Health care in Pakistan
Encyclopedia
Health care in Pakistan
is administered by Ministry of Health
. Like other South Asia
n countries, health and sanitation infrastructure is adequate in urban areas but is generally poor in rural areas. About 19% of the population and 30% of children under age of five are malnourished.
Ministry of Health
of Pakistan states that health expenditure of period 2007-08 was 3.791 billion Pakistani rupee
s while that spent on development was 14.272 billion.
in Pakistan
. Of the few studies available, syphilis
has been shown to form a third of the STIs, followed closely by gonococcal urethritis. Other studies, however, mention non-specific urethritis as the leading disease. The variation in figures probably depend upon the availability of resources to the workers and the population under study. The exact incidence of STDs is difficult to calculate, especially in Pakistan, because of lack of adequate health infrastructure and reporting system, lack of epidemiological studies, social shyness on part of the community in general and inadequate data on the male or female sex workers' community. A 2002 study examined the risk of Pakistani truck driver
s acquiring STIs. It found that multiple sexual partnerships were common, despite high levels of awareness of the sexual transmission of HIV. It reported that truck drivers did not realize the risks associated with unprotected sex, and that most did not believe AIDS existed in their country. The report recommended that condom use should be promoted, in particular by interpersonal communication.
AIDS
HIV/AIDS in Pakistan
The AIDS epidemic is well established and may even be expanding Pakistan. Risk factors are high rates of commercial sex and non-marital sex, high levels of therapeutic injections (often with non-sterile equipment), and low use of condoms Figures are based on dated opinions and inaccurate assumptions; and are inconsistent with available national surveillance data which suggest that the overall number may closer to 40,000.
Some of the main factors that account for this lack of progress with Family Planning include inadequate programs that don't meet the needs of women who desire family planning or counsel users of family planning about potential side effects, a lack of effective campaign to convince women and their families about the value of smaller families and the overall social mores of a society where women seldom control decisions about their own fertility or families.
Currently the government contributes about a third of all FP services and the private sector including NGOs the rest. Government programs are run by both the Ministries of Populaition Welfare and Health. The most common method used is female sterilization which accounts for over a third of all modern method users. Unfortunately this happens too late for most women as sterilized women are over 30 years of age and have 4 or more children. Condoms are the next most popular method.
released a report on The State of the World's Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Pakistan is 260. This is compared with 376.5 in 2008 and 541.2 in 1990. The under 5 mortality rate, per 1,000 births is 89 and the neonatal mortality as a percentage of under 5's mortality is 48. The aim of this report is to highlight ways in which the Millennium Development Goals
can be achieved, particularly Goal 4 – Reduce child mortality and Goal 5 – improve maternal death. In Pakistan the number of midwives per 1,000 live births is 10 and 1 in 93 shows us the lifetime risk of death for pregnant women.
'Pakistan Cancer Care Welfare Society' (PCCWS) is a no-profit public welfare organization registered in Pakistan , aims to strive and raise awareness regarding cancer in Pakistan. PCCWS founded by Abdul Wahid Chaudhary back in 2006, now has more than 200 members and working to raise cancer awareness in lower Punjab at the moment. PCCWS works on monthly theme based calendar system as per published by American Society of Cancer and arranges lectures, seminars, presentations, campaigns all across rural and urban lower punjab. PCCWS provides local residents with easy, comprehensive, up-to-date cancer literature in Urdu language.
the state regulatory body has upwards of 6,200 registered dentists. The four year training culminates in achieving aBachelor of Dental Surgery (BDS) degree, which requires a further one year compulsory internship to be a registered dentist in Pakistan.
Pakistan
Pakistan , officially the Islamic Republic of Pakistan is a sovereign state in South Asia. It has a coastline along the Arabian Sea and the Gulf of Oman in the south and is bordered by Afghanistan and Iran in the west, India in the east and China in the far northeast. In the north, Tajikistan...
is administered by Ministry of Health
Ministry of Health (Pakistan)
The Ministry of Health of Pakistan is a government agency responsible for Pakistan's health system. It is a branch of the Government, that is the department for provision of medical services, responsible to frame the health policies and to enforce the same at a national level...
. Like other South Asia
South Asia
South Asia, also known as Southern Asia, is the southern region of the Asian continent, which comprises the sub-Himalayan countries and, for some authorities , also includes the adjoining countries to the west and the east...
n countries, health and sanitation infrastructure is adequate in urban areas but is generally poor in rural areas. About 19% of the population and 30% of children under age of five are malnourished.
