Arfan M. Afzal

University of the Punjab Gujranwala Campus

CONTENTS

OVER VIEW

HEALTH SYSTEM

PROBLEMS OF HEALTH

MAJOR DISEASES

TREATMENTS OF DISEASES

CONCLUSION

Overview Of Health Sector

Overview Of Health Sector

Definition

The World Health Organization defines a health system as “all the activities whose primary purpose is to promote, restore, or maintain health.

Overview of health system

In the entire span of human history, it is only during last 40 years that life expectancy has improved.

In Developing Countries

• life expectancy was 40 years

1950• life

expectancy had increased to 63 years

1990

Children died before their 5th birthday

•18 out of 100 children

1990•28 out of 100 children

1950

Smallpox (1950)

•Killed more than 5 million annually.

•Now eradicated.

Vaccines

•Reduced measles and polio.•Reduced economic burden (by unhealthy workers and sick children)

Despite these remarkable improvements, enormous health problems still exist

In developing countries:•Child mortality rates are 10 times higher than developed countries. •Average Maternal mortality ratios are 30 times higher than developed countries.

In poor countries:•11 million fewer children would die each year.•Almost half of these preventable deaths are a result of diarrhoeal and respiratory illnesses. In addition every year 7 million adults die of conditions which could be curd, T.B, alone causes 2 million of these deaths.

New Health Challenges

•In 2000, Acquired immune Deficiency Syndrome (AIDS) is rise to more than 1.8 million deaths annually, which reduce mortality.

•In November 2002, severe Acute Respiratory Syndrome(SARS) spread in China, but fortunately Pakistan remained safe.•Pakistan helps Chinese in developing an anti-SARS vaccine.

Malaria parasite’s increased nearly 2 million deaths a year within a decade.

Tobacco related deaths from Heart disease & Cancers to 2 million a year in 1st decade of this century.

New Health Challenges

If present smoking patterns continue, the number of smokers will increase to more than 12 million a year in 2nd quarter of this century.

HEALTH SYSTEM

IN PAKISTAN.

HEALTH SYSTEM .

A health system consists of all the

organizations, institutions,

resources and people whose

primary purpose is to improve health.

DEFINITIO

N

HEALTH SECTOR

Federal GovtProvincial Govt

Responsible for planning and formulating national health policies.

Although the responsibility for implementation rests largely with the provincial government.

HEALTH SYSTEM IN PAKISTAN

Ministry of Health Provincial Health Dept.

HEALTH SYSTEM IN PAKISTAN.

COMPLEX MIXED HEALTH SYSTEM.

Publicly financed govt health system.

Fee-levying private health sector.

CHARACTERISTIC OF HEALTH SYSTEM

TYPES OF HEALTH SYSTEM.

1.PUBLIC2 .PRIVATE

HEALTH SYSTEM IN PAKISTAN.

People take health care

20% from public

80% from private

Expenditure on health

2.5% of GDP(2011)

0.7% on public 1.8% on

private

HEALTH SYSTEM IN PAKISTAN.

FOUR TIRES OF PUBLIC SECTOR

2. primary care facilities

1 . Outreach and community-based services

which focus on immunization, sanitation, malaria control, maternal and child health and family planning.

include Basic Health Units (BHUs) and Rural Health centres (RHCs) mainly preventive, outpatient and basic inpatient care.

3. Secondary health care facilities

4. Tertiary care facilities

which include TehsilHeadquarters Hospital (THQH) and District HeadquartersHospital (DHQH) for out patient, inpatient and also specialist

hospitals located in the major cities for morespecialized inpatient care

FOUR TIRES OF PUBLIC SECTOR

HEALTH SYSTEM IN PAKISTAN.PRIVATE SECTOR

The private sector in Pakistan is varied with no defined structure and weak regulation exists in this sector.

The private sector is primarily a fee-for-service system.

Modern, for-profit:1. Regular hospitals2. Nursing homes/centers.3. Clinics.4. Informal structures.(kuryana stores) Modern, not-for-profit.1. NGO,s 1800 Traditional. (Ayurvedic ,Unani ,Homeopathic)

Facilities Provided By Private Sector.

Allopathic service providers.1) Qualified MBBS, Specialists.2) Semi-qualified (LHV,s,LHW,s)3) Non qualified (Dispensers, Peons etc)Non-Allopathic service providers.1) Homeopaths.2) Hakims.3) Pehlwans.4) Acupuncturists.

Facilities Provided………..

Pakistan International Airlines Corporation.Pakistan Railways. Employees’ social security benefit organization.Water and Power Development Authority (WAPDA).Pakistan Bait-ul-Mal.Others:Pakistan Telecommunication, Fauji Foundation, Armed Forces Institutions, etc

OTHER PUBLIC SECTOR DEPARTMENT INVOLVED IN HEALTH SECTOR

Health facilities in Pakistan

Total Health Facilities 13,937 103,708 beds

Hospitals 968 84,257 beds

Dispensaries 4,813 2,845 beds

Rural health centers 572 9,612 beds

Tuberculosis clinic 293 184 beds

Basic health units 5,345 6,555 beds

M.C.H. centers 906 256 beds

HEALTH SYSTEM IN PAKISTAN.

