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National health policy.

National Health Policy

The ultimate aim of Health Policy is to provide in 10 years time, a universal health cover, free of charge to those who cannot afford to pay for it; democratization of health administration; and provision of trained health manpower.

A National Health Policy was announced on 8th May 1990. The salient features of the new Health Policy and the programmes to be implemented are given below:

A. Salient Features of Health Policy

The ultimate aim of Health Policy is to provide in 10 years time, a universal health cover, free of charge to those who cannot afford to pay for it; democratization of health administration; and provision of trained health manpower. To be more specific, the main targets of the Government will be achieved by: - Improved functioning of existing BHUs and RHCs, establishing of mobile units, providing incentives to doctors to establish practices in rural areas and Katchi Abadis, establishing filter clinics in urban areas and adequate diagnostics support services. - Training programmes for 100,000 Village Health Workers (VHWs) which will be organised at Tehsil and Taluka hospitals and rural health centres. - A special scheme aimed at providing employment opportunities to unemployed doctors would be initiated. - A list of Essential Drugs price of which will be kept at a minimum level will be introduced alongside the existing system. This will help in achieving the widest possible coverage of the population with drugs of proven efficacy. - A drug schedule will be introduced for various types of hospitals and health care facilities in the public sector and a continued supply of such drugs will be ensured. - Health insurance schemes for those who wish to participate, would be initiated. - The health management system will be strengthened, decentralised and democratized. For this purpose Management Boards and Committees will be created. - The private sector will be encouraged to provide primary health care in the rural areas. - Medical education will be made more relevant to primary health care needs and training opportunities will be provided for medical specialists, nurses and paramedical staff in primary health care. - Twenty per cent of the top students of each medical college on successful completion of MBBS degree, will be provided opportunities for specialization. - lodized salt supply to goitrous areas will be ensured. - Food supplements will be provided to vulnerable and malnourished groups, especially lactating mothers, infants and children. - Family planning will be made an effective and mandatory part of the health care programme. - A special programme will be implemented to deal with medical aspects of narcotic control programme.

B. The Health Policy will implement the following programmes: - Basic Health Services will be established on an integrated basis including measures for improving agriculture, increasing clean water supply, sanitation, electrification, roads, schools and grain storage. In other words it will be a part of "total development". - The people of the community will be involved at the outset in identifying their needs, choosing the sequence and in implementing and supervising the programmes. - Advocacy for the needs of children will receive priority. - Physical inventories of all health care establishments alongside their needs and problems will be undertaken on an emergent basis. - Modern record keeping, medical audit system and health information reporting systems will be to acquire essential information for management and evaluation purposes. - Studies will be carried out to measure the effectiveness of organization in the management of health services. - Development programmes in the health sector will be critically evaluated to ensure that in future the cumulative costs will remain realistic and not lead to any programme being abandoned in midstream. - Health manpower policies will be urgently revised. Physical services, analysis of the cost of production of doctors, terms of employment, role of non-physicians in health management, auxiliary services, and problems of the traditional health sector are some of the issues that will be addressed in a concerted and comprehensive manner. - Educating people in healthy life styles will provide back up support to all programmes. Medical Facilities from 1987 to 1989

Years 1987 1988 1989

Beds in Hospital
& Dispensaries 60093 64471 65233
Regtd. Doctors 51020 55346 59777
Regtd. Dentists 1616 1743 1881
Regtd. Nurses 16722 17735 19581

Nurse per

Hospital Bed 3.6 3.6 3.3

Population per

Hospital bed 1678 1610 1640

Population per

Doctor 1973 1880 1790

Population per

Dentist 62314 59873 56900

Source: Ministry of Health

Incidence of Diseases

Cancer cases in Pakistan have increased by three fold during the last dec access to more and better health facilities and better diagnostic equipment. Therefore, many cases which in the past remained undiagnosed are detected in time. Furthermore, there is an increased awareness about the disease in the general populace.

In Pakistan incidence of lung cancer in males and breast cancer among females is the highest. Breast cancer (30%) combined with lung cancer and cancer of the mouth account for almost 60 per cent of the malignancies. Gastrointestinal tract tumours are also quite common among males, incidence being 16 per cent. In paediatric age group brain tumours are very common accounting for 33 per cent of all childhood malignancies.