Ministry of Health
Ministry of Health (Pakistan)
The Ministry of Health of Pakistan is a government agency responsible for Pakistan's health system. It is a branch of the Government, that is the department for provision of medical services, responsible to frame the health policies and to enforce the same at a national level...
of Pakistan states that health expenditure of period 2007-08 was 3.791 billion Pakistani rupee
Pakistani rupee
The rupee is the currency of Pakistan. The issuance of the currency is controlled by the State Bank of Pakistan, the central bank of the country. The most commonly used symbol for the rupee is Rs, used on receipts when purchasing goods and services. In Pakistan, the rupee is referred to as the...
s while that spent on development was 14.272 billion.
| Fertility rate | 4.1% |
| Contraceptive prévalence rate | 30% |
| Population growth rate | 1.8 |
| Malaria Malaria Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases... l parasite incidence |
0.07% |
| Incidence of tuberculosis Tuberculosis Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body... |
0.18% |
Infectious diseases
Priority diseases
Most common and lethal diseases in Pakistan include:- Acute respiratory infection (51%): Among the victims of ARI, most vulnerable are children whose immune systems have been weakened by malnutrition. In 1990, National ARI Control Programme was started in order to reduce the mortality concerned with pneumoniaPneumoniaPneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...
and other respiratory diseases. In following three years, death rates among victims under age of five in IslamabadIslamabadIslamabad is the capital of Pakistan and the tenth largest city in the country. Located within the Islamabad Capital Territory , the population of the city has grown from 100,000 in 1951 to 1.7 million in 2011...
had been reduced to half. In 2006, there were 16,056,000 reported cases of ARI, out of which 25.6% were children under age of five. - Viral HepatitisViral hepatitisViral hepatitis is liver inflammation due to a viral infection. It may present in acute or chronic forms. The most common causes of viral hepatitis are the five unrelated hepatotropic viruses Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, and Hepatitis E...
(7.5%): Viral Hepatitis, particularly that caused by types B and C are major epidemics in Pakistan with nearly 12 million individuals infected with either of the virus. The main cause remains massive overuse of therapeutic injections and reuse of syringes during these injections in the private sector healthcare. - MalariaMalariaMalaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
(16%): It is a problem faced by the lower class people in Pakistan. The unsanitary conditions and stagnant water bodies in the rural areas and city slums provide excellent breeding grounds for mosquitoes. Use of nets and mosquito repellents is becoming more common. A programme initiated by the government aims to bring down malarial incidence below 0.01% by the year 2011. In Pakistan, malarial incidence reaches its peak in September. In 2006, there were around 4,390,000 new reported cases of fever. - DiarrheaDiarrheaDiarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
(15%): There were around 4,500,000 reported cases in 2006, 14% of which were children under the age of five. - Dysentry (8%) and ScabiesScabiesScabies , known colloquially as the seven-year itch, is a contagious skin infection that occurs among humans and other animals. It is caused by a tiny and usually not directly visible parasite, the mite Sarcoptes scabiei, which burrows under the host's skin, causing intense allergic itching...
(7%) - Others: goiter, hepatitisHepatitisHepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat- , meaning liver, and suffix -itis, meaning "inflammation"...
and tuberculosisTuberculosisTuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
Controlable diseases
- CholeraCholeraCholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...
: As of 2006, there were a total of 4,610 cases of suspected cholera. However, the floods of 2010 suggested that cholera transmission may be more prevalent than previously understood. Furthermore, research from the Aga Khan University suggests that cholera may account for a quarter of all childhood diarrhea in some parts of rural Sindh. - Dengue feverDengue feverDengue fever , also known as breakbone fever, is an infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles...
: An outbreak of dengue fever occurred in October 2006 in Pakistan. Several deaths occurred due to misdiagnosis, late treatment and lack of awareness in the local population. But overall, steps were taken to kill vectors for the fever and the disease was controlled later, with minimal casualties. - MeaslesMeaslesMeasles, also known as rubeola or morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses...
: As of 2008, there were a total of 441 reported cases of measles in Pakistan. - Meningococcal meningitis: As of 2006, there were a total of 724 suspected cases of Meningococcal meningitis.
- PoliomyelitisPoliomyelitisPoliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route...
