Challenges and Opportunities in Health Governance

Post 18th Amendment

 HEALTH STATUS IN
BALOCHISTAN
Balochistan is Pakistans least-developed
province with a high rate of maternal mortality,
illiteracy, unemployment, poverty, gender
disparity, insurgency and brutal killings.

Inflexible social customs and practices are

widely blamed for the plight of women and poor
health services in Balochistan but other reasons
are prominent.
 Challenges influencing
Health Services
Strong tribal influence due to illiteracy, poverty and
lack of awareness.

Poor law and order situation is poor, scaring doctors

to work in far flung areas.

27 doctors killed, 16 kidnapped, over 40 tortured

Over 100 doctors, including 20 specialists, have left

the province because of security issues.

73 doctors suspended, 500 doctors salary stopped for

the reason of demanding security

Complete strike in private and govt. sector for more

than 60 days.
 Comparison of National with
Balochistan data
NATIONAL BALOCHISTAN
Maternal Mortality Rate MMR = 600 to785/100 000

272/100,000 live births Live births

Neonatal Mortality rate NMR = 72/1000 Live

54/1000 live births births

Child Mortality rate CMR = 94 to128/1000

89/1000 live births Live births

Total Fertility Rate 3.07 Total Fertility Rate 5.4

children per woman children per woman

Population growth rate 1.8% Population growth rate

2.7%
 Challenges
People living in mountains and far flung areas have
no
access to heath facility.

75000 villages are without proper road network.

Non- functional heath centers and lack of equipment

for emergency services.

Non- availability of gynaecologist and other

specialists
in the periphery

Lack of human resource especially female staff and

inadequate capacity and skills.
 Challenges
Inadequate Family planning services
Lack of human resources especially female staff,
along with inadequate capacity and skills.

Inadequate Family planning services especially

access and coverage
 What's need to be done?
Improvement needed in:
1. Availability of competent midwives and skilled birth
attendants.
2. Activation of BHU and RHCs.
3. Availability of Emergency Obstetric Care services for
women.
4. Good road network in urban and rural areas.
5. Helpline and Flying squad to save maternal life.
6. Power devolution up till the district level
7. Integration of services; family planning, PPHI, neonatal
etc.
8. Nutrition advice services
9. Birth preparedness counseling
Thank you