Amina FayyazBC11034

Problems in Pakistan health system

Pakistan’s health sector is• inadequate• underfunded• focused on urban areas

– With the rapid population growth, the facilities are not expanding proportionally and as desired.

Problems in Pakistan health system

Major problems are :• Inadequate funding• Lack of health facilities in rural areas• Unemployed doctors• Acute shortage of doctors & trained medical

personnel• Brain drain' of medical graduates• Increasing prices of medicines• Circulation of fake medicines

Inadequate funding• Pakistan spends less than 1 % of its GDP on health

sector which is one of the lowest in the world.• Resulting in limited allocations for personnel,

equipment and infrastructure in health sector.

Lack of health facilities in rural areas

• Most of health facilities and medical personnel e.g. ( 85% of practicing doctors ) are found in urban areas– Because of

• Discrimination against rural inhabitants• Since dominant classes live in cities the best facilities

are also located there.

Increasing prices In such scenario where from food to petrol everywhere

fire of inflation has engulfed the poor man• Those with money can afford the health facilities but

the poor face many hurdles• People living in poverty _ 62 million • households unable to meet health care expenses_

30%

Acute shortage of doctors• Around 5000 doctors are coming

every year in the field. (PMDC)• A sizeable number of women

graduates are not practicing.• shortage of 182000 doctors• Ratio of doctors to nurses is 3:1

– international standards 1:3 (WHO)• In governmental hospitals

– each doctor examines more than 100 patients daily

– international standard are 25.

Brain drain of medical graduates

• 1,700 physicians per year are

lost from the pool of practicing physicians

• Because of– lack of security, – poor remuneration,– limited resources of

professional development and – overall discouragement of

health profession in Pakistan

Circulation of fake medicinesA latest World

Health Organization (WHO) report has revealed

that around 30-40% medicines

are fake on Pakistani

Medical Stores.

Circulation of fake medicines • Fake medicines are available

for cure of from Flu to cancer.• Pakistan has

– 4,000 registered pharmacists– and 25 times more merchants

dispensing medicines illegally• A large amount of these false

medicines are producing in Karachi, Lahore, Rawalpindi and Multan.

Major Diseases in PakistanKidney DiseasesCancer DiabetesHepatitis A,B,CHigh Blood PressureMalariaCholeraInfluenzaEye InfectionHeart AttackDepressionAsthmaJaundice

Infectious diseases 40%Reproductive health problem 12%Cancer and

diabetes are 10% of BOD.

What is heart attack?A heart attack is the damage and death of heart muscle from the sudden blockage of a coronary artery by a blood clot.

Cholesterol plaques cause hardening of the arterial walls and narrowing of the inner channel (lumen) of the artery. Arteries that are narrowed by atherosclerosis cannot deliver enough blood to maintain normal function of the parts of the body they supply.

Causes :

Chest painJaw pain, toothache ,headacheShortness of breathNausea , Vomiting SweatingHeartburnArm pain

Symptoms :

About 35 to 40% of population

What is hepatitis C infection?

Hepatitis C infection is an infection of the liver caused by the hepatitis C virus (HCV).

Reasons:Blood transfusionOrgan transplantSharing needles and other equipment(such as cotton ,spoon and water)used to inject illegal drugs.

About 75% of people have no symptoms when they first acquire HCV infection. Remaining 25% may complain of:- FatigueLoss of AppetiteMuscle aches or FeverYellowing of skin or eyes(Jaundice)

Symptoms:

4.8% of populatio

n

Kidney Diseaseswhen the kidneys become damaged, waste products and fluid can build up in the body, causing swelling in your ankles, vomiting, weakness, poor sleep, and shortness of breath.

Causes:

High blood pressureHigh blood sugarKidney infectionLong use of medicinesBlocked renal artery

Oral Cancer Cancer is defined as the uncontrollable growth of cells that invade and cause damage to surrounding tissue. Oral cancer, which includes cancers of the lips, tongue, cheeks, floor of the mouth, hard and soft palate, throat, can be life threatening if not diagnosed and treated early.

Causes :Excessive consumption of alcoholSun exposure , especially at a young age.SmokingFamily history of cancer

Symptoms of oral cancerSwellings, rough spots or eroded areas on the lips, gums, or other areas inside the mouthThe development of velvety white, red, or speckled(white and red) patches in the mouth Bleeding in the mouthEar painDramatic weight loss.

High Blood Pressure

High blood pressure (HBP) or hypertension means high pressure (tension) in the arteries.