: Pakistan is one of the few countries in which polio has not been eradicated. As of 2008, there were a total of 89 reported cases of polio in Pakistan.. Polio cases may be on an increase. The year 2010 saw an increase in the number of cases as well identification of polio from new locations. Experts from the national program and the WHO felt that the new cases identified from southern Punjab and northern Sindh may have resulted from importation of infections from other locations in Pakistan. Locations in FATA and Khyber Pakhtunkhwa remain hosts for year round persistence of infection and environmental sampling by the national program and WHO suggests that polio remains endemic in many other parts of the country.
Sexually transmitted diseases
It is difficult to show a reliable breakup of STDsSexually transmitted disease
Sexually transmitted disease , also known as a sexually transmitted infection or venereal disease , is an illness that has a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex...
in Pakistan
Pakistan
Pakistan , officially the Islamic Republic of Pakistan is a sovereign state in South Asia. It has a coastline along the Arabian Sea and the Gulf of Oman in the south and is bordered by Afghanistan and Iran in the west, India in the east and China in the far northeast. In the north, Tajikistan...
. Of the few studies available, syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...
has been shown to form a third of the STIs, followed closely by gonococcal urethritis. Other studies, however, mention non-specific urethritis as the leading disease. The variation in figures probably depend upon the availability of resources to the workers and the population under study. The exact incidence of STDs is difficult to calculate, especially in Pakistan, because of lack of adequate health infrastructure and reporting system, lack of epidemiological studies, social shyness on part of the community in general and inadequate data on the male or female sex workers' community. A 2002 study examined the risk of Pakistani truck driver
Truck driver
A truck driver , is a person who earns a living as the driver of a truck, usually a semi truck, box truck, or dump truck.Truck drivers provide an essential service to...
s acquiring STIs. It found that multiple sexual partnerships were common, despite high levels of awareness of the sexual transmission of HIV. It reported that truck drivers did not realize the risks associated with unprotected sex, and that most did not believe AIDS existed in their country. The report recommended that condom use should be promoted, in particular by interpersonal communication.
AIDS
HIV/AIDS in Pakistan
HIV/AIDS in Pakistan
HIV is not currently a dominant epidemic in Pakistan. However, the number of cases is growing. Moderately high drug use and lack of acceptance that non-marital sex is common in the society have allowed the AIDS epidemic to take hold in Pakistan, mainly among injection drug users, some male sex...
The AIDS epidemic is well established and may even be expanding Pakistan. Risk factors are high rates of commercial sex and non-marital sex, high levels of therapeutic injections (often with non-sterile equipment), and low use of condoms Figures are based on dated opinions and inaccurate assumptions; and are inconsistent with available national surveillance data which suggest that the overall number may closer to 40,000.
Family planning
The government of Pakistan wants to stabilize the population (achieve zero growth rate) by 2020. And maximizing the usage of family planning methods is one of the pillars of the population program. The latest Pakistan Demographic and Health Survey (PDHS) conducted by Macro International with partnership of National Institute of Population Studies (NIPS) registered family planning usage in Pakistan to be 30 percent. While this shows an overall increase from 12 percent in 1990-91 (PDHS 1990-91), 8% of these are users of traditional methods. Approximately 10 million women use any form of family planning and the number of urban family planning users have remained nearly static between 1990 and 2007. Thus, fertility remains high, at 4.1 births per woman. Owing to such high fertility levels, Pakistan's overall population growth rate is much higher than elsewhere in South Asia (1.9 percent per year).Some of the main factors that account for this lack of progress with Family Planning include inadequate programs that don't meet the needs of women who desire family planning or counsel users of family planning about potential side effects, a lack of effective campaign to convince women and their families about the value of smaller families and the overall social mores of a society where women seldom control decisions about their own fertility or families.
Currently the government contributes about a third of all FP services and the private sector including NGOs the rest. Government programs are run by both the Ministries of Populaition Welfare and Health. The most common method used is female sterilization which accounts for over a third of all modern method users. Unfortunately this happens too late for most women as sterilized women are over 30 years of age and have 4 or more children. Condoms are the next most popular method.
Maternal and child health
In June 2011, the United Nations Population FundUnited Nations Population Fund
The United Nations Population Fund is a UN organization. The work of the UNFPA involves promotion of the right of every woman, man and child to enjoy a life of health and equal opportunity. This is done through major national and demographic surveys and with population censuses...
released a report on The State of the World's Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Pakistan is 260. This is compared with 376.5 in 2008 and 541.2 in 1990. The under 5 mortality rate, per 1,000 births is 89 and the neonatal mortality as a percentage of under 5's mortality is 48. The aim of this report is to highlight ways in which the Millennium Development Goals
Millennium Development Goals
The Millennium Development Goals are eight international development goals that all 193 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015...
can be achieved, particularly Goal 4 – Reduce child mortality and Goal 5 – improve maternal death. In Pakistan the number of midwives per 1,000 live births is 10 and 1 in 93 shows us the lifetime risk of death for pregnant women.
