The healthcare delivery system in Pakistan consists of public and private sectors. Under the constitution, health is the primarily responsibility of the provincial governments. Health care delivery has traditionally been jointly administered by the federal and provincial governments with districts mainly responsible for implementation.
Service delivery is being organised through preventive, promotive, curative and rehabilitative services. The curative and rehabilitative services are being provided mainly at the secondary and tertiary care facilities. Preventive and promotive services, on the other hand, are mainly provided through various national programmes; and community health workers’ interfacing with the communities through primary healthcare facilities and outreach activities.
The state provides healthcare through a three-tiered healthcare delivery system and a range of public health interventions.
Some government/semi government organisations like the armed forces, parastatals such corporates, WAPDA, Railways and the Employees Social Security Institution provide health service to their employees and their dependents through their own system which collectively cover about 10 per cent of the population.
The private health sector constitutes a diverse group of doctors, nurses, pharmacists, traditional healers, drug vendors, as well as laboratory technicians, shopkeepers and unqualified practitioners.
Public sector health care system endeavours to deliver healthcare through a three level healthcare delivery system and a range of public health interventions. The first level includes Basic Health Units (BHUs) and Rural Health Centers (RHCs) founding the fundamental of the primary healthcare model, secondary care encompassed first and second referral facilities providing acute, ambulatory and inpatient care through Tehsil Headquarter Hospitals (THQs) and District Headquarter Hospitals (DHQs) and tertiary care including teaching hospitals.
The public health activities have persistently increased in terms of physical infrastructure and workforce. The national health infrastructure comprises of 1201 hospitals, 5518 Basic Health Units, 683 Rural Health Centres, 5802 Dispensaries, 731 Maternity & Child Health Centres and 347 TB Centres, and the total availability of beds in these health facilities is estimated at 125,000. In addition more than 95,000 Lady Health Workers are providing primary health care services to the community through the health houses.
The numbers of doctors, dentist, nurses and LHVs have increased and availability of one doctor, dentist, nurse and one hospital bed versus population has gradually improved. Despite an elaborate and extensive health infrastructure, the healthcare delivery suffer from some key issues like the high population growth, uneven distribution of health professionals, deficient workforce, insufficient funding and limited access to quality health care services.
The rising population pressure on state health institutions has encouraged the private sector to bridge the gap of rising demand and limited public health facilities. A number of private hospitals, clinics and diagnostic labs has increased considerably and is contributing health services in the country.
Majority of private sector hospitals has sole proprietorship or a partnership model of organisation. Stand-alone clinics across Pakistan are the major providers of out-patient care majority of these clinics falls in the sole proprietorship category.
Because of high population growth rate, unsafe drinking water, inadequate sanitation, poor socioeconomic conditions, low health awareness, and inadequate vaccination coverage, Pakistanis bears the significant portion of the regional burden of many communicable diseases and is at high risk of epidemics due to communicable diseases.
Significantly large percentage of population in Pakistan live below the poverty line. Due to a lack of resources, some folks cannot even meet their most basic demands. Furthermore, they have nowhere to go with a medical diagnosis.
The Government of Pakistan has not given health care a high priority. Local hospitals have provided free medical care to the needy, but due to a lack of funding, they are unable to serve a large number of patients. Additionally, due to the waiting list, patients who require surgical care at nearby hospitals have to wait for very long time.
The patient either passes away or becomes sicker by the time he/she reaches hospital.
On top of that residents of rural areas are less conscious of their illness, which prevents them from receiving timely, effective care. In Pakistan, several diseases are common, and the poor are primarily affected by these. Amidst this chaos, common health issues in Pakistan are rising.
The most common health problems in the country are:
Malaria
The bite of a mosquito, which breeds in contaminated water, is what causes malaria. Malaria spreads easily, given the size of the slum population. Malaria can prove fatal without proper treatment.
Slum dwellers frequently lack education and knowledge, so they turn to over-the-counter drugs to cure their illnesses. As a result, malaria has developed drug resistance.
Tuberculosis
Tuberculosis (TB) is an infectious illness that affects the lungs and spreads through coughing and sneezing.
According to the World Health Organisation (WHO), up to two-thirds of tuberculosis patients who receive inadequate care die. Tuberculosis is one of the common health issues in Pakistan that might have permanent effects.
