, the state of health in Pakistan has been declining. This is due to a number of factors, including the poor infrastructure and governance of the public healthcare system, the increasing cost of healthcare, and the growing burden of chronic diseases.
A healthcare system is one of the most essential pillars of any country. Two parallel systems exist in the healthcare system of Pakistan. One consists of public hospitals and the other consists of private hospitals.
The National Security Policy (NSP) 2022 identifies health security as an important constituent of human security, a key pillar of economic security. Furthermore, the COVID-19 pandemic significantly raised the prominence of health as a national security concern. The NSP-2022 reiterates Pakistan’s pledge to address the lack of quality health facilities and highlights the need to invest in preventive, curative, and public health ecosystems.
Public health ecosystems
The public healthcare system in Pakistan is plagued by a number of problems.
- A severe shortage of healthcare facilities, especially in rural areas. According to a 2018 economic survey, there is one doctor for every 963 people in Pakistan. This means that there are not enough doctors to meet the needs of the population, especially in rural areas.
- Inadequate staffing, with many healthcare facilities lacking the necessary nurses, midwives, and other healthcare workers. This is due to the low salaries offered by the public sector, which make it difficult to attract and retain qualified healthcare workers.
- There is a massive shortage of hospitals, doctors, nurses, and paramedical staff. Most life-saving medications are too expensive for people to afford. Now and then, there is a shortage of medicines in the market. Above all, there exists a lack of trust in the healthcare system,
- Lack of equipment and supplies often leads to patients having to wait long hours to see a doctor or receive treatment. According to a 2022 report by the World Health Organisation, only 40 percent of public hospitals in Pakistan have the necessary equipment and supplies to provide quality care.
- Poor quality of care is often due to the lack of resources and training. A 2020 study by the Pakistan Medical Association found that only 30 percent of patients who sought care at public hospitals were satisfied with the quality of care they received.
- We are witnessing our national demise in intellect by keeping our children hungry. We have a major problem with infectious diseases, but chronic diseases are killing us more. Neonatal disorders, ischaemic heart diseases and stroke are the main causes of premature deaths in Pakistan. Malnutrition, pollution, high systolic blood pressure and tobacco consumption are other major causes.
- Pakistan is even behind Rwanda in its spending on healthcare and education — 164th out of 188. After corruption, whatever is left is consumed by salaries, according to a published report.
Rising cost
The cost of healthcare in Pakistan has been increasing at a faster rate than inflation. This is due to a number of factors, including the increasing demand for healthcare services, the rising cost of medical education, and the increasing cost of drugs and medical equipment. The rising cost of healthcare has made it difficult for many people to afford it, especially the lower class. The private healthcare system is also growing in Pakistan, but it is only accessible to a small percentage of the population.
The growing burden of chronic diseases
Chronic diseases, such as heart disease, cancer, and diabetes, are now the leading causes of death in Pakistan. These diseases are often preventable or treatable, but they require access to quality healthcare, which is not always available to everyone. The growing burden of chronic diseases is putting a strain on the public healthcare system.
Growing Concern for the Lower Class
The lower class is more likely to suffer from poor health and have less access to healthcare than the upper class. This is due to a number of factors, including their lower income, their lack of education, and their limited access to healthcare facilities. The lower class is also more likely to be uninsured or underinsured, which means that they have to pay out of pocket for healthcare, which can be a financial burden.
In the existing system, each tehsil headquarters is allocated one THQ and each district headquarters one DHQ, irrespective of population and geographic spread. The number of beds in THQs and DHQs is based to some extent on the population differentials among districts and tehsils. However, the major dilemma of the existing system is that rural blocks or union councils have at the very least BHUs for offering basic healthcare services. On the other hand, cities and urban centers like tehsil and district headquarters primarily rely on THQs or DHQs with an insufficient number of dispensaries or filter clinics operated by the local government. Their ownership is also a problem, as some of these dispensaries and clinics have been transferred to the health department but still lack funds and oversight.
The development of PPPs (public-private partnerships) is an example of such innovative models. Under the universal health coverage (UHC) initiative of the WHO, Pakistan launched the Sehat Sahulat Programme (SSP) in 2015. This operated through collaboration between the Government of Pakistan and the State Life Insurance Corporation of Pakistan. Its main goal has been to provide free healthcare services to vulnerable and marginalized communities. While this programme has largely been a success and made significant strides in improving healthcare accessibility, Nevertheless, this programme can serve as the foundation for other PPPs.
