HEALTH SYSTEM ORGANIZATION OF PAKISTAN.pptx

7/27/2019 HEALTH SYSTEM ORGANIZATION OF PAKISTAN.pptx

1/31

History of Health care system ofPakistan

Dr Riffat Jehanzeb

Coordinator MPH

PHSA


2/31

HEALTH SYSTEM ORGANIZATIONOF PAKISTAN

Brief History of the Health Care System

Pakistan at the time of its independence in 1947 inheriteda health care delivery system that was a legacy of colonial

British period. This rudimentary system was in the shape ofpublic health services and some curative services. It wasessentially designed to prevent large scale epidemicsand provide curative services for the population in largeand medium sized towns, many of which were along thelines of communication or political or strategicconsequences


3/31

History of the Health CareSystem continued

During initial phase (1947-1955), most important initialproblem was the replenishment of staff. In addition to otherprograms, BCG vaccination campaign was launched withthe support of UNICEF and two medical schools wereopened in the West Pakistan.


4/31

History of the Health Care Systemcontinued

From 1955 onwards, developmental activities wereaffected in phases of five year and each phase was knownas Five Year Plan


5/31


During 1st Five Year Plan (1955-1960)

1. Six new medical colleges, including one for women were

opened in both wings.2. A nursing school was attached to each of these medicalschools.

3. Postgraduate institutions were established.

4. A bureau was established to produce vaccines and sera.


6/31


During 2nd five year plan (1960-1965),

1. Under the recommendations of a Medical ReformCommission,

2. Rural Health Center scheme to cover 50000 populationby each unit,

3. Two Health TechniciansTraining Institutes were opened,

4. Family planning program,

5. And a malaria eradication program were launched.


7/31


During 3rd five year plan (1965-1970) in addition tocontinuation of the aforementioned initiatives,witnessed

1. launching of Tuberculosis Control Program and

2. Small pox eradication programs.

3. The major infrastructure of the public health care systemwas set up in the 1970s.

4. Pakistan endorsed the "health for all by 2000" initiativewhich had been launched by the World Health Organization.


8/31


5. Government launched an extensive infrastructure andpolicy building initiative.

6. From the villages to the cities different levels of healthcare were started like the "Basic health units" for the villages.

7. The Tehsil headquarter hospital represented secondaryhealth care, and district hospitals and teaching and referral

units represented tertiary care units.


9/31


8. Along with this a significant public health campaign waslaunched for the first time, keeping in view local needs andWHO guidelines to meet the target. . These were

: An expanded program of immunization to eradicate theprevalent infectious diseases; Malaria control program;Tuberculosis control program; Family planning program;Diarrhea and pneumonia control programs; and many others.

10. To monitor all these and to achieve further improvements

and make sure the policy was being applied the nationalinstitute of health was created.


10/31


During fourth five year plan (1970-1975),

1. Quota of medicines was substantially increased for majorhospitals,

2. a generic name drug system was introduced to bring downthe prices of medicines,

3. Eight state-owned fair price drug shops were opened,

4. Six new medical colleges, three new nursing schools, andone public health school were opened.


11/31


The fifth five-year plan (1978-1983) was scheduledfor 1975-1980, but to cover the deficiencies and tomake a more realistic plan, the slight shift was made.

Under a process of a Country Health Program (CHP), thataimed at improving

1. Planning and management of health services.

2. Under CHP it was recommended that rural health coveragebe increased at least to 50%, in addition to others,


12/31


3. Striking the communicable diseases,

4. Combating malnutrition,

5. Food adulteration and

6. Industrial hygiene were highlighted.


13/31


During Sixth five-year plan (1983-1988),1. Government launched extensive rural developmentprogram that provided sound base for Health for all by theyear 2000.


14/31


Seventh five year plan (1988-1993): Alma Atadeclaration of 1978 remained the basis of all five

years plan afterwards.

1. During seventh five-year plan, new health facilities (BasicHealth Units and Rural Health Centers) were established,

2. A female medical technician school was established, andhealth facilities were provided with laboratory facilities.

3. Health facilities were linked with semi-skilled, trained

paramedics termed as community health workers.


