Research-based policymaking: Public health systems are challenged by urban migration

Health experts lament that Pakistan still lacks a concrete healthcare policy.

KARACHI: For a densely populated city like Karachi, where 45 per cent of residents are living in squatter settlements, and where people from all parts of the country come to settle every day, policymakers need to give public health some serious thought.

Experts made the observation during the “Community Health Sciences Research Day” of the Aga Khan University Hospital (AKUH) on Friday. They also lamented that authorities had never given public health its due importance, and that the country still lacked a concrete healthcare policy. They also highlighted the need for policymakers to make informed decisions based on research.

Over 100 papers were presented on the occasion. They were based on four main research themes: health systems and public healthcare development, women’s health and empowerment, environmental and occupational health, and chronic disease and nutrition.

“We want policymakers to review the present healthcare system, and make the required changes based on systems research, rather than clinical research,” said Dr Imtiaz Jehan, associate professor at the community health sciences department at AKUH. If a balance is achieved between these two types of research, then the cost of healthcare can be brought down and a high yield of healthcare services obtained as well. There should be a direct link between research and policymaking, stressed Dr Jehan.



Dr Fauziah Rabbani, chairperson of AKUH’s community health sciences department, observed that a healthy population directly contributed to a country’s economy. Coming back to the healthcare system in Pakistan, she lamented that “access to healthcare is dismal, and there is no coherent or concise healthcare policy”.

The experts also noted that there was an increased focus on curative rather than preventive healthcare in the country.

Dr Agha Xaher Gul, a researcher at the AKUH’s Urban Health Programme, observed that there was a need to overcome the “dependency syndrome,” so that people realise that they were themselves responsible for their health. “Every day we have more and more people migrating to cities, but this mass urbanisation has not come without its share of problems.” He added that many migrants held a “rural” mindset when it came to taking care of the health of their women and children.

Dr Rabbani told the audience that the disorganised rise in the urban population did not bode well for public health systems in these cities, which were already being stretched thin by their own residents.

Published in The Express Tribune, February 23^rd, 2013.