Healthcare – Still an Expensive and Luxurious Idea in Pakistan
Health in Pakistan is an expensive idea. It is not a right but a privilege, afforded only by those who have wealth when, on the contrary, it should be within the reach of every citizen with equity and without discrimination. Until June’11, all health responsibilities (mainly planning and fund allocation) were led by the Ministry of Health; a federal constituency. Since then, the ministry was devolved to provincial Health Departments which had until now been the main implementers of public sector health programs.
Total spending on healthcare is equal to around 2.6% of GDP, which is considered low by world standards. Healthcare in Pakistan is administered mainly in the private sector which accounts for approximately 80% of all outpatient visits. According to the Planning and Development Division, at present there are 149,201 registered doctors in the country which means for every 1,206 people there is just one doctor. Internationally, this ratio is 1:1000.
12,804 health facilities in the country cater for over 170 million people. There are only 76,244 registered nurses in the country, and for every 1,665 people there is just one bed in the hospitals. For a country that has high rates of oral cancer, Pakistan has a total of 10,958 registered dentists, which means for every 16,426 people there is just one dentist. The concept of oral healthcare is considered a luxury for most.
According to a report by WHO Commission on Macroeconomics and Health, US$ 34 per capita is required for a package of essential health services in Pakistan. However, the total expenditure on health in Pakistan is US$ 18 per capita out of which the total government health expenditure is US$ 4 per capita. This demonstrates the vacuum of commitment to invest in the health sector, especially for the poor who do not afford private consultation.
In a nutshell, Pakistan’s health care system is inadequate, inefficient, and expensive; and comprises an under-funded and inefficient public sector along with a mixed, expensive and unregulated private sector. These poor conditions in the health sector may be attributed to a number of factors like poverty, malnutrition, unequal access to health facilities, inadequate allocation for health, and high population growth and infant mortality. For equity, efficiency and effectiveness of the health sector, inputs from both the public and private sector would be necessary. What can be done? WHO defined a framework towards the development of a better and efficient health care system and they emphasized on the importance of good and able governance rather than focusing on the finances.
If we talk about Pakistan then the government is spending 2.7% of their GDP in healthcare, which means we are talking about billion(s) of rupees. What truly needed in Pakistan right now is good governance that would regulate and govern the public and private healthcare imparting institutes all over the country.
Apart from governance, there should be authorities which closely monitor the smooth implementation and utilization of funds allocated. A good system can only be formed and made functional when it is transparent and corruption free. Pakistan is unfortunate to have political influences in almost every field of life, which in this case, should be looked after.
About the Author: Noman Khalid is a 4th year medical student at JMDC, Karachi, Pakistan. He is a student member of American College of Surgeons, member and college representative at Asian medical students association. Noman is also a member of PMSRS. He can be reached at [email protected]
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