There is a strong and wide consensus that Pakistan must pursue universal health coverage (UHC) attainment as the driving force for achieving sustainable development goals by 2030. Nevertheless, several institutional and socioeconomic challenges may hinder the progress toward UHC.
Measures and proposals
The government has shown keen interest in improving the current conditions of healthcare. However the political unrest in Pakistan has played a huge role as the rapid change in management and leadership interrupts the continuity of policies. Improving the health sector must be a priority regardless of government or regime changes.
The government needs to take these 11 steps urgently to improve the state of health in Pakistan.
- Increasing funding for the public healthcare sector. This would allow the government to build more hospitals and clinics, hire more healthcare workers, and provide better equipment and supplies.
- Increase the taxes on tobacco and alcohol.
- Improving the governance of the public healthcare system. This would involve making the system more transparent and accountable, and ensuring that resources are used efficiently.
- Safety nets for health must continue regardless of the change in the political regimes.
- Decrease the reliance on donors’ funding.
- Accountability is to be ensured across the board for service providers, managers, administrators and policymakers in the health system.
- Regulating the private healthcare sector. This would ensure that private hospitals and clinics provide quality care at affordable prices.
- Promoting healthy lifestyles. This would involve educating the public about the importance of eating a healthy diet, exercising regularly, and not smoking.
- Implementing public health measures. This would involve vaccinating children, providing clean water, and improving sanitation.
- Supporting research into new treatments for chronic diseases. This would help to reduce the burden of chronic diseases in the country.
- Raising awareness of the importance of healthcare among the general public. This would encourage people to seek preventive care and to get treatment for illnesses early on.
Role of Technology
Technology can play a major role in improving the healthcare system in Pakistan. Some of the ways that technology can be used to improve healthcare include:
Telemedicine: This allows patients to consult with doctors remotely, which can help reduce the need for travel and improve access to healthcare in rural areas.
Electronic health records: These can help to improve the quality of care by providing doctors with access to patients’ medical histories.
Artificial intelligence: This can be used to develop new diagnostic tools and treatments, and to improve the efficiency of the healthcare system.
Big data analytics: This can be used to identify trends and patterns in healthcare data, which can help to improve the quality of care.
The government can take a number of measures to increase the role of technology in the healthcare system. These include:
- Investing in the development and adoption of new technologies.
- Providing training to healthcare workers on how to use technology.
- Creating a regulatory framework that encourages the use of technology in the healthcare system.
- Promoting public awareness of the benefits of technology in healthcare.
As the saying goes, “There are no easy fixes, but only the attention of decision-makers is required.” The government needs to pay attention to the healthcare system and take the necessary steps to improve it.
Conclusion
There is little strength in the health care delivery system in Pakistan in making health policies, participating in the Millennium Development Goals programme, initiating vertical programmes and introducing public-private Partnerships, and improving human resource development and infrastructure by making basic health units and rural health centres. However, these all programmes are very limited in its scope and that is the reason that Pakistan’s healthcare system is still not very efficient.
The state of health in Pakistan is a matter of concern; Pakistan has been improving very slowly in the health sector for the last 7 decades as is evidenced by its health indicators and above mentioned strengths and weaknesses. Especially for the lower class. The government needs to take steps to improve the healthcare system by increasing funding, improving infrastructure, and providing training to healthcare workers. Technology can play a major role in improving the healthcare system, and the government should invest in the development and adoption of new technologies.
The NSP-2022-2026 is a significant step in the right direction, but it is important to remember that it is just a policy document. The government now needs to take concrete steps to implement the policies outlined in the NSP-2022-2026. This includes increasing funding for the healthcare sector, improving infrastructure, and providing training to healthcare workers. The government should also invest in the development and adoption of new technologies to improve the efficiency and quality of healthcare in Pakistan.
About the Author:
The author is an ICT expert with over 12 years of experience in the field. He is deeply passionate about empowering young people in Pakistan and contributing for the development of the country, helping youth develop the necessary skills to thrive in the digital age. Through his expertise and commitment, Kapeel strives to contribute to the country’s technological advancement and economic growth.