Pakistan's Health System In Jeopardy - Shortage Of Trained Staff And Equipment

KARACHI- Shortage of proper equipment and trained staff has been greatly affecting Pakistan's health system, while malnutrition, poor health status and diseases have become barriers for our country’s economic growth. Our system is in dire need to expand its services and address the shortfall in health-related human resources and utilize technology, in order to enhance and reform our resources.

According to Pakistan’s new Economic Survey, Public-private partnership should be encouraged and coverage of public health programs like TB, Malaria, Hepatitis and other communicable diseases needs to be expanded.

Under the 18th Constitutional Amendment, health service delivery has been transferred to the provinces. Pakistan Vision 2025, provides a roadmap, that includes reducing the widespread prevalence of communicable diseases, disease surveillance, addressing inadequacies in primary-secondary health care facilities, correcting rural-urban biases, bridging basic nutritional gaps and improving the pharmaceutical sector to ensure the availability, affordability and quality of medication drugs. Inter-sectorial cooperation is required to achieve the goals, for which, resource allocation should increase and primary healthcare services are to be strengthened, under good governance. The country’s ownership of the SDGs would be a prerequisite for health and development in future.

Cumulative health expenditures of Federal sector and the Provinces are estimated at Rs 384.57 billion for the fiscal year 2017-18, being 31.75 percent higher than the actual expenditures of Rs 291.90 billion realized during the fiscal year 2016-17. A brief look into previous year’s performance reveals that, total health expenditures increased both in terms of growth and as a percentage of GDP. It grew by 29.54 percent to stand at Rs 291.90 billion during the fiscal year 2016-17 against Rs 225.87 billion in 2015-16. Encouragingly, health expenditures surpassed the budget allocation of Rs 273.34 billion set for 2016-17. While in terms of GDP, health expenditure increased to 0.91 percent during the fiscal year 2016-17 from 0.77 recorded in 2015-16. During the months of July-February, 2017-18 health expenditures consumed 43.5 percent of budget allocation to reach Rs 167.16 billion against the expenditure of Rs 121.57 billion in the comparable period of fiscal year 2016-17. In terms of growth, it increased by 37.51 percent. Viewed from GDP, it increased to 0.49 percent during July-February, 2017-18 from 0.38 percent recorded.

Prime Minister’s Health Program is a social protection initiative, providing financial protection to all people, for which the Benazir Income Support program’s data will be used. Under this program, provision of free of cost health insurance to 3.2 million families (in Punjab, Balochistan and FATA in its two phases) living below poverty line of US$2 per day to access cashless healthcare services package of 0.3 million rupees per family per year, available in public and private sector through a health card issued by a highly transparent mechanism. Thousands of poor patients have benefited from the treatment facilities including deliveries, cardiac surgeries, cancer treatments and other major diseases in the best private and government hospitals, all free of cost.

As of 31st January 2018, more than 1,655,657 families have been enrolled in Prime Minister’s National Health Program and more than 56,000 families have been treated for various illnesses from 125 empaneled hospitals across Pakistan. There is also an option of inter-district portability in the program which enables the enrolled beneficiaries and families to access quality indoor hospital services from any empaneled hospital, both in public and private sector.

In Pakistan, stunting, wasting and deficiency micronutrients has become an endemic issue due to dietary deficiencies, poor maternal and child health, compromised nutrition, and high burden of morbidity. National Nutrition Program (NNP) 2017-18, the largest survey has been initiated by Nutrition Wing at the federal level. It includes 120,000 households and district-specific data. It also includes Water, Sanitation and Hygiene (WASH) indicators, adolescent and childhood obesity and the process is being monitored and supervised through national steering and national technical committees for National Nutrition Survey (NNS).

Some of the key achievements of the program are as follows:  Development of National guidelines targeting different components of malnutrition, development of strategies for fortification, maintaining capacity building of provincial health departments on IYCF, revised Community Based Management of Acute Malnutrition (CMAM) guidelines, nutrition in emergencies, Behavior Change Communication (BCC) on breastfeeding, coordination with provinces and other relevant stakeholders for wheat flour fortification and universal salt iodization through National Food Agency and Provincial Fortification Alliances (PFAs), and establishment of infant feeding committees in provinces parallel to Individual and Family Business (IFB) for oversight.