Name: Abdul Rafay

Sap ID: 20214

Subject: Pak Studies
Class: BBA-04
Submitted To: Mam Faiza Maryam
Riphah International University, Islamabad

Report on Health Issues in Pakistan

Pakistan is ranked 122nd out of 190 countries in the World Health
Organization performance report. Pakistan ranks 154th among 195
countries in terms of quality and accessibility of healthcare, according to
a Lancet study.
According to the study Pakistan has seen improvement in healthcare
access and quality since 1990, with its HAQ index increasing from 26.8
in 1990 to 37.6 in 2016. Pakistan per capita income (PPP current
international $, 2013) is 4,920 and the total expenditure on health per
capita (intl $, 2014) is $129, which is only 2.6% of GDP (2014). The
gender inequality in Pakistan is 0.536 and ranks the country 147 out of
188 countries (2004). The total adult literacy rate in Pakistan is 55%
(2014) and primary school enrolment is 73%. Life expectancy at birth is
68 years (Male 65.8, female 67.9), Pakistan's population is around 185
million out of which more than 70 million people are living below the
poverty line. The proportion of population which has access to improved
drinking water and sanitation is 91% (2015) and 64% respectively.
Expenditure in health Pakistan in 2018 was mostly Out of Pocket
spending (OOPS), which is around 56.2% followed by the Government
health spending 35.5%
Primary Health Care
Primary Healthcare system is the very basic health system for providing
accessible, good-quality, responsive, equitable and integrated care.
Primary healthcare in Pakistan mainly consists of basic health units,
dispensaries, Maternal & child health centers (MNCH) and some private
clinics at community level. In Sindh (Province in Pakistan), Primary
healthcare activities are supported by government itself but managed by
external private & non-government organizations like People's primary
healthcare initiative (PPHI Sindh), Shifa foundation, HANDS etc.
Secondary Health Care
It mainly includes tehsil & district hospitals or some private hospitals.
Tehsil & district hospitals (THQs & DHQs) are run by the government,
the treatment under government hospitals is free of cost.
Tertiary Health Care
It includes both private and government hospitals, well equipped to
perform minor and major surgeries. There are usually two or more in
every city. Most of the Class “A” military hospitals come in this category.
Healthcare and stay comes free of charge in government hospitals. There
is also a 24 hours emergency care that usually caters to more than 350
patients every day.
Other health related services
The government of Pakistan has also started “Sehat Sahulat Program”,
whose vision is to work towards social welfare reforms, guaranteeing that
the lower class within the country gets access to basic medical care
without financial risks. Apart from that there are also maternal and child
health centres run by lady health workers that aim towards family
planning and reproductive health.
Main Health Issues and Controllable diseases
• Cholera: 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 fever: 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.
• Measles: 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.
• Cancer is another deadly disease that is one of the leading causes of
death in Pakistan. The two major cancer types that are widespread
in Pakistan are breast cancer and lung cancer. More than 40,000
women in Pakistan die every year because of breast cancer. There is
a lack of awareness and proper health care facilities due to which
cancer is rising at an alarming rate in Pakistan. On the other hand,
lung cancer is caused mainly because of smoking as Pakistan is the
largest consumer of tobacco in South Asia.
• Ischemic Heart disease is one of the most fatal diseases in Pakistan.
Factors such as pollution, unhealthy food, unclean water, and
smoking give rise to this heart disease. In rural and slum areas of
Pakistan, people don’t have enough resources to treat themselves if
they suffer from heart disease. This results in causing further health
problems and even deaths.
• Stroke: Around 350,000 cases of stroke are reported in Pakistan
each year. Stroke is one of the leading causes of death in Pakistan.
Depressive symptoms in particular, but also the chronic stress in life,
increases the risk of older people having a stroke or transient
ischemic attack. There is a need for a better understanding of
important, potentially modifiable stroke risk factors, including stress
and negative emotions among the patients to avoid strokes.
• Diabetes: More than 7 million people are suffering from diabetes in
Pakistan right now. Lack of nutritious food and awareness is
increasing the number of diabetic patients in the country. According
to the study, by 2030 Pakistan will be among the top 5 countries
having the largest diabetic population in the world.
• Hepatitis A and E are formed through the consumption of unhealthy
food and drinking unclean water. Since the hygiene conditions are
far from satisfactory in the rural and slum areas of Pakistan, hepatitis
is increasing with each passing day. The symptoms of such hepatitis
include diarrhea, jaundice, and fever. Hepatitis E also affects the
urinary tract in the body. On the other hand, hepatitis B and C are
also very common all over Pakistan. Hepatitis B and C are formed
because of blood transfusions and sharing pieces of equipment such
as razors, toothbrushes, and other household articles.
• HIV/AIDS: According to the UNAIDS, it is estimated that there are
around 100,000 HIV positive cases in Pakistan. The major cause of
this disease in Pakistan is the use of infected syringes among drug
addicts. Sindh has the highest rate of HIV with more than 50,000
patients. The government needs to take serious action to prevent
HIV AIDS in Pakistan as the number of patients with this disease is
growing at an alarming rate with each passing year.
• Acute respiratory infection is the leading cause of death in
children of Pakistan. The main causes of this infection include
malnutrition, lack of vaccines, and awareness. In rural Pakistan,
women are unable to provide proper nutrition to their children due
