“HEALTH

SYSTEMS”

Lecture #2

Dr. Momena Shahzad

Lecturer
FR&AHS
PRIVATE HEALTH SYSTEM
PRIVATE HEALTH SYSTEM

 Private health care system differs across

the world.

 In Canada, private health care is

whatever the public health care system
does not cover.
 In the United states, private health care
is the primary source of health care. At
least 85% of Americans have private
health care insurance either through their
employees or out of their own pocket.
PRIVATE HEALTH CARE FACILITIES

 Hospitals
 Long-term care facilities (LTC or LTCF)
 Medical offices
 Dental offices
 Clinics or satellite centers
 Optical centers
 Emergency care services
 Laboratories
 Home health care
PRIVATE HEALTH CARE FACILITIES

 Mental health facilities

 Genetic counseling centers
 Rehabilitation facilities
 Health maintenance organizations (HMOs)
 Industrial health care centers or occupational health clinics
 School health services
ROLE OF PRIVATE HEALTH CARE SYSTEM
 The private sector in Pakistan is varied with no defined structure
and weak regulation exists in this sector.
 The private sector is primarily a fee-for- service system.
 70- 80 % health care providers in Pakistan are private.
 The private sector specially in urban areas has become main health
provider in Pakistan.
 In Sindh, private providers act on the front line and are often the
only form of health care available.
 Although the private sector plays an increasingly important role in
health care in Pakistan, it remains a new area of study and
innovation.
ROLE OF PRIVATE HEALTH CARE SYSTEM

 As government fall short of providing widespread access to

care, the private sector presents an opportunity for
sustainable scale up of health care services along side social
and economic development.

 Included the scope of private sector agencies are both for

profit private providers and NGOs that apply market based
approaches to service delivery.

 Unfortunately private sectors true role was never understood

in Pakistan.
ROLE OF PRIVATE HEALTH CARE SYSTEM

 To introduce such a health care infrastructure model where

all citizens can get better health care facilities in Sindh.

 Only access to health care, even if universal, will have no

meaning unless the larger social determinants of health are
squarely addressed and issues of ethnicity, caste, class and
gender are engaged-with as a society.

 With regards to health, we also believe that the private sector

should play only a supplementary and never a complementary
or competitive role.
RESPONSIBILITY OF PRIVATE
HEALTHCARE SECTOR
 Must properly analyze the ethical and Professional Competency
standards of our private healthcare sector.
 Must make a full audit of all the existing private practice outlets.
 Must also look into the possibilities of government and Private
partnership.
 Should clearly define our health issues, health priorities and
health policy.
 Must have full Time properly functioning Public Health
Department at all levels.
 Must eliminate quackery in all forms.
 Should adopt the concept of affordable treatment for all.
SCIENTIFIC HEALTH SYSTEM
SCIENTIFIC HEALTH SYSTEM
 Research has an important role to
play in strengthening health systems
to improve system performance and
public health impact.

 “Research” is defined as “a systematic

investigation, including research
development, testing and evaluation,
designed to develop or contribute to
generalizable knowledge.”
SCIENTIFIC HEALTH SYSTEM
 This is a broad definition that may
include biomedical research,
epidemiological studies, and health
services research, as well as studies
of behavioral, social, and economic
factors that affect health.
 Perhaps the most familiar form of
health research is the clinical trial, in
which patients volunteer to
participate in studies to test the
efficacy and safety of new medical
interventions.
THE IMPORTANCE OF HEALTH RESEARCH
 Like privacy, health research has high value to society.

 It can provide important information about disease trends and risk

factors, outcomes of treatment or public health interventions,
functional abilities, patterns of care, and health care costs and use.

 The different approaches to research provide complementary insights.

 Clinical trials can provide important information about the efficacy

and adverse effects of medical interventions by controlling the
variables that could impact the results of the study, but feedback
from real-world clinical experience is also crucial for comparing and
improving the use of drugs, vaccines, medical devices, and
diagnostics.
THE IMPORTANCE OF HEALTH RESEARCH
 It is also vital to record and assess experience in clinical
practice in order to develop guidelines for best practices
and to ensure high-quality patient care.

 Economists have found that medical research can have an

enormous impact on human health and longevity, and that
the resulting increased productivity of the population
contributes greatly to the national economy in addition to
the individual benefits of improved health.
TRADITIONAL HEALTH SYSTEM
TRADITIONAL HEALTH SYSTEM
 About 70% of the population, particularly in rural areas
use traditional and complementary /alternate Medicine.
 The Government of Pakistan has issued the Unani,
Ayurvedic and Homeopathic System of Medicine Rules of
1965.
 Under this Act courses in homeopathy provided by
recognized institutions must be four years in duration
,culminating in a qualifying examination.
 Homeopaths, Hakims, Pehlwans and Jirhas.
 Acupuncture and Chinese Medicine treatment Provider.
PROBLEMS IN PAKISTAN
HEALTH SYSTEM
PROBLEMS IN PAKISTAN HEALTH SYSTEM

 Pakistan’s health sector is

• inadequate

• underfunded

• focused on urban areas

 – With the rapid population growth, the facilities are not

expanding proportionally and as desired.
PROBLEMS IN PAKISTAN HEALTH SYSTEM

 Major problems are :

• Inadequate funding

• Lack of health facilities in rural areas

• Unemployed doctors

• Acute shortage of doctors & trained medical personnel

• Brain drain' of medical graduates

• Increasing prices of medicines

• Circulation of fake medicines

INADEQUATE FUNDING

• Pakistan spends less than 1 % of its GDP on health sector which is

one of the lowest in the world.

• Resulting in limited allocations for personnel, equipment and

infrastructure in health sector.
LACK OF HEALTH FACILITIES IN RURAL
AREAS

 • Most of health facilities and medical personnel e.g. ( 85% of

practicing doctors ) are found in urban areas

– Because of

• Discrimination against rural inhabitants

• Since dominant classes live in cities the best facilities are also
located there.
INCREASING PRICES

 In such scenario where from food to petrol

everywhere fire of inflation has engulfed the poor
man
• Those with money can afford the health facilities but
the poor face many hurdles

• People living in poverty _ 62 million

• households unable to meet health care expenses_ 30%

ACUTE SHORTAGE OF DOCTORS

 • Around 5000 doctors are coming every year in

the field. (PMDC)
• A sizeable number of women graduates are not
practicing.

• shortage of 182000 doctors

 In governmental hospitals – each doctor

examines more than 100 patients daily –
international standard are 25.
BRAIN DRAIN OF MEDICAL GRADUATES

 • 1,700 physicians per year are lost from the pool

of practicing physicians

• Because of
– lack of security,

– poor remuneration,

– limited resources of professional development and

– overall discouragement of health profession in

Pakistan
CIRCULATION OF FAKE MEDICINES
 A latest World Health Organization (WHO) report has
revealed that around 30- 40% medicines are fake on
Pakistani Medical Stores.

 Fake medicines are available for cure of from Flu to cancer.

 Pakistan has – 4,000 registered pharmacists – and 25

times more merchants dispensing medicines illegally

 A large amount of these false medicines are producing in

Karachi, Lahore, Rawalpindi and Multan.
MAJOR DISEASES IN PAKISTAN
Kidney Diseases
Cancer
Diabetes
Hepatitis A,B,C
High Blood Pressure
Malaria
Cholera
Influenza
Eye Infection
Heart Attack
Depression
Asthma
Jaundice