Pakistan is one of the most populated countries nurturing more than 24 crores of people with inadequate economic resources. 30% population lives below the poverty line and the healthcare system offers extremely unequal services throughout the country. There is a desperate need to increase the health budget to improve its health delivery infrastructure. The government should prioritise constructing and upgrading healthcare facilities, particularly in rural and underserved urban areas to facilitate people to conveniently access the facility.
Oral health is an integral part of general health and the existence of inequalities in oral health care can well be anticipated in a country where merely 50% of the population has access to basic healthcare needs. It adversely impacts an individual’s quality of life, affecting speech, eating habits, and self-esteem. Oral health issues have an atrocious bearing on educational and employment prospects, as poor oral health leads to distress, sleeplessness, discomfort, pain, and aesthetic concerns. Many studies have shown that these issues increase absenteeism from school and workplace and contribute to or exacerbate systemic health conditions such as Diabetes, Low birth weight, Arthritis and Coronary Artery Diseases.
Disparities in oral healthcare frequently result in unnecessary suffering of fellow citizens as most of the oral health issues are largely preventable or manageable with a timely and affordable care system. On the contrary, untreated oral health problems lead to substantial difficulties, resulting in increased healthcare costs and lost productivity due to absence from work or school. It intensifies the burden on the country’s economy and taxpayers, whose number is negligible in comparison to the enormous population, have to swallow this bitter pill in the shape of increased taxes every year.
Addressing disproportions and discrepancies in oral health delivery requires a wide-ranging, collaborative effort involving policymakers, healthcare professionals, educators, and communities but improving access to affordable oral and dental healthcare is a quite complicated and challenge that necessitates addressing deficiencies present in the existing infrastructure of the country. Following strategic approaches may be proposed to bring in some preliminary changes;
- First and foremost is the emphasis on the prevention of dental ailments as prevention can save the economy from the unnecessary burden of treatment cost. The government should invest in public health campaigns to educate communities about the importance of preventive oral care practices acquiring, at-home oral hygiene maintenance and healthy lifestyle choices. Oral cancer is a notable health concern, particularly among the less educated sections of its population. The use of betel nut and gutka is prevalent and contributes significantly to the high incidence of oral cancer. Limited awareness about the risks associated with betel nut and gutka consumption among individuals with lower levels of education further exacerbates the problem. Efforts to enhance awareness and education on the association between these tobacco products and oral cancer are crucial in addressing and mitigating the impact of this public health concern.
- The establishment of community-based dental clinics is a dynamic option to bring services closer to underserved sections of our population. Mobile dental units may show great worth in areas where transportation is a problem for ailing individuals as these units bring dental care directly to the community, offering accessible, timely, and cost-effective solutions that contribute to improved oral health.
- Federal and provincial governments should device mechanism to identify the dental professionals who commit to serve in underserved rural and urban areas for a specific period of time. The governments should support and incentivize such dentists to motivate them to work with devotion, dedication and mental peace.
- Insurance companies can design and offer affordable dental insurance plans tailored to low-income individuals and families or they can provide flexible payment plans for dental treatments, making it easier for needy people to manage their expenses over time. Alternate insurance models should be explored to make dental care more affordable for a broader range of individuals as Muslims prefer Takaful over conventional insurance because Takaful aligns with Islamic principles and values.
Pakistan government has launched an insurance program under the universal health coverage initiative of the WHO as Sehat Sahulat Program. This initiative functions through a partnership between the government and private insurance firms, intending to deliver free healthcare services to disadvantaged and marginalized communities. The effectiveness of the program is uncertain due to the apparent lack of awareness about it and requires appropriate advertising.
- Limited availability of oral health care and the significant unmet oral health needs are extensively recorded, necessitating active engagement from the private sector. The public sector alone is insufficient to effectively address this critical situation. Therefore, the private sector should actively participate in sharing responsibilities. Encouragement should be provided to the private sector to contribute to reducing existing disparities and facilitating access to dental treatment for those in need through generous donations to philanthropic projects designed for free or low-cost dental care.
The deficiencies in the oral healthcare system of the country have been identified repeatedly in various studies. It is time for action for all stakeholders to sit together and formulate policies to reduce and rectify these disparities and shortcomings.