 to a lack of finance. This results in many health complications in
their children.
• Maternal and Child Health: Mother and child health is a serious
issue that is widespread in rural areas than that in cities. Due to lack
of proper food, awareness, and treatment, women in rural areas
suffer during their pregnancy resulting in poor health of their babies.
In many cases, babies are born dead or they suffer from minor to
major birth defects. Maternal and child health is one of the serious
health issues in Pakistan which needs immediate action.
Covid-19 Pandemic:
From last two years, whole world including Pakistan is facing this Covid-
19 pandemic. COVID-19 pandemic and health emergencies also
determine the health status of a country. The novel coronavirus, COVID-
19 (or SARS-COV-2) is a highly communicable disease, labelled as a
modern-era pandemic and a public health emergency by the World Health
Organization. Spreading throughout the world, it has infected millions,
and claimed the lives of more than 5.27 million people, as of December
2021. Countries all over the world are faced with the unenviable challenge
of balancing the health of their citizens with stay-at-home orders, closure
of industries, etc and the need to ensure that social safety nets to maintain
the livelihoods of the poorest demographics also remain functional. In
Pakistan, COVID-19 cases were reported from Islamabad and Karachi on
February 26, 2020.
Pakistan being one of the densely populated countries in Asia, with a
population of 232 million, and Karachi being the largest metropolitan city
in Pakistan, has been greatly vulnerable to this outbreak. The
administration had a huge responsibility to constrain the spread through a
timely response and the adoption of appropriate measures to avoid any
major catastrophe. The disease was initially difficult to contain, especially
because of noncompliance of the general population to the necessary
measures and timely reporting of symptoms. Within 45 days, on April 10,
2020, Pakistan reported 4,601 confirmed cases with a death toll
approaching 66 individuals. The government of Pakistan has been lauded
by international organizations including the WHO (and rightly so) for
taking the necessary precautions and measures against the COVID-19
pandemic early on to guarantee not only the containment of disease spread
but also to fulfil its responsibility as a state toward its people and their
safety One of the first steps taken by the government was to develop a
functional National Command and Control Centre (NCOC) and to detect
the route of disease spread in Pakistan.
The origin of the virus was the first question; hence, detailed history-
taking of patients was crucial not only in understanding the outbreak but
also in determining the contacts of patients with other people in the
community. This helped in cordoning off areas or home-bounding people
who came in close contact with a patient with COVID-19. In addition to
this, patients with a recent international travel history were monitored
closely because many cases and persons are fully vaccinated, 27 million
have been administered the first dose. The government has announced
booster shots for overseas travellers to be administered at a cost of PKR
1,270. Whereas free booster vaccination is now offered to people above
50 years of age, health care providers and immune compromised patients.
So far, the government has spent more than US$ 1.6 billion on vaccine
and diagnostic services, which is an extra-ordinary response considering
difficult economic situation and high inflation rate. Partners have also
supported Pakistan to mitigate the risks related to COVID-19 pandemic.
COVID-19 poses major challenges to population health and well-being
globally and thwarts the progress in meeting SDGs and the WHO Triple
Billion targets. Disruptions of essential health services due to COVID-19
have been widespread due to the shortage of medicines, staff, diagnostics
and public transport services. Prior to the COVID-19 pandemic, positive
progress in health was being made. However, the progress is inadequate
for attaining the Triple Billion targets and health-related SDGs, calling for
more effective disease and injury prevention and control programmes.
Pakistan’s Lahore again tops world’s most polluted cities list
Pakistan’s second largest city Lahore has once again topped the daily
ranking of the most polluted cities in the world, leaving authorities
scrambling to fight the environmental crisis.
The air quality of the eastern city was recorded as 296, making it the most
polluted city in the world on Friday, according to IQ Air, a global
environmental think-tank.
Pakistani authorities blame industrial emissions, smoke from brick kilns
and vehicles, the burning of crop residue and general waste for being
behind air pollution and smog in Lahore.
Pakistan is responsible for less than one percent of global
carbon emissions but is among the top 10 most climate-vulnerable
nations.
Government Initiatives for Health in Pakistan
The biggest initiative is “Sehat Sahulat Programme” of present
Government. Sehat Insaf Card or Sehat Quomi Card, now the people of
Pakistan can use their ID cards as Sehat Insaf card for many health
services in many hospitals.
The SSP is an IP-only scheme, and is cashless to the insured beneficiaries.
There are no exclusions and all pre-existing conditions are covered. The
main benefits for Phase 1 are:
• Indemnity coverage for secondary IP hospital care up to 50,000
Rupees per annum per family
• Indemnity coverage for priority hospital care up to 250,000 Rupees
per family per annum5
.
• Priority care, as defined in the rules, is for the following conditions
only:
o Cardiovascular diseases
o Diabetes Mellitus complications
o Burns and road traffic accidents
o End stage renal disease and dialysis
o Chronic diseases
o Organ Failure Management
o Oncology
• Maternity care up to 17,000 Rupees per annum per family
• Transportation benefit for non-local beneficiaries of 350 Rupees per
discharge, also available to women who are discharged from local
district hospitals after receiving maternity services.

The End