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About 89% of Pediatricians and Obstetricians are in provincial Capitals

Cost effective package of care combined with
universal health insurance is essential

ISLAMABAD: We have to find a solution to our healthcare problems and we can do it. We need to improve access to healthcare. We have to overcome lack of everything ensure implementation with policy makers, increase financial allocations, female protection and build collaboration. Cost effective packages of healthcare combined with universal health insurance is the answer to our healthcare problems. This was stated by Prof. Z. A. Bhutta a noted pediatrician while delivering a Keynote lecture at the recently held international medical conference of Pakistan Society of Internal Medicine The topic of his presentation was “Bridging the health equality gap in Pakistan”.

Sharing some of the data Prof Bhutta said that about ten million children died during 2003 and most of these deaths were in Africa and Asia. We could achieve 66% reduction in maternal mortality as against 75% which was projected in Millennium Development Goals. Mortality decreased but at the same time inequality also increased. Speaking about inequality and inequity Prof. Bhutta said that drivers of inequity are structural discrimination, social factors and unequal distribution of income. We have achieved 38% reduction in child mortality but we have achieved very little reduction in newborn mortality. Three lac fifty six thousand mothers and babies die on the day of birth.

We had lowest reduction in neonatal mortality which is just 1.58%. We are faced with the problem of increasing poverty, lack of human resource. We have more doctors and less nurses and midwives. Almost 89% of pediatricians and obstetricians are in provincial capitals. We need proper distribution of human resource though there is some trickle down effect. Gender disparities are never discussed. We must find out what strategies should be adopted to reduce poverty. We have to work on demand creation and provision of outreach services. We have to link community to healthcare facilities. He then discussed the conventional and unconventional cash transfer to remove financial barriers.

Benazir Income Support Programme addressed the issue of poverty and we have seen the stunting reduced considerably in KPK and other parts of the country. Community level workers can play a significant role in reduction of neonatal mortality. He advocated the concept of universal health insurance, increased coverage of key interventions. Lady Health Workers have played a vital role in reduction of mortality and improved coverage. Distance of health facility also matters. Integration of health services and immunization coverage is essential. However, conflicts and insecurity are some of the issues which do create lot of problems, he remarked.

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