- Time to improve policies and start manufacturing medical devices within the country
The Sustainable Development Goals (SDGs), also known as the Global Goals, were adopted by the United Nations in 2015 as a universal call to action to end poverty, protect the planet, and ensure that by 2030 all people enjoy peace and prosperity. The 17 SDGs are integrated—they recognise that action in one area will affect outcomes in others, and that development must balance social, economic and environmental sustainability. Countries have committed to prioritise progress for those who are furthest behind. The SDGs are designed to end poverty, hunger, AIDS, and discrimination against women and girls.
Whereas the Targets of Sustainable Development Goal-3 are to ensure healthy lives and promote well-being for all at all ages. These includes maternal mortality, maternal mortality, road traffic, sexual and reproductive health, environmental health, etc. SDG-3 aspires to ensure health and well-being for all, including a bold commitment to end the epidemics of AIDS, tuberculosis, malaria and other communicable diseases by 2030. It also aims to achieve universal health coverage, and provide access to safe and effective medicines and vaccines for all.
The global healthcare sector continues to rise up to the new challenges presented by the ongoing pandemic, which continues to dominate healthcare systems’ attention and resources. They continue to elevate the human experience of their workforce and reshaping what, how, and where work is performed, swiftly scaling virtual health services for patients, and forging partnerships to produce and procure the required vaccines, treatments, and supplies. At the same time, they continue to address the heightened importance of inequities of health care, sustainability, and the environment.
The health systems in countries throughout the developing world suffer from insufficient financial and human resources, limited institutional capacity and infrastructure, weak health information systems, lack of comprehensiveness, embedded inequity and discrimination in availability of services, absence of community support etc.
The negligence in the health sector of Pakistan is evident. We all have witnessed the pathetic conditions of Government hospitals where there is no proper treatment for the patients. Moreover, there are lack of doctors for the treatment of patients and as a result many patients suffer serious complications due to lack of proper treatment.
With the increasing economic pressure and lack of resources, healthcare system in Pakistan is deteriorating day by day. The pathetic conditions and poor services in the public sector health care system, especially in rural areas, has created opportunities for private sector to grow.
While larger public-sector hospitals are the major providers of critical hospital admissions, and the main lifeline for the poor, 70 per cent of Pakistan’s population (66% rural and 76% urban), including many from the lower socioeconomic segments, go to private medical providers for routine consultations. These are not ‘traditional’ health providers but mainstream medical clinics and hospitals. The numbers are particularly high in Punjab and Sindh (77-75%), but also substantial in KP and Balochistan (47-61%).
The private health sector, which has grown phenomenally in response to deficiencies in government health services, is firmly entrenched and highly entrepreneurial. In fact, noticeably high private usage is also found in areas of primary care typically considered the government’s domain: 73% of treatment for diarrhoea in children (the second highest cause of child mortality), 57% of pregnancy care visits, and 69% of all births take place in private clinics. The private sector also boasts a substantial share of blood bank, routine laboratory and X-ray services, and in some provinces, ambulance services too.
Despite high cost, lack of ethics of medical practices and questionable low quality, the Private sector is a reality. The Private sector is mostly unregulated and unchecked due to the absence of proper control of the state authorities.
Despite the peculiarity of profit making, the private sector is playing a substantial role both in preventive and curative service provision. Private sector medical services demonstrated great deal of responsiveness and created an Aura of trust with the consumers. There is definitely a potential to engage and involve private and non-state entities in the health care system building their capacities and instituting regulatory frameworks, to protect the poor’s access to health care system.
In the framework of health system development, there is an alarming shortage of skilled and qualified healthcare experts. Pakistan rank sixth in the world population wise and as per its requirement the health human workforce in quite insufficient. Pakistan is one of the 57 countries that critically deficient in human health resource. In Pakistan doctor to patient ration is 1:1300, nurse to patient ratio is 1:20 whereas, doctor to nurse ratio is 1:27. However, according to WHO, it is recommended that doctor to patient ratio should be 1:1000, whereas, appropriate doctor to nurse ratio is 1:4. In addition, according to the Pakistan Nursing Council the nurse to patient ratio should be 1:10 and 2:1 in general and specialized areas, respectively.
Likewise, there is acute shortage of qualified midwives, pharmacists, public health experts, dentists and physiotherapists etc. However, approximately 90,000 lady health workers are working in the rural areas for the healthcare delivery.
What could be the reasons that we are lacking behind in achieving our health goals. What are our major challenges faced by sector.
Deficiency of Resources
Because of the weak infrastructure of the Basic Health Units (BHUs) and Rural Health Centers (RHCs), the majority of people are unwilling to use the public health system’s healthcare services, and as a result, rural people are diverted to tertiary care facilities. Also accessibility is a big issue.
Infrastructure
Poor healthcare infrastructure is one of the reasons of downfall of healthcare system in Pakistan. This leads to inadequate healthcare facilities available to the citizens. A typical government hospital lacks sufficient doctors, nurses, and personnel. Hospitals are filthy and unhygienic, they lack security, patient care is unheard of, medicines and consumables are frequently in low supply, employees may be unscrupulous and demand bribes from patients, and they may even lack essential utilities such as a continuous supply of water, power, and fuel. Because of breakdowns or corruption, their ambulances may be unavailable, leaving patients to fend for themselves.
Corruption
Political and higher authority corruption is one of the reasons of poor health sector in Pakistan. The resources are unavailable in the hospitals and other healthcare centers due to corruption.
Lack of Educated Health Specialists
In Health sector of Pakistan, there is still a lack of educated and professional individuals. Another reason for lack of educated health specialists in Pakistan is, many health specialists go abroad for higher education and work there. This is the major loss of the health sector of Pakistan.
High Prices of Medicines
Pakistan is to import medicines though we have good network of pharmaceutical industries. Due to the lack of resources and increasing economic pressure, Health sector in Pakistan is unable to meet the need of these products that are necessary for the basic needs of citizens.
Lack of Awareness
People living in urban areas are more privileged and have access to basic health facilities. Similarly they are well aware about the health issues. But the situation in rural areas in different. People in rural areas are not well aware about the vaccines, treatment, precautions, preventions, etc. of many health issues. This increase the pressure on health sector of Pakistan. So it is need of the hour to start educating people of rural areas and help them to get the basic health facilities.
How can Health Sector in Pakistan be improved
The main objective should be to improve the life quality and to decrease the mortality rate in public. Pakistani government and private sectors should focus on these points to build a better health sector in Pakistan
- Improving the quality of medical, nursing, and technical education
- Check and balance of health units to control the corruption.
- Continuous training programs
- Awareness programs
- Encouraging research culture
- Increased investment in medical research.
- Public health insurance
Last word
Pakistan is facing a lot of economic and political challenges. Pakistan have poor health sector that has many challenges to face. From corruption to lack of well-educated manpower, Pakistan has to fight with a lot of challenges. It is the high time to implement better health policy and start manufacturing medical devices within the country. Achieving universal health coverage by 2030 demands the inclusion of the private sector. Creative solutions and capacity investment in the ‘softer skills’ of private market management are critical to a pluralistic entrepreneurial healthcare system. There are countries that have made headway with the private sector; let’s import some lessons from them, instead of only aid monies.
The author, Mr. Nazir Ahmed Shaikh, is a freelance writer, columnist, blogger and motivational speaker. He writes articles on diversified topics. Mr. Shaikh can be contacted at nazir_shaikh86@hotmail.com.