PAKISTAN

 Pakistan is one of the poorest country in the South East Asia and is ranked 145th of 190 countries on the Human Development Index. 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.

Health concerns

Infectious diseases

 

Priority diseases

Most common and lethal diseases in Pakistan include:

  • Acute respiratory infection (51%): Among the victims of ARI, most vulnerable are children whose immune systems have been weakened by malnutrition. In 1990, National ARI Control Programme was started in order to reduce the mortality concerned with pneumonia and other respiratory diseases. In following three years, death rates among victims under age of five in Islamabad had been reduced to half. In 2006, there were 16,056,000 reported cases of ARI, out of which 25.6% were children under age of five.
  • Viral Hepatitis (7.5%): Viral Hepatitis, particularly that caused by types B and C are major epidemics in Pakistan with nearly 12 million individuals infected with either of the virus. The main cause remains massive overuse of therapeutic injections and reuse of syringes during these injections in the private sector healthcare.
  • Malaria (16%): It is a problem faced by the lower class people in Pakistan. The unsanitary conditions and stagnant water bodies in the rural areas and city slums provide excellent breeding grounds for mosquitoes. Use of nets and mosquito repellents is becoming more common. A programme initiated by thegovernment aims to bring down malarial incidence below 0.01% by the year 2011. In Pakistan, malarial incidence reaches its peak in September. In 2006, there were around 4,390,000 new reported cases of fever.
  • Diarrhea (15%): There were around 4,500,000 reported cases in 2006, 14% of which were children under the age of five.
  • Dysentry (8%) and Scabies (7%)
  • Others: goiter, hepatitis and tuberculosis

  

Controlable 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.
  • Poliomyelitis: Pakistan is one of the few countries in which polio has not been eradicated. As of 2008, there were a total of 89 reported cases of polio in Pakistan.[5]. Polio cases may be on an increase. The year 2010 saw an increase in the number of cases as well identification of polio from new locations. Experts from the national program and the WHO felt that the new cases identified from southern Punjab and northern Sindh may have resulted from importation of infections from other locations in Pakistan. Locations in FATA and Khyber Pakhtunkhwa remain hosts for year round persistence of infection and environmental sampling by the national program and WHO suggests that polio remains endemic in many other parts of the country.

Maternal and child health

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. 

There is a huge imbalance in these figures. In Baluchistan, 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. 

  

 

© 2012 IMCHF

International Maternal & Child Health Foundation Canada (IMCHF)