Chap 2 – Choked Pipes

Health system is defined as ‘comprising all the organizations, institutions and resources that are devoted to producing health actions.

1. Service Delivery 2. Health Workforce 3. Information 4. Medical Products 5. Vaccines & Technologies 6. Financing, Leadership, and Governance

‘A health system in which out-of-pocket payments and market provision of services predominates as means of financing and providing services, respectively in an environment where publicly financed government health delivery coexists with privately financed market delivery.’

Tertiary Care Secondary Care Primary Health Care

Basic Health Unit: a medical facility situated in the smallest administrative unit of government (Union Council) with an average catchment population of 10,000 – 20, 000

Rural Health Center: an upgraded PHC facility located at the sub-district administrative unit at the junction of four or five Union Councils; the population served ranges from 20, ,000

First Level Care Facilities: comprise BHUs and RHCs

Maternal and Child health Centre: MCH Centre of the Department of Health

Family Welfare Clinic: family planning facility of the Ministry of Population Welfare

Lady Health Worker: village-based female community health worker

Tehsil Headquarter Hospital: secondary level hospital

District Headquarter Hospital: secondary level hospital

Over 12,000 FLCF in Pakistan 30% of which are non-functional

90,000 community-based female Lady health Workers Prevention, maternal and child health, and related family planning services to 55% population.

2740 Family Welfare Clinics (FWC) of Ministry of Population Welfare

965 Public Hospitals in Pakistan

Ambulatory Clinics Maternity Homes Private Dispensaries Diagnostic Facilities Private Hospitals Few large sophisticated private sector hospitals in major population centers. <10 private hospitals can be compared favourably with international hospital standards.

NGOs Charitable Organizations Trust-funded Organizations Pakistan’s largest and most effectively functioning ambulance network is owned and operated by a charitable trust – the Edhi Foundation. Family Planning Association of Pakistan – Rehnuma HIV/AIDS 74 large charitable hospitals with over 7000 beds

5.4/woman 4.1/woman

117/1000 live births 94/1000 live births

47% 35%

‘Although there have been some improvements in the health status of the Pakistani population over the last 62 years, key health indicators lag behind in relation to the international targets articulated in the Millennium Declaration and in comparison to averages for low income countries.’

Inadequate State Funding Burgeoning Unregulated Private Sector Lack of Transparency in Governance

63.8

68.7

4.1

29.6

61%

39%

54

78

94

47%

84%

58

7.4%

15.75%

91.5%

38.5 %

48.35%

13.7 %

7.65 %

1:1,326

1:22,662

1:3,039