Is there a doctor in the house?


There’s a Healthcare crisis in Pakistan

It is indeed disillusioning to see that the health sector in Pakistan, which is deemed to be a paramount component of human well-being, is the most neglected. Pakistan’s government over the years has not prioritised health sector as expected for its improvement. Though the media often plays a pivotal role in highlighting the health issues such as breast cancer, spread of polio, tuberculosis and child death in Thar; a sound and effective debate on the causes of poor health services is always lacking.

The health indicators in Pakistan indicate that ineffective healthcare facilities are one of the greatest adversities facing Pakistan. At present, the infant mortality rate in Pakistan is 53.9 deaths per 1000 births compared with 39 in India, and 8.9 in SriLanka. The life expectancy in Pakistan for women is 67 years compared with 69 years in India, and 73 years in Bangladesh. Likewise, in Pakistan it is 65 years for men compared with 67 years in India and 70 years in Bangladesh. The maternal mortality rate in Pakistan is 178 per 100,000 live births compared with 167 in India, and 20 in Thailand.

Such appalling health indicators of Pakistan are attributed to the indifference of the government towards the health sector. The ratio of GDP to health spending in Pakistan is only 0.9%. This figure is relatively lower when compared against 3.4% of GDP spent on defence, and 2% of GDP spent on education. This reflects the pervasive negligence of the government in reformation of the health sector, which ultimately results in its underperformance. The current budget for fiscal year 2016/17 has allocated Rs 22.4 billion for its health as compared to Rs 11 billion in the previous fiscal year. However, there still stands a question mark as to whether the allocated sums could be effectively used or not to bring a marked change in the health sector than before.

Another major anomaly seen in the health sector is that there is a wide expenditure gap seen in the public and private health institutions across the country. The expenditure on public health institutions is merely 3% of the total health expenditure owing to which the public hospitals lack well-developed and effective healthcare facilities. It is a pity that the public at large especially the poor echelon of the society is deprived of quality and affordable healthcare facilities; as the government hospitals fail to provide timely effective and sound medical treatment. The limited purchasing power of the poor deprives them from accessing quality health facilities of the private hospitals whenever required. This makes them worse off, and often results in heartrending stories of their ruined lives and casualties.

On the other side of the spectrum, it is only the affluent strata of our society; which is privileged to afford an access to provision of quality medical treatment rendered by private hospitals whenever required. The private hospitals enjoy state of the art infrastructure with effective quality medical facilities. In contrast, the public hospitals lack basic health facilities, and are even deprived of adequate patient beds.

Such a bleak scenario of discrimination between the public and private hospitals is an outcome of negligence of the government. It is a shame for the government that healthcare is not an immediate priority rather it is on the backburner of the policy discourse. This negligence is counterproductive indeed as lack of equal accessible healthcare for all stratas of the society leads to an unhealthy population, which cannot substantially contribute to an economy.

The assertion that Pakistan is a developing nation with limited resources is insufficient in justifying its limited expenditure on public healthcare. Compared with other developing countries such as Thailand and Srilanka; it is known that the public expenditure accounts for most of health spending in these countries. Such developing countries are rapidly progressing in the field of health, and their invaluable experiences should be learnt and applied in Pakistan.

An effective action plan is immediately required to be formulated by the government for overcoming the health crisis in Pakistan. The government support in making healthcare services affordable and accessible to all is inevitably required. Health services require a political priority by the government to make it functional and effective. The elected representatives and public officials should consider health the backbone of its political issues. The support of well-informed public in activating public health units can also reap positive results for reformation of health institutions.