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Healthcare in Pakistan is administered mainly in the private sector which accounts for approximately 80% of all outpatient visits. The public sector was until recently led by the Ministry of Health, however the Ministry was abolished in June 2011 and all health responsibilities (mainly planning and fund allocation) were devolved to provincial Health Departments which had until now been the main implementers of public sector health programs. Like other South Asian 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 rupees while that spent on development was 14.272 billion.[1]
| Fertility rate | 4.1% |
| Contraceptive prévalence rate | 30% |
| Population growth rate | 1.8 |
| Malarial parasite incidence | 0.07% |
| Incidence of tuberculosis | 0.18% |
Most common and lethal diseases in Pakistan include:
It is difficult to show a reliable breakup of STDs 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 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.[6]
HIV/AIDS in PakistanThe AIDS epidemic is well established and may even be expanding Pakistan. Risk factors are high rates of commercial sex and non-marital sex,[7][8] high levels of therapeutic injections (often with non-sterile equipment),[9][10] and low use of condoms [11] The former National AIDS Control Programme (it was devolved with the Health Ministry) and the UNAIDS state that there are an estimated 97,000 HIV positive individuals in Pakistan. 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.[12]
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.[13] 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 7 million women use any form of family planning and the number of urban family planning users have remained nearly static between 1990 and 2007. Since a majority of contraception users are sterilized (38%), the actual number of women accessing any family planning services in a given year are closer to 3 million with nearly half buying either condoms or pills from stores directly. Government programs by either the Health or Population ministries together combine to reach less than 1 million users annually. 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. However the single most important factor that has confounded efforts to promote family planning in Pakistan is the lack of consistent supply of commodities and services. Indeed, the unmet need for contraception has remained high at around 25% of all married women of reproductive age (higher than the proportion that are using a modern contraceptive) and historically any attempt to supply commodities has been met with extremely rapid rise (over 10% per annum) in contraception users compared with the 0.5% increase in national CPR over the past 50 years.
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.
In June 2011, the United Nations Population Fund 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.[14]
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.[15]
Cancer information on Pakistan [16] Approximately one in every 9 Pakistani women is likely to suffer from breast cancer which is one of the highest incidence rates in Asia.[17]
'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.
| 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 |
According to official data, there are 127,859 doctors and 12,804 health facilities in the country to cater for over 170 million people.[18]
Many Pakistani doctors and medical professionals choose to migrate to other countries, contributing to a brain drain and chronic skills shortage in the country. In the United States alone, there are over 17,000 doctors of Pakistani origin.[19] Pakistan is the fourth highest source of International medical graduate doctors in the U.S[20] as well as the fourth highest source of foreign dentists licensed in the United States.[21]
As of 2007, there were 48 medical colleges and 21 dental colleges in the country.[1]
Nursing is a major component of health care in Pakistan. The topic has been the subject of extensive historical studies,[22] is as of 2009[update] a major issue in that country,[23] and has been the subject of much scholarly discussion amongst academics and practitioners.[24] In 2009, Pakistan’s government stated its intent to improve the country's nursing care.[25]
At present there are upwards of 70 dental schools (public and private) throughout Pakistan, according to the Pakistan Medical and Dental Council the state regulatory body has upwards of 11500 registered dentists. The four year training culminates in achieving a Bachelor of Dental Surgery (BDS) degree, which requires a further one year compulsory internship to be a registered dentist in Pakistan.
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.
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