Shortage of equipment, staff affects Pakistan’s health system


Shortage of equipment and staff affects Pakistan’s health system, while malnutrition, ill-health, and diseases are barriers to economic growth. There is a dire need to expand services delivery and address the shortfall in health-related human resources and making better use of technology.

“Public-private partnership needs to be encouraged and coverage of public health programmes like TB, Malaria, Hepatitis and other communicable diseases also needs to be expanded. Pakistan has a mix of public and private health service delivery system,” according to new Pakistan Economic survey.

Under 18th Constitutional Amendment, health service delivery has been transferred to the provinces. Pakistan Vision 2025, which was prepared in consultation with provinces, provides a roadmap which 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.

An inter-sectoral cooperation and sector-wide approaches are required to achieve the pioneering goals in the years ahead for which, there is a dire need to increase resource allocation, strengthening primary health care services and motivating the human resources employed in the health sector by good governance. The country’s ownership of the SDGs would be a prerequisite for health and development in future.

Cumulative health expenditures of federal and the provinces are estimated at Rs 384.57 billion for the fiscal year 2017-18 which is 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 Jul-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 the 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 Programme is a social protection initiative by providing financial protection cover to all people in phases and the data of the Benazir Income Support Programme will be used. Under this programme 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 both public and

private sector through a health card issued by a highly transparent mechanism. Thousand of poor patients have been benefited from the treatment facilities including deliveries, cardiac surgeries, cancer and other major diseases in the best private and government hospitals in their districts, without spending a single rupee.

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

In Pakistan, stunting, wasting and deficiency micronutrients are the endemic issue due to dietary deficiencies, poor maternal and child health and nutrition, and a high burden of morbidity. National Nutrition Programme (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 programme 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, Behaviour Change Communication (BCC) on breastfeeding, coordination with provinces and other relevant stakeholders for wheat flour fortification and universal salt iodization through National Food Agency (NFA and Provincial Fortification Alliances (PFAs), and establishment of infant feeding committees in provinces parallel to Individual and Family Business (IFB) for oversight.