There are certain factors causing cancer which are preventable. Environmental pollution in general, cigarette smoking, poorliving conditions and dietary habits (such as intensive use of spices) are known causes. Prognosis at the moment for majority of cancer cases is rather poor as many cases are reported at a very late stage when only palliative treatment can be given and achieving cure is almost impossible.

At present ten Nuclear Medical Centres and four Radiotherapy Departments are providing diagnosis and treatment facilities to over 160,000 patients anuullay. On the diagnostic side, these centres are equipped with latest SPECT cameras, computerized gamma counters, radioimmunoassay, diagnostic X-ray and ultrasound machines. For treatment of different types of malignancies, the centres have the latest machines available in the form of linear accelerators, co-60 units, superficial and deep X-ray therapy units. For accurate localization of tumors and their proper treatment the centres are also equipped with treatment simulators and computerized treatment planning systems. Treatment facilities for intracavitary insertions in case of gynaecological malignancies are also available at some of the centres. Establishment of a nuclear medical centre at Abbottabad (NWFP) has been approved by ECNEC while another one at Faisalabad (Punjab) is under consideration.

Facilities for cardiovascular diseases are being added to important hospitals and coronary care units have been provided at major district hospitals. Case detection, treatment and follow up of leprosy cases is being carried out by 109 leprosy control units spread all over the country along with six hospitals with 334 beds.

An expanded programme of immunization against six diseases i.e. tuberculoses, poliomyelitis, diphtheria, tetanus, persusis (whooping cough) and measles is under execution since 1982 for the pre-school going children alongwith a programme of production/distribution of oral rehydration salt (ORS) packets. Vaccine/dozes provided to the children upto 5 years of age under the immunization programme for the year 1987, 1988 and 1989 are given below:
Vacine/Doze Exported Programme of
 1987 1988 1989
B.C.G. 4,238,220 4,236,292 4,065,712
Polio 13,047,472 12,844,916 13,286,195
D.P.T. 10,857,447 11,097,859 12,038,415
D.T. 1,857,532 1,247,978 691,952
T.T. 3,788,320 5,150,602 7,794,725
Measles 3,372,650 3,171,508 3,534,952

Source: Ministry of Health B.C.G. = Bacillus + Calamus + Guerin D.P.T. = Diphtheria + Perussis + Tetanus D.T. = Diphteria + Tetanus T.T. = Tetanus Toxoid

Drug Abuse

Drug addiction has also become a serious social problem in Pakistan. The 4th SAARC Summit at Islamabad on December 29, 1988 declared 1989 as the Year Against Narcotics and the Pakistan Narcotics Control Board (PNCB) has prepared an action plan to implement the directive of the Prime Minister and the Islamabad SAARC Declaration. Pakistan is also heading the SAARC Technical Committee on the Prevention of Drug Trafficking and Drug Abuse. Effective and meaningful steps have been initiated by the Committee for regional cooperation for the solution of drug problem in SAARC countries. Narcotic drugs like opium, heroin and cannabis are abused by about 2.024 million people falling in the age group of 15-25. Out of this 1,079,635 are heroin addicts. Another 944,365 are addicted to other drugs. A network of 29 treatment and rehabilitation centres is working in the country. Around 100,000 drug addicts are reported to have been cured so far. Over 1,500 private medical practitioners have been trained countrywide to treat drug addicts in their private clinics. Four thousand social workers from non-governmental organisations have also been trained in preparing society for community intervention against drug abuse.

An awareness programme has been launched through the use of the national television network, radio and newspapers besides holding of conferences, seminars, symposia, public meetings and group discussions. A Drug Abuse Prevention Resource Centre (DAPRC) has been established under PNCB with a cost of $3 million. The Centre will establish a library, publish Narcotics information Bulletin and prepare a Manual for the Prevention Consultant Network. [Tabular Data 1 to 2 Omitted]

PHOTO : A typical 5-bed ward of the Aga Khan University Hospital at Karachi

PHOTO : Polio drop being administrated by SESSI's mobile unit
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Title Annotation:Pakistan
Publication:Economic Review
Date:Aug 1, 1990
Previous Article:Pharmaceutical industry has bright future.
Next Article:Seventh Plan and the health sector.

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