With ‘Universal Healthcare’ as the theme for the World Health Day by the World Health Organization (WHO), it is important to note why universal healthcare is so pivotal and why Pakistan would have been better off tackling Covid-19 had it adopted universal health coverage.
As a part of its sustainable development goals, Pakistan is one of the many UN member states that have agreed to achieve universal health coverage by the year 2030. According to the WHO, this virus will cause more damage to South Asia than any other region in the world. India is currently leading with the highest number of coronavirus cases in South Asia, with Pakistan close behind.
Public health has been floating in media highlights due to this leeching pandemic and many efforts are being made to respond by engaging with the disregarded healthcare framework. Before this, Pakistan’s policymakers have ignored the raised attention-seeking hands of healthcare and its workers as it shockingly spends less than 1% of GDP on the sector — the lowest in South Asia. The more concerning fact is that despite increasing demands of healthcare and the stagnant low quality provided, the percentage of GDP towards healthcare has dropped over the years from a low, yet higher number of 1.12% in 2017. This pandemic is a knock on the door for Pakistan. Calling it “high time” is now an understatement and the neglected healthcare accessibility and infrastructure should have been addressed a long time ago. Especially more with the majority of Pakistan’s population being low-income and vulnerable to change.
Seventy-five per cent of Pakistan’s population resorts to the utilisation of private healthcare facilities that prove to be more patient-centred and are outperforming the public sector with better accessibility and quality of care. However, looking beyond this silver lining, the private sector is a privilege and squeezes people dry with its high costs for even the most basic provisions.
In a country of 220 million people, the bed-to-population ratio is less than one per 1,000 when the recommended average by WHO is five per 1,000. Pakistan lacks the strategy to analyse this data and implement policies that would allow the public sector to set priorities and better fund and allocate resources.
However, this pandemic has helped Pakistan see its potential. Sindh, for example, has taken constructive steps towards combating this virus which sets an example for future policymaking. The way forward is to take steps towards implementing universal health coverage and it will reduce the financial adversity with prevention, treatment and rehabilitation — all vital aspects of healthcare that are usually disregarded.
The first step towards introducing universal health coverage is to ensure a well-functioning healthcare administration with good governance and then focusing on revisiting the nation’s primary care for further development. Universal healthcare will improve the well-being of the population as a whole. Accessibility to healthcare will increase with a consequent increase in the percentage of population receiving satisfactory healthcare from public facilities with a mere drop in the overall expenditure per household on healthcare. The National Health Vision 2016-2025 states that Pakistan will nationally move towards universal health coverage to confront the various health challenges it is facing.
This year, the World Health Day signifies the importance the government of Pakistan must allocate to signifying national and provincial healthcare strategies and for developing primary care towards a universal health system which will improve health service delivery and reduce financial burdens on the population.
Published in The Express Tribune, April 8th, 2020.