There is a huge imbalance in these figures. In Balochistan, for instance, the maternal mortality is 785 deaths per 100,000 live births which is nearly triple the national rate. It should be noted here that in rural Pakistan, maternal mortality is nearly twice than that in cities. The sad reality is that 80 per cent of maternal deaths are preventable.
Cancer care
Cancer information on Pakistan Approximately one in every 9 Pakistani women is likely to suffer from breast cancer which is one of the highest incidence rates in Asia.'Pakistan Cancer Care Welfare Society' (PCCWS) is a no-profit public welfare organization registered in Pakistan , aims to strive and raise awareness regarding cancer in Pakistan. PCCWS founded by Abdul Wahid Chaudhary back in 2006, now has more than 200 members and working to raise cancer awareness in lower Punjab at the moment. PCCWS works on monthly theme based calendar system as per published by American Society of Cancer and arranges lectures, seminars, presentations, campaigns all across rural and urban lower punjab. PCCWS provides local residents with easy, comprehensive, up-to-date cancer literature in Urdu language.
Resources
| Doctors (2009) | 139,555 |
| Dentists (2009) | 9,822 |
| Nurses (2009) | 69,313 |
| Midwives (2009) | 26,225 |
| Health visitors (2009) | 10,731 |
| Registered vets (2009) | 4,800 |
| Total Health Facilities | 13,937 | 103,708 beds |
| Hospitals | 968 | 84,257 beds |
| Dispensaries | 4,813 | 2,845 beds |
| Rural health centers | 572 | 9,612 beds |
| Tuberculosis clinic | 293 | 184 beds |
| Basic health units | 5,345 | 6,555 beds |
| M.C.H. centers | 906 | 256 beds |
Personnel
According to official data, there are 127,859 doctors and 12,804 health facilities in the country to cater for over 170 million people.Professional institutes
As of 2007, there were 48 medical colleges and 21 dental colleges in the country.- List of schools of medicine in Pakistan
- List of schools of dentistry in Pakistan
- List of schools of pharmacy in Pakistan
- List of schools of nursing in Pakistan
- List of schools of veterinary medicine in Pakistan
Nursing
Nursing is a major component of health care in Pakistan. The topic has been the subject of extensive historical studies, is a major issue in that country, and has been the subject of much scholarly discussion amongst academics and practitioners. In 2009, Pakistan’s government stated its intent to improve the country's nursing care.Dentistry
At present there are upwards of 20 dental schools (public and private) throughout Pakistan, according to the Pakistan Medical and Dental CouncilPakistan Medical and Dental Council
Pakistan Medical and Dental Council is the statutory regulatory authority for medical and dental education and practitioners in Pakistan. PMDC was established under Pakistan Medical and Dental Council Ordinance 1962 as a body corporate. It is part of International Community of Medical Regulatory...
the state regulatory body has upwards of 6,200 registered dentists. The four year training culminates in achieving aBachelor of Dental Surgery (BDS) degree, which requires a further one year compulsory internship to be a registered dentist in Pakistan.
Community medicine
Pakistan is committed to the goal of making its population healthier, as evidenced by the continuing strong support for the Social Action Program (SAP) and by the new vision for health, nutrition, and population outlined in the National Health Policy Guidelines published by the government.- Lady health workers: A recent initiative, lady health worker, has turned out to be a promising community-based health workerCommunity health workerCommunity health workers are members of a community who are chosen by community members or organizations to provide basic health and medical care to their community...
program. These workers bring health information, some basic health care and family planning services to doorsteps of women. Presently, 96,000 women are serving as in this initiative in their home villages.
- Telemedicine: Over the last five years, telemedicineTelemedicineTelemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities...
efforts have been attempted to connect rural population to doctors in the city. However, there has been limited success. A new initiative has begun in Karachi to connect hospitals and doctors to patients over the internet. Mediconnect, an organization aimed to develop community medicine in Pakistan, is creating a centralized database of all healthcare facilities in Pakistan with impartial ratings systems and instant online appointment bookings.