Health Conditions in Pakistan
Haidari, Iqbal, Economic Review
Inspite of steady improvements in the health sector over the years the position is not yet satisfactory. The health status of the nation is characterized by a high rate of population growth of around 2.8 per cent per annum and infant mortality rate of 86 per thousand live births. The major killers are diarrhea and pneumonia in children, complications of pregnancy in women of child bearing age, accidents in adults and cardiovascular disease and cancer in the elderly. Drug abuse has emerged as a public health problem while malaria and tuberculosis continue to be a potential threat. Communicable, infectious and parasitic diseases remain a severe burden although recent gains have been made especially under the Expanded Programme of Immunization. Dental cares and gum diseases are on the increase. Cavitation of teeth affects children more than other age groups. Gums diseases affect a large number of population causing premature and massive loss of other wise sound teeth by the age of 40-50.
At present there is one doctor for 1,837 persons, one dentist for a population of 46,498, one primary health care facility for 14,900 persons (rural) and one hospital bed for 1,503 persons. Statistical Appendix Table-1 gives some details of the facilities available during 1993 to 1995-96. The problems being faced by the health sector include:
a) inadequate primary health care (PHC).
b) high rate of population growth
c) prevalence of communicable diseases
d) managerial deficiencies.
e) inadequate funding
f) manpower imbalances.
Besides there are other contributing factors like malnutrition, inadequate water supply, lack of inter-sectoral coordination and environmental pollution.
Primary Health Care
In the rural areas Basic Health Units and Rural Health Centres (BHUs/RHCs) have been set up to provide PHC. However, they are a long way from realizing their service goals. At the village level there is no organized public sector health system and no linkage with the dai. There is no community involvement with the management of health services which is contrary to the basic philosophy of PHC. In the urban areas PHC is provided through PHC facilities of local government and through outpatient departments of secondary and tertiary hospitals. These health outlets have serious shortage of medicines, equipment and work space.
High Rate of Population Growth
The population of Pakistan has increased nearly four times since independence. Most of the increase took place during the last two decades. the country is in the middle of a classical demographic transition. Mortality in general has dropped as a result of modern medical practices and rising living standards. Fertility has not yet reduced. The result is a very high rate of growth of the population. The population consists predominantly of young age groups so that as much as 46 per cent of the population is constituted by people under the age of 15 years. If to this were added the percentage of women in the child bearing period of life then almost 50-60 per cent of the population would consist of individuals in the biologically vulnerable period of life. The implication of such a demographic pattern on the health programme are obvious viz. maternal and child health (MCH) services should feature strongly in the nation's health programmes.
Prevalence of Communicable Diseases
Communicable diseases can be considered under three headings:
a) Preventable Infectious Diseases: According to a Joint Review (GOP/International Agencies (71 per cent of the children were fully immunized against six preventable diseases of childhood in 1990. The same percentage of mothers were immunized against tetanus in the corresponding period. It is expected that the coverage is around 80 per cent during 1993. The use of oral dehydration salts (ORS) in diarrhoea is estimated at 85 per cent. Programmes for control of mortality from acute respiratory tract infections are well under way. …