PANORAMIC VIEW OF CHALLENGES AND OPPORTUNITIES FOR PRIMARY HEALTHCARE SYSTEMS IN PAKISTAN

Authors

  • Hina Sharif Al-Shifa School of Public Health, Rawalpindi
  • Ume Sughra Al-Shifa Trust Eye Hospital, Department of Public Health, Rawalpindi
  • Zahid Butt Al-Shifa Trust Eye Hospital, Department of Public Health, Rawalpindi

Abstract

Background: Pakistan has a broad system of primary health care facilities to achieve mission of “Health for all”. Over the last seven years health expenditure by government of Pakistan has been increased to attain this goal. This study was conducted with the aim to assess all blocks of service readiness (basic equipment, basic amenities, laboratory capacity, standard precautions and essential medicines) in public-primary health care facilities of tehsil Rawalpindi, Pakistan. Methods: A cross-sectional survey was carried out utilizing two separate structured questionnaires for basic health units and rural health centres. Information was collected from administrative heads along with other staff where required, of all public-primary health care facilities of Tehsil Rawalpindi. Data were analysed by using SPSS version.17. Results: A total of 26 health facilities were assessed; only 56% BHUs had a sign board that was available in readable form. BHUs with women medical officer as administrative head constituted 52%. Backup for electricity and toilet were the most neglected areas. Basic amenities, standard precautions and laboratory capacity of Basic Health Units (BHUs) showed a clear deviation from standards and is thus a challenge for Pakistan’s Primary Health care (PHC). On the other hand for Rural Health Centres (RHCs), most were on the way to meet expectations. Conclusion: Pakistan’s government is undoubtedly putting efforts in order to achieve targets of primary healthcare but it needs better mainstreaming of political, institutional and social commitments with modified standards for PHC.Keywords: Health systems; Primary healthcare; Service readiness; Healthcare facilities

References

WHO. The world health report 2000: health systems: improving performance. Geneva, Switzerland. World Health Organization; 2000.

Pakistan economic survey: Health and Nutrition[Internet]2015 June 02 [cited 2015 Dec 3] Available from: http://www.finance.gov.pk/survey/chapters_15/Highlights.pdf

Primary healthcare [Internet] 2014 [Cited 2015 May 3]. Available from:

http://www.euro.who.int/en/health-topics/Health-systems/primary-health-care

Nishtar S, Boerma T, Amjad S, Alam AY, Khalid F, ul Haq I, et al. Pakistan’s health system: performance and prospects after the 18th Constitutional Amendments. Lancet 2013;381(9884):3193–206.

Punjab Devolved Social Services Program. Minimum Service Delivery Standards for primary and secondary health care, Punjab: 2005. [Internet]. [cited 2015 Dec 3]. Available from: http://www.pdssp.gop.pk/downloads/documents/MSDS%20_Health_%20Final.pdf

WHO. Service Availability and Readiness Assessment (SARA) An annual monitoring system for service delivery. World Health Organization 2013. [Internet]. [cited 2015 Dec 3]. Available from: http://www.who.int/healthinfo/systems/SARA_Reference_Manual_Full.pdf

Mills A. Health care systems in low- and middle-income countries. N Engl J Med 2014;370(6):552–7.

Saleem M, Saeed A, Ahmad S, Ch AQ. Measuring Extent of Autonomy in Teaching Hospitals of Punjab : A Case of Services Hospital, Lahore. Eur J Bus Manage 2013;5(8):83–91.

National Institute of Population Studies (NIPS) [Pakistan] and ICF International. 2013. Pakistan Demographic and Health Survey 2012-13. Islamabad, Pakistan, and Calverton, Maryland, USA: NIPS and ICF International. [Internet]. [cited 2015 Dec 3]. Available from: http://www.nips.org.pk/abstract_files/PDHS%20Final%20Report%20as%20of%20Jan%2022-2014.pdf

Pakistan economic survey: Health and Nutrition [Internet]. 2013 June 01 [cited 2014 Dec 03]. Available from: http://finance.gov.pk/survey/chapters_13/11-Health%20and%20Nutrition.pdf

Bajwa A. Pakistan National Health Accounts 2011-12. Government of Pakistan Statistics Division Pakistan Bureau of Statistics Islamabad: 2014. [Internet]. [cited 2015 Dec 3]. Available from: http://www.pbs.gov.pk/sites/default/files/national_accounts/national%20health%20accounts/NHA_Report_2011-12.pdf

Mahmood A, Arshad MJ, Sadiq M. Situation Analysis of Health Facilities with Special Reference to Family Planning Services in Pakistan: 2012. [Internet]. [cited 2015 Dec 3]. Available from: http://www.popcouncil.org/uploads/pdfs/2012RH_FALAH_SituationAnalysisReport.pdf

Van Lerberghe W. The world health report 2008: primary health care: now more than ever. Geneva, Switzerland. World Health Organization; 2008.

Kenya Service Availability and Readiness mapping report. Kenya. Ministry of health: 2013. [Internet]. [cited 2015 Dec 3]. Available from: file:///C:/Users/Wali%20Muhammad/Downloads/SARAM_KEN_report_2013.pdf

Essential Package of Health Services for Primary Health Care, Government of Punjab, Pakistan: 2013. [Internet]. [cited 2015 Dec 3]. Available from: http://pspu2.pitb.gov.pk/system/files/Essential%20Package%20on%20Health%20Services%20(EPHS).pdf

Technical Resource Facility (2012). Health Facility Assessment, District Rawalpindi. [Internet]. [cited 2015 Dec 3]. Available from: file:///C:/Users/Wali%20Muhammad/Downloads/HFA-Rawalpindi.pdf

O’Neill K, Takane M, Sheffel A, Abou-Zahr C, Boerma T. Monitoring service delivery for universal health coverage: the Service Availability and Readiness Assessment. Bull World Health Organ 2013;91(12):923–31.

MoHSW. Tanzania service availability and readiness assessment (SARA) 2012. Dar es Salaam. Dar es Salaam, Tanzania: Ifakara Health Institute. 2013.

Leone SS. Ministry of Health and Sanitation: Multiple indicator survey 2010. 2012. p. 99.

Nishtar S, Bhutta ZA, Jafar TH, Ghaffar A, Akhtar T, Bengali K, et al. Health reform in Pakistan: a call to action. Lancet 2013;381(9885):2291–7.

Downloads

Published

2016-08-20