Pakistan’s healthcare system is at a crucial juncture. Amidst the rapidly growing population and the escalating health challenges, existing healthcare policies fall short of addressing the country’s needs. In any society, a sturdy healthcare system is essential, especially within a developing country like ours. However, the current framework is plagued with inefficiencies, chronic underfunding, and glaring inequities, making it necessary to call for a comprehensive overhaul to ensure the well-being of all citizens.
The country’s healthcare policy is riddled with flaws. While initiatives like the Sehat Sahulat Program try to provide financial protection for medical treatments, their reach remains restricted, particularly in rural areas. Public health efforts are usually poorly executed, with little emphasis on long-term planning or preventive treatment. There is a lack of focus on equitable resource allocation, which complicates the situation, denying significant sectors of the population access to essential medical treatment.
Now let's delve into the major shortcomings of the current system. Despite the critical role of healthcare in national development, Pakistan’s healthcare expenditure remains majorly below international benchmarks, constituting less than 3% of its GDP (World Bank). Government-run healthcare institutions, which are supposed to serve the majority of the population, frequently lack even basic amenities, forcing quite a bit of the population to rely on the expensive private healthcare system.
There is no doubt about the fact that healthcare in Pakistan is heavily skewed towards urban centers, leaving rural populations deprived. Villages and small towns lack functional hospitals and clinics, leaving the local residents no choice but to travel long distances for treatment. This disparity not only heightens health inequities but also amplifies preventable mortality rates in rural areas. Moreover, public hospitals and clinics are overcrowded, and the struggle remains to cater to the growing demand. Research shows that the ratio of doctors, nurses, and other medical staff to patients is alarmingly low, which leads to long wait times and compromised quality care. Pakistan’s doctor-to-patient ratio is approximately 1:1,300, which is below the World Health Organisation's (WHO) recommended ratio of 1:1,000. This leads to patients facing poor diagnostic facilities and a shortage of specialised care.
Pakistan's healthcare expenditure has been consistently low, with public health spending around 1% of GDP in recent years. When considering both public and private expenditures, the total health expenditure is approximately 2.91% of GDP as of 2021
The current policies only focus on remedial interventions over prevention. Diseases such as hepatitis, tuberculosis, and diabetes are widespread but can be largely prevented with proper education and community health programs. The lack of awareness programs and preventive health measures paves the way for the country’s increasing disease burden. Furthermore, the private health sector is majorly dominating the country’s health terrain, usually providing better services but at a high cost. For low- and middle-income families, private healthcare is not affordable at all, leaving them vulnerable to meagre public services. In addition to this, the private sector operates with negligent regulation, leading to erratic quality and exploitative practices. Also, it is important to note that mental health remains one of the most neglected areas of the country’s healthcare system. Social stigma, paired with a stern shortage of trained mental health professionals, leaves countless individuals without the support they need. Policies addressing mental health are non-existent, further impeding the crisis.
Thus, keeping in view the shortcomings of Pakistan’s healthcare policies, it is safe to say that these policies have far-reaching implications. Preventable diseases continue to grasp precious lives as each day passes by. Pakistan has the highest rate of maternal, perinatal, and neonatal mortality globally. The maternal mortality ratio stands at 100,000 live births, which is more than double the sustainable development goal 3, which focuses on "Good Health and Well-Being." Specifically, SDG 3.1 aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. This goal stresses the importance of addressing maternal health as a critical component of sustainable development. Additionally, the infant mortality rate was reported at 51% (per 1,000 live births) in 2022, according to the World Bank collection of development indicators. These challenges have a direct impact on national productivity and economic growth since an ill workforce is unable to contribute effectively to the country’s development.
To rectify the deficiencies in the country’s healthcare system, the government must prioritise healthcare in its budget, allocating more resources to improve infrastructure, technology, and workforce capacity. Pakistan's healthcare expenditure has been consistently low, with public health spending around 1% of GDP in recent years. When considering both public and private expenditures, the total health expenditure is approximately 2.91% of GDP as of 2021. In contrast, Rwanda’s health expenditure has consistently exceeded 6% of its GDP in recent years. In 2021, it was 7.32%, slightly down from 7.48% in 2020. This has led to major improvements in healthcare access and outcomes. Hence, Pakistan must increase its health budget to address the gaps. Resources should be allocated to modernising existing facilities, equipping rural clinics, and hiring more medical workers.
A national mental health policy must be implemented to create greater awareness, diminish stigma, and make services available
Another primary focus should be the expansion of healthcare facilities into the rural areas. Countries such as Bangladesh have effectively adopted community-based health programs and mobile clinics to serve rural populations. Pakistan should imitate similar projects by deploying mobile health units, integrating telemedicine services, and offering financial and professional incentives to doctors who work in rural areas. These strategies can help to close the urban-rural gap and ensure equal access to care. In addition to this, improving the quality of public healthcare is equally important. Drawing on Cuba's strong public health system, Pakistan should invest in preventive care through community health workers and public education programs. This can help lower the number of cases of avoidable diseases such as hepatitis and tuberculosis.
The private healthcare industry should ideally be controlled to ensure affordability and quality. A case in point is India's implementation of the National Health Protection Scheme (Ayushman Bharat), which provides a model for balancing public and private healthcare services. Pakistan can implement similar restrictions to ensure that private providers fulfill standardised quality requirements while remaining affordable to patients. Additionally, a national mental health policy must be implemented to create greater awareness, diminish stigma, and make services available. Take South Africa as an example to integrate mental health into primary care, where investment in training more mental health professionals, setting up community-based systems of support, and nationwide public awareness campaigns must be made, which would have the ability to tackle the looming mental health crisis very effectively.
Pakistan’s healthcare system is in dire need of reform. The current policies fail to meet the demands of a growing population and address the inequities that plague the system. A reformed healthcare policy must focus on increasing funding, addressing rural health disparities, strengthening public health infrastructure, and ensuring affordability through regulation of the private sector. The soaring ambition of a healthier population, a life of improved quality, and sustainable development for all citizens remains elusive. Yet, with a concerted effort from all stakeholders—the government, healthcare providers, and the people themselves—a fair, accessible, and effective healthcare system can be created.