1. Pakistan

2. Pakistan is the seventh most populous country in the world
Pakistan – A Preview
Total Population – million
Male : Female Proportion – 52 : 48
Urban : Rural Proportion – 33.4: 66.6
Population Density / Sq. Km – 187/person
Pakistan is the seventh most populous country in the world

3. Demographic Indicators Pakistan is categorized by high mortality and population growth rates
Total Fertility Rate
Crude Birth Rate
Population Growth Rate
Infant Mortality Rate 82
Under 5 Mortality Rate 98
Maternal Mortality Ratio 350
Contraceptive Prevalence Rate 34
Economic survey of Pakistan

4. MGD 4: Reduce Child Mortality
INDICATORS FOR PAKISTAN
Under-five mortality rate
Infant mortality rate
Proportion of fully immunised children (12-23 months)
Proportion of children < 1 yr immunised against measles
Prevalence of under-weight children (under 5 yrs)
Lady Health Workers’ coverage of target population

5. MGD 5: Improve Maternal Health
INDICATORS FOR PAKISTAN
Maternal mortality ratio
Proportion of births attended by skilled birth attendants
Contraceptive prevalence rate
Total fertility rate
Proportion of women years who had given birth during last 3 years, and made at least one antenatal care consultation

6. MGD 6: Combat HIV/AIDS, Malaria and Other Diseases
INDICATORS FOR PAKISTAN
HIV prevalence among year old pregnant women
HIV prevalence among vulnerable groups (e.g., active sex workers)
Proportion of population in malaria risk areas using effective malaria prevention and treatment measures
Incidence of tuberculosis per 100,000 population
Proportion of TB cases detected and cured under Directly Observed Treatment Short Course (DOTS)

7. Reduce under – 5 mortality by two-thirds
MGD 4: Reduce Child Mortality (MGD Goals Report 2004 – Planning Commission of Pakistan)
Target 5
Reduce under – 5 mortality by two-thirds
Indicators
1990/91
2001/02
2002/03
2005/06
Targets
2011
2015
UNDER 5 MORTALITY RATE
140
105
103 80 65 52
INFANT MORTALITY RATE
102 77 75 63 50 40

8. STATE OF SUPPORTIVE ENVIRONMENT Reduce child mortality
MGD 4: Reduce Child Mortality Status at a Glance – Summary of Progress (MGD Goals Report 2004 – Planning Commission of Pakistan)
GOAL/
TARGETS
WILL TARGET BE REACHED?
STATE OF SUPPORTIVE ENVIRONMENT
Reduce child mortality
Probably
Potentially
Unlikely
Strong
Fair
Weak
Reduce under 5 mortality by 2/3

9. MGD 4: Reduce Child Mortality Capacity for Monitoring and Reporting Progress (MGD Goals Report 2004 – Planning Commission of Pakistan)
Quality and Regularity of Survey Information
Statistical Analysis
Statistics in Policy Making
Reporting and Dissemination of Information
Strong
Fair
Weak

10. Reduce maternal mortality by three quarters
MGD 5: Reduce Maternal Mortality (MGD Goals Report 2004 – Planning Commission of Pakistan)
Target 6
Reduce maternal mortality by three quarters
Indicators
1990/91
2001/02
2002/03
2005/06
Targets
2011
2015
Maternal mortality ratio
550
350
180
140
Births attended by skilled birth attendants
18%
40%
75%
90%
>90%

11. STATE OF SUPPORTIVE ENVIRONMENT Reduce child mortality
MGD 5: Reduce Maternal Mortality Status at a Glance – Summary of Progress (MGD Goals Report 2004 – Planning Commission of Pakistan)
GOAL/
TARGETS
WILL TARGET BE REACHED?
STATE OF SUPPORTIVE ENVIRONMENT
Reduce child mortality
Probably
Potentially
Unlikely
Strong
Fair
Weak
Reduce under 5 mortality by 2/3

12. MGD 5: Reduce Maternal Mortality Capacity for Monitoring and Reporting Progress (MGD Goals Report 2004 – Planning Commission of Pakistan)
Quality and Regularity of Survey Information
Statistical Analysis
Statistics in Policy Making
Reporting and Dissemination of Information
Strong
Fair
Weak

13. Baseline to be reduced by 50%
MGD 6: Combating HIV/AIDS, Malaria and Other Diseases (MGD Goals Report 2004 – Planning Commission of Pakistan)
Indicators
1990/91
2001/02
2002/03
2005/06
Targets
2011
2015
HIV prevalence among year old pregnant women
n/a
Nil
Baseline to be reduced by 50%

14. STATE OF SUPPORTIVE ENVIRONMENT
MGD 6: Combating HIV/AIDS, Malaria and Other Diseases Status at a Glance – Summary of Progress (MGD Goals Report 2004 – Planning Commission of Pakistan)
GOAL/
TARGETS
WILL TARGET BE REACHED?
STATE OF SUPPORTIVE ENVIRONMENT
Halt & begun to reverse
HIV / AIDS
Probably
Unlikely
No Data
Strong
Fair
Weak but improving

15. MGD 6: Combating HIV/AIDS, Malaria and Other Diseases Capacity for Monitoring and Reporting Progress (MGD Goals Report 2004 – Planning Commission of Pakistan)
Quality and Regularity of Survey Information
Statistical Analysis
Statistics in Policy Making
Reporting and Dissemination of Information
Strong
Fair
Weak

16. Issues Inadequate budgetary allocation High population growth rate
High fertility rate
Focus on curative medicine than the preventive treatment
Poor primary health care services
Lack of integration of vertical Preventive programs

17. Issues (cont’d) Inadequate social sector services delivery
Professional and managerial deficiencies
High prevalence of communicable diseases
Lack of integrated management of childhood illnesses
Malnutrition
Low skilled birth attendance rate

18. Issues (cont’d) Lack of awareness
Insufficient accessibility to maternal health care services especially emergency obstetric care
Lack of sex education for HIV/AIDS

19. Advantages / Strengths
Health System Infrastructure
Improving fiscal environment
Functional community-based LHWs
Devolution
Poverty-alleviation strategies

20. Government Programs - Health
National Program for Family Planning and Primary Health Care
Food and Nutrition
Women Health Project
Reproductive Health Project
Expanded Program on Immunization
National Maternal and Child Care Program

21. NCHD – Health Programs Focus is on ensuring access to health services
Primary Health Care Extension
National ORS Campaign
National School Health Program
Strengthening of Primary Health Care System

22. ROLE OF ICT IN HEALTH
ICTs provide opportunities for individuals, medical professionals and healthcare providers to
obtain information,
communicate with professionals,
deliver first-line support especially where distance is a critical factor and
promote preventive medicine programmes.

23. APPLICATION OF ICT IN HEALTH
At Referral Hospitals/Regional Hospitals/ District/Sub-district Health Centres, ICT enable:
more effective planning, decision-making and monitoring
improved shared service operations
greater access to more reliable health & population data
more effective resource management

24. APPLICATION OF ICT IN HEALTH (Cont’d)
Particular value for patients from improved information systems include:
development & use of electronic patient records
multi-media decision support systems
remote monitoring
updating patient notes using wireless Personal Digital Assistants (PDA)

25. E-HEALTH CHALLENGES
Creating ICT technologists and technicians in health sector at all levels
Attitudes about use of ICT/e-health technologies
Time - Man’s greatest enemy
Achieving consensus
Lack of investment in technology in healthcare sector
Lack of Stakeholder participation

26. Solutions are needed to solve these challenges.
E-HEALTH CHALLENGES
Solutions are needed to solve these challenges.
How can e-health help to meet health sector challenges?