Pakistan was placed seventh among the 22 nations with the highest rates of tuberculosis, according to the WHO. In Pakistan, there are over 420,000 new tuberculosis cases recorded each year. To assist lower the chance of contracting tuberculosis, the Pakistani government established the National TB Control Programme (NTP).
The official NTP website states that it offers skill training for lab technicians, paramedics, and doctors. All diagnosed individuals can also receive a free supply of anti-TB medications under the program.
Dengue Fever
A mosquitoes carrying the dengue virus attack people and spread the mosquito-borne illness, known as dengue fever. Direct transmission from one person to another is not possible.
The illness can cause a high fever, headaches, muscle pain, vomiting, and skin rashes, among other symptoms.
It’s possible to confuse the flu or other viral diseases with dengue fever. However, dengue fever is a severe type of virus that, if untreated, can lead to serious illnesses like liver enlargement and circulatory system failure.
Cancer
Cancer is one of the most common health issues for Pakistanis, accounting for 8 per cent of all fatalities in the country. The two most prevalent types of cancer in Pakistan are lung and breast cancer.
According to a recent study, breast cancer affects around one in every nine Pakistani women. Additionally, Pakistan has South Asia’s largest tobacco consumption.
Many cancer patients are not diagnosed until they are in advanced stages of the disease, and they frequently lack access to effective therapy. A crucial step toward cancer prevention and control in Pakistan was taken in 2013 with the establishment of a cancer registry that gathers information on cancer patients from throughout the nation.
Heart attacks
In Pakistan, ischemic heart disease is responsible for over 12% of deaths per year. The three main risk factors—smoking, obesity, and high blood pressure—are all quite prevalent in Pakistan.
Heart disease occurs due to an unhealthy lifestyle and a lack of awareness, just like other diseases. Public health awareness efforts and simple access to healthcare services can significantly lower the occurrence of such diseases.
High blood pressure/Stroke
Approximately 350,000 cases are reported each year in Pakistan. High blood pressure is the main cause of stroke.
The most common health issues in Pakistan, high blood pressure, and high blood cholesterol occur due to the use of low-quality oils and ghee. In addition, ignorance is another factor contributing to it.
People do not receive education on the value of eating well and leading a healthy lifestyle. Moreover, they are ignorant of the significance of exercising and keeping a healthy weight.
Diabetes
Seven million individuals in Pakistan have diabetes, making it the country in South Asia with the highest prevalence of the condition. It is also one of the major health issues in Pakistan.
Diabetes is a condition that impairs the body’s capacity to react to insulin, leading to abnormal carbohydrate metabolism and elevated blood and urine glucose levels.
Untreated elevated glucose levels can harm the body’s blood vessels and other organs. The unhealthy food sector in Pakistan may be to blame for the high diabetes rate. Since its establishment in 1996, The Diabetic Institute of Pakistan (DIP) has worked to combat diabetes.
Hepatitis
Hepatitis A and E are still widespread illnesses in Pakistan even though vaccinations are available. It is a viral liver disease spread by polluted water or bad food.
Along with the vaccine, safe drinking water, wholesome food, improved sanitation, and handwashing are all powerful approaches to combat the disease.
Hepatitis E is a liver condition that typically resolves on its own. But it might result in sudden liver failure. The WHO reports that East and South Asia have the highest rates of hepatitis in the globe.
However, the Government of Pakistan is reportedly utilising all available communication avenues to raise public awareness of hepatitis. Additionally, the government gives patients medicine and vaccinations.
Maternal and Child Health
Maternal health is one of the significant health problems in Pakistan. Women have to fend for themselves since they lack status and many women’s health issues are taboo. A woman’s state of health directly affects the health of her unborn child.
The main contributor to diseases affecting mothers and their newborns is the absence of adequate healthcare facilities in rural and other underdeveloped areas. Neonatal problems account for 16.67 per cent of all deaths, which is a result of this disregard for the baby’s health.
The health of the mother and child is a critical issue that affects rural communities more than cities. Women in rural areas suffer during their pregnancies due to a lack of sufficient diet, education, and care, which hurts the health of newborns.
Babies are frequently born dead or with birth defects ranging from minor to severe. One of Pakistan’s serious health problems that requires immediate attention is maternal and child health.