15/31


4. Third health project was launched aiming at improving MCHservices.

5. Second Family Health Project was started to improve thehealth of masses in general and that of women in particular.

6. Minimization of drug abuse,

7. Establishment of national school health services

8. and goiter control were other salient initiatives under thisplan


16/31


In Eighth five year plan (1993-1998),

1. Health management information system (HMIS),

2. Social action program (SAP), and Prime Minister Programfor Family Planning and

3. Primary Health Care were launched


17/31


During Ninth five year plan (1998-2003)

1. Decentralized Planning, levying user charges for financing,public private partnership and privatization of health facilities

were the areas of programming.

2.The strategy of the plan was to consider the gains alreadyachieved in the previous plan and to improve the quality ofservice by creating a balance of promotive, preventive andcurative services and removal of management weaknesses ofthe health system


18/31

System continued

1. In 2001 the government aimed to bring aboutProgrammatic and Organizational and Management Reforms.

These were to foster alleviation of poverty agenda ofgovernment, under health sector reforms, devolution hadacquired immediate importance and major impetus was ondistrict health system.

2. At federal level a policy analysis and reform unit is being

established.

3. The Health Policy 2001 considered health sectorinvestment as a part of governments Poverty Alleviation Plan.It gave more importance to primary and secondary healthservices as opposed to tertiary level health services in thepast.

4. Good governance is seen as a basis of health sector reformto achieve quality health care


19/31

Functions of the Health Department(KPK) Present Status

I. Leadership and evidence-based direction setting for

health sector.1. Health policy and reforms.

2. Health planning, financing and budget.


20/31


II. Health Support and Development.

3. Health promotion

(a) Health education; and

(b) Community involvement and advocacy.


21/31


4. Disease Prevention and control:

(a) Communicable diseases; and

(b) Non-communicable diseases.

5. Occupational Health.

6. Environmental Health.


22/31


7. Curative and rehabilitative care.

(a) Primary, secondary and tertiary level curative servicesincluding mental health; and

(b) Rehabilitative care.

8. Health related preparedness and response to disasters


23/31


III. Health Regulation and Enforcement.

9. Health personnel, facilities and services

10. Levying of fees and charges by medical professionals

and facilities.11. Quality assurance and control.

12. Facilities and services.

13. Drugs control.

14. Alternative systems of medicine.


24/31


15. Food and sanitation:

(a) Prevention and control of adulteration in food; and

(b) Monitoring & reporting upon safe drinking water supplyand sanitation services.

16. Devices and technology.


25/31


IV. Management Support Services.

17. Health human resource planning.

18. Health human resource development:

(a) Provision of quality medical and allied education;

(b) Pre-service training of support medical and healthprofessions; and

(c) In-service training of health human resource.


26/31


19. Health human resources management.

20. Logistics and procurement.

21. Internal audit and accounting in the HealthDepartment.


27/31


22. Legal services:

(a) Propose medico-legal advice and litigation;

(b) Propose law review, amendment, formulation relating toHealth Department; and

(c) Facilitate Law Department in litigation related to HealthDepartment.


28/31


V. Monitoring and evaluation.

23. Generation of evidence:

(a) Performance assessment;(b) Information and communication systems; and

(c) Health, medical and allied research.

24. Knowledge management for evidence based decisionmaking.


29/31


VI. Co-ordination on health related matters.

25. Ministries, Departments, Local and InternationalPartners and donors.


30/31

Programs/Projects

HIV/AIDS

Expanded Programme on Immunization

TB Control Programme Prime Minister programme for prevention and control of

Hepatitis

Roll Back Malaria Programme

National Maternal, Newborn & Child Health Program,Khyber Pakhtunkhwa

National Program for Family Planning and Public HealthCare Khyber Pakhtunkhwa


31/31

THANKS

HEALTH SYSTEM ORGANIZATION OF PAKISTAN.pptx

Documents

Transcript of HEALTH SYSTEM ORGANIZATION OF PAKISTAN.pptx