Abstracts
Theme: Health
Panel: Critical Issues in Pakistan’s Health Care
Session II: Health Policy/HIV AIDS/Service Delivery
 Proposing Health Sector Reforms for Maternal and Neonatal Health in Pakistan
Shafqat Shehzad* and Farid Midhet**
Pakistan’s current health system is becoming obsolete in the face of health sector reforms being introduced in other developed and developing countries. The new priorities, in changing health systems, aim at expanded access to health services and removing inequality and inefficiency in services delivery. Thus, the process of health sector reforms aims to introduce new national health policies that improve health outcome through change in existing priorities and organizational structures. Pakistan is going through both demographic and epidemiological transitions, where age structures are changing and fertility and mortality rates are declining. However, by comparative standards, such macro-level health indicators still lag behind other developing countries. Public health services are of poor quality and there is a big gap in peripheral facilities in the public sector and their utilization rates. Hence, there is a need for reforms to correct unproductive expenditures in Pakistan’s health care that do not result in positive health outcome.
This paper integrates public and private health facilities into a National Health System (NHS). The proposed National Health System (NHS) will have the following features: decentralized and participatory management, semi-privatization of public health facilities, introduction of cost-sharing mechanisms with safety nets for the poor, integrated referral systems and emphasis on health maintenance. The authors review the recently proposed health sector reforms at the national and provincial levels, maternal and child health strategic framework and Poverty Reduction Strategy Papers to identify ways in which these can be incorporated into an integrated National Health System.
* Dr. Shafqat Shehzad is Research Fellow (Health), Sustainable Development Policy Institute, Islamabad, Pakistan.
** Dr. Farid Midhet is Director, Programs (Health), The Asia Foundation, Islamabad.
Issues in the Delivery in Health Care: Some Policy Options
Asma Bokhari* and Zafar H. Ismail**
The paper analyses the existing situation of health care specifically
in the Punjab and identifies the issues which lead to the failure of
both the public and the private health care system being unable to
provide affordable services of standard, particularly to the
poor. It suggests a set of policy options for improving the delivery
of health care services including improvements ranging from changes
in the institutional set-up from preventive health care to tertiary
services, regulation of the private sector and private practice, a
more rational structure in the use of human resources, the
introduction of alternate medicine and changes in medical education.
The approach of the paper will be both qualitative and quantitative analysis
that will highlight implications for health policy in Pakistan.
* Dr. Asma Bokhari is Director National AIDS Control Program in the Ministry of Health, Islamabad, Pakistan.
** Zafar H. Ismail, is Project Manager at Grant Thorton and consultant NACP, Islamabad, Pakistan.
Role of Information and Communications Technology (ICTs) in Promoting Access to Health Services in Remote Mountain Areas of Pakistan
Hans Frey, Shafqat Shehzad and Irfan Haye*
This research report presents findings of a model project that has been initiated with the financial support of IDRC’s ICT4D-programme and the technical support of COMSATS. Through this project, a telehealth centre has been established at Abdullah Hospital/Rahman Clinic, Skardu, where patients and doctors can consult medical specialists at COMSATS-Telehealth Resource Center, Islamabad, or where the communication facility exists, via e-mail/SMS-transfer of medical history and diagnostic reports, and where required via video-conferencing. A Patient Information Management System (PIMS) has been introduced through which a patient’s personal data are being recorded in a computer file and biomedical data are forwarded to the medical doctor on a computer screen at the consultation room in Islamabad.
The report presents initial findings of the project compiled through health records of some 500 patients in the remote area of Sakurdu. The study presents findings for access and utilization of health care services through information technology and explores effects on patients for reduction in travel time, seeking expert medical advice and costs. The initial findings present a success story where the model can be successfully replicated to other areas through the use of information technology in health.
* Dr. Hans Frey is the Director Baltistan Health and Education Project. Dr. Shafqat Shehzad is Research Fellow (Health), Sustainable Development Policy Institute, Islamabad, Pakistan.
Irfan Haye is Program Manager COMSATS.
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