Without doubt, health is one of the major sectors in Pakistan that have not received the attention that they deserve over the last 70 years. The problems hobbling the growth of the health sector are many, including lack of sufficient budgetary allocations.
According to World Health Organization (WHO) recommendations, for adequate health coverage a country should allocate at least 5pc of its GDP to the sector. Developed countries spend as much as 8pc on health. As against this, Pakistan allocates less than 3pc of its GDP to the health sector and this amount too is not fully and usefully utilized for the benefit of the people.
Given the importance of the sector, the government needs to make health one of its top priorities. Without a healthy nation, a country cannot achieve optimum social and economic development. To this end, the government should allocate at least 5-6 percent of the GDP to the health sector.
Due to lack of sufficient funds, the health infrastructure has remained underdeveloped. Hospitals lack basic health facilities like X-ray, ventilators, ultrasound and other equipment. The number of hospitals and healthcare units is also very low. The infrastructure of the Basic Health Units (BHU) and Rural Health Centres (RHC) in Pakistan is woefully inadequate and poorly maintained. Ambulances are not available in required numbers: as such necessary health services cannot be provided to people in times of emergency.
According to WHO, the doctor-to-patient and doctor-to-nurse ratio should at least be 1: 100 and 1:4 respectively. But the doctor-to-patient, doctor-to-nurse, and nurse-to-patient ratios in Pakistan are 1:1300 and 1:2 and 1:20 respectively. A highly unsatisfactory situation, indeed.
To make matters worse, the health sector suffers from an acute shortage of trained and skilled workforce at both urban hospitals and rural dispensaries as a result of which the ailing public is poorly served at both urban hospitals and rural dispensaries.
To take care of this problem, not only should the standard of medical education be improved but also in-service refresher courses should be introduced and training workshops regularly conducted. The shortage of paramedical staff calls for special attention in this context.
There is also an urgent need to set up more medical colleges to produce more health professionals to take care of the health needs of a burgeoning population. In the last few years a large number of doctors, nurses and paramedics have left the country and are working in the US, Europe, the UAE, Saudi Arabia and other countries. This has created a serious dearth of health workers in hospitals in Pakistan. We should attract back this medical talent by offering them handsome salaries and perks. This step will go a long way in overcoming the shortage of qualified and trained medical personnel in the country.
A serious problem of the health sector in Pakistan today is the rising prices of medicines which have gone out of the reach of the common man. In the last few years, the prices of medicines in the country have doubled and tripled. According to a recent survey, over 60 percent of health expenditure is borne by patients from their pocket. Covid 19 has further complicated the situation. High prices are one of the major obstacles to access to medicines by the average man in Pakistan. Medical treatment and related services are also too expensive.
Over the years, no government in Pakistan cared to set up a free healthcare system for the poor. In the cities large medical complexes in the private sector have sprouted to cater to the rich. But the poor are at the mercy of the ill-equipped and poorly staffed public hospitals. More than 35% of the population in Pakistan lives below the poverty line. These people have no access to professional medical care and turn to quacks for “relief”.
It is good that the Pakistan Tehreek-i-Insaf (PTI) government has lately introduced a health card system which will enable the poor to access quality medical service both in the private and public sectors. At the same time, a health insurance scheme for the poor should be started to benefit all sections of society.
As pointed out by many experts, the healthcare system in Pakistan needs an effective mechanism of monitoring and evaluation so that its shortcomings are identified and removed. A strong system of accountability will also take care of efficiency and quality issues in our hospitals.
Health is a basic need and it is the responsibility of the government to provide the facility to the people. Riasat-e-Madina which Prime Minister Imran Khan has set as his goal should make health one of its topmost priorities.