Causes of high blood pressure:•age •diet•excessive alcohol consumption•lack of exercise•sleep apnea•stress

Symptoms of high blood pressure

HeadacheVision ProblemDizzinessShortness of breath

But most people with hypertension have no symptoms, it is referred as “silent killer”

Treatment of major

diseases

TREATMENT OF MAJOR DISEASES

Treatment of heart diseasesTreatments for heart disease range from low-tech to high-tech. Medical care is essential once heart disease is diagnosed, with the goals of stabilizing the condition immediately, controlling symptoms over the long term, and providing a cure when possible.

Treatment of heart diseases through surgeries

Heart Transplant Heart Bypass Surgery Valve Disease Treatment Angioplasty and Stents Implantable Cardioverter

Defibrillators (ICD) Pacemakers Ablation

Treatment of heart diseases through medications

Angiotension II Receptor Blockers

Antiplatelet Drugs Aspirin Therapy Beta-Blocker Therapy Calcium Channel Blocker Drugs Digoxin Antiarrhythmics

Treatment of heart diseases through care

Plant-Based Diet for Heart Health Finding Strength During Tough Times Recovery After Heart Surgery

Treatment of Dengue In Punjab especially in Lahore many people are

suffering from dengue fever. Medical science has not any proper treatment for this fever except Panadol, but natural cure is available to tackle this disease. Here are some proven natural home remedies to treat the fever.

Fresh Juices Papaya Juice Tulsi (Basil Leaves)

Treatment of Dengue Fresh Juices

Pomegranate, orange, apple and sweet lemon juices are recommended by the doctors. Add one lemon juice in apple juice before in taking.

Papaya juicePapaya juice is much effective to cure the fever and to increase the platelets. To make papaya juice, grind papaya leaves then add a little amount of water in it and strain.

Treatment of Dengue Tulsi (Basil Leaves) If you want to take tea, add basil leaves

in tea to give it herbal touch. Basil leaves have properties to lower down the temperature of body. 

TREATMENT OF HEPATITIS ‘ C ’

The main treatment for hepatitis C is to kill the virus that causes the disease. A combination of two antiviral drugs — peginterferon and ribavirin — is successful in eliminating the virus in as many as half those treated.

What's the Treatment for Hepatitis C?

For years, the standard hepatitis C treatment was a combination of injected interferon alpha and the oral antiviral drug ribavirin A combination form of these drugs is also available, called Rebetron.

More recently, another form of interferon -- peginterferon, or pegylated interfero-has become the standard of care. Interferon is a man-made version of certain natural proteins that fight viruses .

TREATMENT OF KIDNEY DISEASES

Kidney disease is :• progressive disease, which means that the damage

in the kidneys tends to be permanent and can't be undone. So it is important to identify kidney disease early.

• Medications, especially drugs that control diabetes and high blood pressure, can sometimes help slow the progress of chronic kidney disease.

Lose weight Eat plenty of whole grains Eat plenty of fruits and vegetables Dairy up. Limit meat, fish, and poultry to two servings a day Go nuts. Limit fats and oil to two to three servings per day Hold the salt. Get off the couch Drink in moderation

Top10 ways to reduce the high blood

pressure

MEDICINES FOR HIGH BLOOD PRESSURE

Several types of medicine are used to treat high blood pressure. Your health care provider will decide which type of medicine is right for you. You may need to take more than one blood pressure medicine.

CoNcLuSi0nAlthough the government has made efforts to improve the health facilities , there is still more to be done.

According to Pakistan Economic Survey, the infant morality rate per 1,000 live births was 82.

The life expectancy at birth was only 64 years.

The percentage of total population having access to safe water was 65 percent & sanitation 23 percent .

The health care system in Pakistan comprises the public as well as private health facilities.

In Pakistan vast majority of doctors resides in urban area and attracts the educated class towards private sector.

Utilization of public health care facility is not the main priority of the educated class of the country.

According to the Economic Survey of Pakistan, the government spent 0.75 percent of GDP on health sector in order to make its population more healthy

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To overcome the problems..

Government officials should pay attention to make it more convenient for general public.

Poverty Reduction Strategy should be make.

Widespread prevalence of communicable diseases shouldBe reduced.

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Private Sector should be Regulated

Deficiency of Health Education System should reduced

Make National Health Policy (Health Sector Reform)

Greater gender equity should be promote.

By correcting urban bias in health sector

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Required regulation in private medical sector should introduced.By Creating Mass Awareness in Public Health.

By Effecting Improvements in the Drug Sector

Access to Health Care Services should be easy.

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Resources should reallocate and health strategy should reformulate.

low income people access to medical services is the desired need of the time.

professional/managerial deficiencies in the district health system should remove.

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The government should invest in nursing colleges to overcome the limited human capital in the health sector.

The private sector is playing a vital role in the health care service delivery in Pakistan. However, this sector needs to be regulated and monitored.

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