THERE is a very common saying that Health is Wealth. Good health is much important as the wealth to live a healthy, peaceful and prosperous life. Everyone knows that nothing is important in life than the good health. But when we realize the situation of our citizens who are suffering from poor health conditions since ages. Health care sector in Pakistan consist of private and public sector. The private sector serves nearly 70% of the population, is primarily a fee for service system and covers the range of health care provision from trained allopathic physicians to faith healers operating in the informal private sector. Neither private, nor non-government sectors work within a regulatory framework and very little information is available regarding the extent of human, physical, and financial resources involved. A survey by the Federal Bureau of Statistics in Pakistan indicated that about 50 percent of the basic health units were without doctors and that about 70 percent of government health facilities were without any female staff. Only about 56 percent of the country’s people have safe drinking water and just 24 percent have good sanitation.
Pakistan’s health system comprises many institutional actors. 26.32% of the population is covered for health care costs to a varying degree. Majority pay out-of-pocket (73.68%). Even when attending the government funded system, a patient is expected to cover various costs, user’s charges as well as medication and consumables. With more than 25% of the population below the poverty line of less than $1.00 a day, many spend catastrophically and are pushed into the ‘medical poverty trap’, or worst, do not receive any care. The infrastructure of public health service delivery of Pakistan consists of 5000 basic health units, 600 rural health centers, 7500 other first-level care facilities and over 100,000 lady health workers which are providing a basic health care a service across the country. As far as secondary care hospitals are concerned then there are 989 hospitals, at tehsil and district levels which are responsible for the referrals. Health care is sold in market on competitive basis like other commodities. So, only those who are able can buy this service. In Pakistan majority of those living in poverty are unable to purchase health care. This situation created a type of health sector which is pro rich in its access and thus less efficient, because the facilities are enjoyed by few, hence regional inequality in access and utilization of health services is increasing among different economic classes.
There are direct and indirect channels that contribute to lower health status in Pakistan which includes; lack of education (especially the mother’s education), poverty, high fertility, urban bias in health services provision, lack of planning and poor management and unnecessary delay in implementation, lack of evaluation process and low utilization of funds and corruption, lack of adequate health facilities, paramedical staff, low level of public spending (development spending is less than non-development spending), lower doctor patient ratio, prevalence of infectious diseases etc. About 80% of all major diseases such as diarrhea, cholera, typhoid, hepatitis is due to unsafe drinking water, inadequate sanitation and poor hygiene. Health and hygiene are causing major disruptions in the lives of people of Pakistan.
Children health in Pakistan is the most important national issues that have been given less attention. Many children in Pakistan are suffering from nutritional disorders which is common and particularly effect women and children. According to statistics, 27 infant deaths occur per thousand, 19 child deaths per thousand and 11 percentage babies are born with low birth weight. The child mortality in Pakistan is a major cause of concern, with every 1among 10 children dying before reaching the age of five and 1 among30, just after they are born. Pneumonia and air pollution seem to be the factors affecting the health of the children. On the other side women in rural Pakistan have lesser access to health care than men, because of absence of female doctors. Factors like lack of awareness regarding women’s health requirements, low literacy ratio, low social status and civil constrains on females are responsible for women’s below standard health. Pakistan is a signatory to the United Nations mandate of the MDGs, which are to be attained by 2015. While there have been successes in some areas, the country has not fared well in health-related goals.
Given the current situation, there is much that needs to be done, possibly in every domain of the health sector. Women and children still have the most to lose. There is a dire need for aggressive intervention to strengthen the network of health services, expand the outreach of health programmes and introduce technologies to improved monitoring and strengthening health care system. Pakistan is a country where the government spends less than 2% of the GDP on healthcare, the major portion of taxpayers does not enjoy health insurance, and in spite of having many laws of providing basic health care facilities to every citizen the implementation is zero. Care for the sick is a highly critical issue, yet it is ignored in Pakistan.
— The writer is a working lawyer, based in Islamabad.