Healthcare continues downward slide

Large increase by Punjab masks cuts elsewhere in nationwide data

ISLAMABAD: Overall health sector remains to be the lowest priority of the federal government. Most health indicators in the economic survey released on Thursday showed downward slide.

The federal and Khyber-Pakhtunkhwa (K-P) governments’ response to the deterioration of a number of health indicators has been to further reduce funding.



Health expenditure in K-P and at federal level has considerably dropped during outgoing financial year, according to the economic survey for FY 2015-16.

Despite urgency to increase spending under this head, the health sector received only 0.45% of gross domestic product (GDP), or Rs133.9 billion, during the first nine months (of FY 2015-16. The share of GDP represented by health expenditure is almost unchanged from FY- 2014-15, when it stood at 0.42% of GDP.

In K-P, overall health expenditure dropped from Rs16.9 billion in 2014-15 to Rs14.5 billion this year.

Similarly, at federal level, spending dropped from Rs 22.4 billion in FY 2014-15 to Rs15.3 billion in FY 2015-16.

The survey suggests that K-P and Balochistan are spending the lowest amounts on health, while Punjab and Sindh are the highest and second-highest spenders respectively.

Health expenditure

The report quotes World Bank statistics which say that Pakistan spends $37 (Rs3,873) per capita on health, which is lower than the World Health Organisation’s (WHO’s) prescribed level of $44 per capita (Rs4,606) — the minimum spending package required for essential health services.



During the last decade, a slight decrease has been noted under this head. In FY 2000-01, health expenditure was 0.58% of GDP, in FY 2001-02, it was 0.57%, while during FY 2014-15, it was just 0.42% of GDP.

Public healthcare network

The public healthcare system in Pakistan is made up of 1,167 hospitals, 5,695 dispensaries, 5,464 basic health units, 675 rural health centres, and 733 mother-and-child health centres, according to the document.

There are 184,711 doctors — one doctor per 1,038 persons — and 16,652 dentists, while the 118,869 available hospital beds translate to one bed for every 1,613 people. In FY 2015-16, seven rural health centres and 32 basic health units were added to the existing system.

Food and nutrition

Pakistan’s economy is primarily agriculture based, but the Integrated Food Security Phase Classification (IPC) analysis conducted from March to June 2015, quoted in the survey, shows that 29 out of 148 districts in Pakistan are highly food insecure and require immediate attention.

Of these 29 districts, four have been identified as “severely food insecure”.

Interestingly, the survey has no hard stats available on malnutrition. It only provides details of nutrition-related programmes and activities that the government has been undertaking with private partners.

The survey concludes that health outcomes have improved over the years, but some critical weaknesses such as shortage of equipment and staff continue to affect health systems. “There is a dire need to expand service delivery, address the shortfall in health-related human resources, and making better use of technology.”

It suggests that public-private partnership need to be encouraged and coverage of public health programmes such as tuberculosis, malaria, hepatitis, and other communicable diseases need to be improved.

Published in The Express Tribune, June 3^rd, 2016.