Healthcare in Pakistan

Pakistan's health indicators, health funding, and health and sanitation infrastructure are generally poor, particularly in rural areas. About 19 percent of the population is malnourished—a higher rate than the 17 percent average for developing countries—and 30 percent of children under age five are malnourished. Leading causes of sickness and death include gastroenteritis, respiratory infections, congenital abnormalities, tuberculosis, malaria, and typhoid fever. The United Nations estimates that in 2003 Pakistan's human immunodeficiency virus (HIV) prevalence rate was 0.1 percent among those 15–49, with an estimated 4,900 deaths from acquired immune deficiency syndrome (AIDS). Hepatitis B and C are also rampant with approximately 3 million cases of each in the country at the moment.

According to official data, there are 127,859 doctors and 12,804 health facilities in the country to cater for over 170 million people. In 2007 there were 85 physicians for every 100,000 persons in Pakistan. Or in other words, one doctor for 1,225 people. There are only over 62,000 nurses all over Pakistan who are supplemented with a strong force of 96,000 Lady Health Workers (primary health care providers). According to the latest Ministry of Health Pakistan statistics, there were 13,937 health institutions in the country including 945 hospitals (with a total of 103,285 hospital beds), 4,755 dispensaries, 5,349 Basic Health Units (mostly in rural areas), 903 Mother and Child Care Centers, 562 rural health centers and 290 TB centers.

According to the World Health Organization, Pakistan's total health expenditures amounted to 3.9 percent of gross domestic product (GDP) in 2005, and per capita health expenditures were US$49. The government provided 24.4 percent of total health expenditures, with the remainder being entirely private, out-of-pocket expenses.

Nevertheless, 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 government's National Health Policy Guidelines up to 2010. An example of a promising recent initiative is the lady health worker (LHW) community-based program, which is bringing health information, some basic health care, and family planning services to women's doorsteps. Presently, 96,000 women are serving as LHWs in their home villages.

Over the last 5 years telemedicine efforts have been attempted to connect rural Pakistanis to doctors in the city. However, they have had limited success and have not affected the general population. A new initiative has begun in Karachi to connect hospitals and doctors to patients over the internet. MediConnect is creating a centralized database of all healthcare facilities in Pakistan with impartial ratings systems and instant online appointment bookings.

Former Prime Minister Benazir Bhutto wanted Pakistan to have universal healthcare. However, this is impossible in a country where only 2.5% of the total population pay income tax.

Infectious disease

Communicable diseases such as diarrheal diseases, respiratory infections, tuberculosis, and immunizable childhood disease still account for the majority of sicknesses and deaths in Pakistan. Pakistan is one of the few countries in which polio has not been eradicated.

Dengue fever

An outbreak of dengue fever occurred in October 2006 in Pakistan. Many cases were reported in major city hospitals. Several deaths occurred due to misdiagnosis, late treatment and lack of awareness in the local population. But overall, steps were taken to kill mosquitoes (vector for dengue fever) and the disease was controlled later, with minimal casualties.

Malaria

Malaria is a problem faced by the lower class and some of the upper class people in Pakistan. The unsanitary conditions and stagnant water bodies in the rural areas and city slums provide excellent breeding grounds for mosquitoes (Vector for Malaria). Whereas some people are now using nets and mosquito repellents, still a large population is at risk and large number of people die especially in the villages every year due to malaria.

Sexually transmitted diseases

It is difficult to show a reliable breakup of sexually transmitted infections (STIs) 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 STIs 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 drivers 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.

HIV/AIDS

Main article: HIV/AIDS in Pakistan

HIV is not a dominant epidemic in the adult population of Pakistan. Nevertheless, coupled with an extremely low awareness of HIV/AIDS in Pakistan (Pakistan Demographic Health Survey 2007), as well as a growing number of cases, particularly among key risk groups such as injection drug users and male sex workers (Nationa AIDS Control Programme 2008, The HIV Surveillance Reports 2005 to 2008), the AIDS epidemic is well established and may even be expanding Pakistan. The presence of risk factors, such as high rates of commercial sex and non-marital sex , high levels of therapeutic injections (often with non-sterile equipment), unscreened blood, and low condom use rates, makes the situation fertile for AIDS to become a major public health issue. The National AIDS Programme's latest figures show that over 4,000 HIV cases have so far been reported since 1986, but UN and government estimates put the number of HIV/AIDS cases between 70,000 and 80,000 with the vast majority going unreported due to social taboos about sex , and victims' fears of discrimination . However, these 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

Maternal health problems are also widespread, complicated in part by frequent births most of which take place at home under untrained supervision. Hence it is not very surprising to see 297 deaths for every 100,000 live births (MMR). The MMR translates lifetime risk of dying from complications related to childbirth as one in 89. In absolute number this amounts to 10,400 maternal deaths every year. Moreover, 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, the maternal mortality is nearly twice than that in cities. The sad reality is that 80 per cent of maternal deaths are preventable.

The infant mortality rate for Pakistan is 77 per 1,000 live births and the mortality rate for children under age five stands at 97.

Cancer

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.

See also

• Nuclear medicine in Pakistan
• Pakistan Pharmacists Society

==Shaukat Khanum Memorial Cancer Hospital== Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) is a state-of-the-art cancer centre located in Lahore, Punjab, Pakistan. It is a project of the Shaukat Khanum Memorial Trust, which is a charitable organization established under the Societies Registration Act XXI of 1860 of Pakistan. The institution is the brainchild of Pakistani cricket superstar, Imran Khan. The inspiration came after the death of his mother, Mrs. Shaukat Khanum, from cancer.

==Mission statement==

To act as a model institution to alleviate the suffering of patients with cancer through the application of modern methods of curative and palliative therapy irrespective of their ability to pay, the education of health care professionals and the public and perform research into the causes and treatment of cance

Pakistan Cancer Care Welfare Society (PCCWS)

File:Pccwslogo.png

Pakistan Cancer Care Welfare Society is a no-profit public welfare organization registerd in Pakistan , aims to strive and raise awareness regarding cancer in Pakistan. PCCWS founded by Dr. 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.

PCCWS Organization Structure

Dr. Abdul Wahid Chaudhary (Founder & President) Dr. Saleem Arshad (Chairman) Mr. Zaheer Ahmed (Vice President) Chaudhary Zahid Saleem (Gen. secretary) Omer Ali (Media/web/content administrator)

PCCWS Links

Pakistan Cancer Care Website

References

• D'Souza RM. Role of health-seeking behaviour in child mortality in the slums of Karachi, Pakistan. J Biosoc Sci. 2003 Jan;35(1):131-44.
• D'souza RM, Bryant JH. Determinants of childhood mortality in slums of Karachi, Pakistan. J Health Popul Dev Ctries. 1999 Fall;2(1):33-44.
• D'Souza RM. Housing and environmental factors and their effects on the health of children in the slums of Karachi, Pakistan. J Biosoc Sci. 1997 Jul;29(3):271-81.
• Rehan N. Profile of men suffering from sexually transmitted infections in Pakistan

External links

• Ministry of Health
• Women's Health in Pakistan

Doctors of the World