Abstract:
The Millennium Development Goals provided countries with well-rounded objectives
for achieving human development over a period of twenty-five years. Pakistan is not on
track to achieve health-related goals. With the eighth highest newborn death rate in the
world, between 2001 to 2007 one in every ten children born in Pakistan died before
reaching the age of five. Similarly for women, there is a one in eighty chance of dying of
maternal causes during reproductive life. Compared to other South Asian countries,
Pakistan currently lags behind in immunization coverage, contraceptive usage and infant
and child mortality rates. The share of out-of-pocket expenditures of total health
expenditures in Pakistan was one highest in the world in 1998, and the situation has not
changed much since then. Pakistan is going through an epidemiological transition of a
double burden of communicable diseases combined with maternal and perinatal
conditions, as well as chronic, noninfectious diseases. The landscape of public health
service delivery presents an uneven distribution of resources between rural and urban
areas. The rural poor are at a clear disadvantage in terms of primary as well as tertiary
health services. Moreover, they also fail to benefit fully from public programs such as
immunization of children. There has been a massive increase in the role of the private
sector in the provision of service delivery. The poor state of public facilities is a
contributing factor to the diminished role of public health facilities. After the 18th
Amendment of the Constitution, health as a sector has been devolved to the provinces,
yet the distribution of responsibilities and sources of revenue generation between the
tiers remains unclear. There is a need for a multipronged national health policy that
tackles the abysmal child and maternal health indicators, along with reducing the burden
of disease. Moreover, it is imperative to improve the provision of primary as well as
tertiary health care with a strong system for monitoring in place, along with the provision
of social safety nets for the vulnerable.
