IN Pakistan, limited healthcare infrastructure and uneven distribution of resources often mean that patients from rural and underserved areas face significant delays in accessing tertiary healthcare. A poignant example is that of a patient in critical condition, who, after traveling 8 hours to reach a tertiary care hospital in Rawalpindi from lower Punjab, found treatment only at this final stage due to inadequate local facilities. This scenario is common as patients bypass local health centres, straining tertiary care resources and bed occupancy for cases that could be managed closer to home.
Family Physicians and General Practitioners (GPs) play a crucial role in disease management and reducing disease burden. They serve as the first line of care, providing screening, managing mild to moderate cases and reducing the load on tertiary facilities. Family physicians can contribute significantly by managing communicable and non-communicable diseases, thereby improving the nation’s Disability-Adjusted Life Years (DALYs) and Quality-Adjusted Life Years (QALYs).
However, there are challenges. Weak integration between private and public healthcare centres, inadequate follow-up systems and lack of patient information management often result in treatment complications, drug resistance and rising patient mistrust. Family physicians often lack structured catchment areas, leading to poor distribution of services and inconsistent patient management. Though the Healthcare Commission has provided guidelines for GPs, enhanced efforts are required to ensure compliance and accountability.
A stronger network of primary healthcare, focused on Family Physicians, could be achieved through policies such as registration of all clinics at Union Council (UC) offices and data synchronization with the Healthcare Commission. Currently, there is an absence of a unified approach among healthcare levels. In European countries, GPs are established as the primary care providers for preventive and curative care. Pakistan could follow this model by encouraging GPs to obtain at least basic public health certification to increase their capacity for screening and prevention of diseases. This approach would enable GPs to predict and reduce future disease burdens, contributing to national health improvement.
An integrated Family Physicians and Public Health Information System (FPPHIS) is proposed to link primary and secondary healthcare facilities with a comprehensive patient management system. Such a system would ensure timely access, record-keeping and follow-ups, particularly for rural areas. The proposed “National Policy for Integrated Healthcare Delivery Services” supports this integration and aligns with Sustainable Development Goals (SDGs), including SDG 1 (No Poverty), SDG 3 (Good Health and Well-being), and SDG 5 (Gender Equality).
The policy could alleviate financial stress on low-income families who frequently face high out-of-pocket healthcare costs due to inaccessible facilities and lack of nearby care. Enabling better-equipped primary and secondary care services would reduce long-distance referrals, cut travel expenses and prevent families from falling into poverty due to healthcare costs. In sum, an integrated healthcare and referral system would not only improve health outcomes but also advance the nation’s SDG 2030 goals by addressing poverty and health disparities and ensuring sustainable healthcare for all.
—The writer is contributing columnist, based in Rawalpindi.
