What does health mean to this nation? Economic? Social? Political? But ever Health purely and essentially, Health? I presume Not. Ironically, health in this part of the world is only restricted to being the stepping-stone to the socio-economic development of a country. The truth, however, is that no matter how economic leaps a country makes, will never find itself competitive at the international fore until it improves its health care system and allow its people to enjoy a healthy and hearty life.
It must not come as a shock to any of us, that Pakistan is among the slowest developing countries of the world primarily because the health sector has not yet taken its roots despite reasonable foreign, if not governmental, along with workforce, and the like.
Sadly, even after sixty-five years of statehood, the country has not yet managed to come up with a standardized national health care policy. One that can ensure access to equitable and high quality health care for all, irrespective of class and status.
What’s more, the gap in the quality of health services between urban and rural areas has widened to an alarming extent.
Take our war-torn neighbor Afghanistan and how it is has managed to achieve a salient milestone in developing a standardized health policy and strategy for the country n partnership with the international community. Today, the Ministry of Public Health in Afghanistan is recognized and acknowledged as one of the best ministries among the developing countries.
On the other hand, the situation in Pakistan is incredibly sad and doleful. A little over a year ago, the Government abolished the Health Ministry and transferred power from the central government to provincial governments under the 18th constitutional amendment. This has made Pakistan perhaps the only country delivering below average health services without a central health ministry.
Rationally speaking, the decentralization or absence of health managements can improve the efficiency and quality of services and ensure equity in health care provided . What should not be missed is the strong accountability mechanisms, evidence based planning, good financial management and effective human resources planning and execution, that should come along. Otherwise, it’s bound to collapse. As we saw in January 2012, seventy patients of the Punjab Institute of Cardiology lost their lives at the hands of substandard medicine. And in November 2012, another eighteen people died after drinking a toxic cough syrup in Shahdra Town in Lahore.
It is also be looked at that owing to major socio-political instability and terrorists strikes, poor provinces like Baluchistan, Gilgit Baltistan and Azad Kashmir do not have their own resources and are mostly dependent on the central government. How will the provincial governments subsidize quality health care services if they are not even self-sufficient and autonomous?
One can also not choose to ignore how lack of an effective financial management system at the provincial level led to increased health care costs. Also, due to poor monitoring mechanism, vaccine preventable and other communicable diseases like polio, cases have resurfaced.
It is a sad truth that the provincial health ministries are clearly not prepared nor have the required resources to cope up with emergencies if an epidemic or a natural disaster strikes their region.
The outbreak of dengue fever in Lahore Punjab in 2011 and the Attabad Lake disaster in Gilgit Baltistan in 2010 are the two worst incidents that the nation has witnessed in the last few years. Even today, around 25,000 people in Gojal Hunza do not have access to immediate and formal emergency medical services. Thus, the plight is so profoundly rooted that it needs a lengthy span of time to pull Pakistanis out of the quagmire.
Who should we blame for the situation? Central government? or provincial government that pinpoints the central government for not providing it with enough resources? For me, it simply appears to be a blame-game. And this wont end until the federal government steps in and assists the provincial health ministries by establishing a central Health Ministry or similar regulatory authority across the nation.