Pakistan Health Statistics Quiz

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Questions and Answers

What percentage of Pakistan's population is under the age of 15?

40%

34% (correct)

21%

28%

What is the infant mortality rate in Pakistan per 1000 live births?

55 (correct)

Which of the following diseases accounts for the highest percentage of non-communicable diseases in Pakistan?

Cardiovascular diseases (correct)

Cancer

Diabetes

Respiratory diseases

What is the crude birth rate in Pakistan per 1000 individuals?

30 Signup and view all the answers

What is the immunization coverage percentage in Pakistan?

65% Signup and view all the answers

What remains absent at the national level in Pakistan's health information architecture?

Vital registration and notifiable disease reporting Signup and view all the answers

Which healthcare delivery approach has shifted focus in Pakistan following the Alma Ata declaration?

Primary healthcare Signup and view all the answers

What is a significant strength of Pakistan's Health Care Delivery System (HCDS)?

Outreach primary healthcare services by community health workers Signup and view all the answers

Under which constitutional amendment is health care a responsibility of the provincial government in Pakistan?

18th amendment Signup and view all the answers

What has Pakistan's health policy determined to improve in collaboration with the UN?

Health indicators defined by the UN Signup and view all the answers

What percentage of outpatient visits in Pakistan is accounted for by the private sector?

80% Signup and view all the answers

Which of the following health professions saw the largest increase in registered professionals from 2012 to 2023?

Registered Doctors Signup and view all the answers

What change occurred in Pakistan's national health policy after the Alma Ata Declaration?

Shift towards primary healthcare Signup and view all the answers

Which entity was responsible for public sector health programs before its abolition in June 2011?

Ministry of Health Signup and view all the answers

What is the reported population per doctor in Pakistan as of 2023?

997 Signup and view all the answers

Which organization was NOT part of Pakistan's initiative to achieve the Millennium Development Goals?

World Health Organization (WHO) Signup and view all the answers

What percentage of rural population in Pakistan has health facilities within 5 kilometers as stated in the health policy?

70% Signup and view all the answers

Which of the following healthcare metrics improved from 2012 to 2017 in Pakistan?

Population per Bed decreased Signup and view all the answers

What characterizes a mixed health system?

It involves both public and private healthcare sectors. Signup and view all the answers

What is a major issue faced by the public healthcare system in Pakistan?

Lack of modern equipment. Signup and view all the answers

Which factor can limit access to private healthcare services for certain populations in Pakistan?

Expensive services for lower-income individuals. Signup and view all the answers

What is the primary role of District Health Managers in Pakistan's health system?

To develop District Health Plans based on situation analyses. Signup and view all the answers

What does the effectiveness of a healthcare system depend upon?

The availability and accessibility of human, materials, and finance resources. Signup and view all the answers

What was the main goal of the Lady Health Worker training initiative in Pakistan?

To ensure healthcare services are accessible at community level. Signup and view all the answers

Which of the following is NOT a component of health services that a balanced healthcare system should provide?

Advanced surgical techniques exclusively. Signup and view all the answers

Which organization is primarily associated with the Expanded Program on Immunization (EPI) in Pakistan?

Global Alliance for Vaccines & Immunization (GAVI). Signup and view all the answers

What percentage of Pakistan's GDP was allocated to Current Health Expenditure in 2020?

2.95% Signup and view all the answers

What issue is currently affecting the planning process in districts for health care in Pakistan?

No effective planning is taking place. Signup and view all the answers

Which of the following services is included in the healthcare system coverage throughout an individual's life cycle?

Diagnosis. Signup and view all the answers

What percentage of the population in Pakistan seeks treatment in the private sector?

70% Signup and view all the answers

What is the role of Lady Health Workers (LHWs) in the health system of Pakistan?

To connect communities with healthcare services. Signup and view all the answers

What is the primary role of the 30 teaching hospitals in Pakistan?

Offer curative services primarily Signup and view all the answers

Which services are mainly provided through national programs and PHC centers?

Preventive Services Signup and view all the answers

Which of the following is NOT a major source of financing for health in Pakistan?

Corporate sponsorships. Signup and view all the answers

Which agency is an external funding agency supporting health programs in Pakistan?

USAID. Signup and view all the answers

What percentage of the pharmaceutical demand in Pakistan is met by local manufacturing?

80% Signup and view all the answers

What issue do public health facilities in Pakistan commonly face regarding medicines?

Frequent stockouts Signup and view all the answers

Which tier of the public health care delivery system in Pakistan would typically handle referrals from primary care facilities?

Secondary Health Care. Signup and view all the answers

What is the main reason for the rising demand on state health institutions in Pakistan?

Rising population pressure Signup and view all the answers

What does the Drug Regulatory Authority of Pakistan (DRAP) do?

Sets policies and controls pharmaceutical companies Signup and view all the answers

What is a significant problem faced by public health facilities regarding medical equipment?

Lack of policy for upgradation and replacement Signup and view all the answers

What is the role of stand-alone clinics in Pakistan's health care system?

They are major providers of outpatient care Signup and view all the answers

Study Notes

National Model of Health System

Pakistan's healthcare system is a mixed system, combining public and private sectors.
A mixed health system combines elements of both public and private healthcare sectors to provide medical services to the population.

Mixed Health System (Details)

The public sector includes government-funded hospitals, clinics, and basic health units.
These facilities often face insufficient funding, lack of modern equipment, and shortages of essential medicines.
The private healthcare sector in Pakistan is well-developed, serving a substantial portion of the population, notably in urban areas.
Private hospitals, clinics, and individual practitioners often offer better quality services but can be expensive and inaccessible to many, particularly those from lower-income backgrounds.

Decentralization

Decentralization is defined as the transfer of authority and responsibility from the central government to subordinate offices or quasi-independent government organizations.
Decentralization takes two forms:
- Deconcentration: Shifting power from central offices to peripheral offices within the same administrative structure (e.g., provincial health departments to district offices).
- Delegation: Shifting responsibility and authority to semi-autonomous organizations (e.g., a hospital's board of governors).
- Devolution: Shifting responsibility and authority to separate administrative structures, such as an elected local government.

Healthcare System in Pakistan (Local Government)

Under the Local Government, District Health Managers and District Health Management Teams (DHMTs) are required to develop District Health Plans.
These plans prioritize problems, establish realistic objectives and targets, and specify interventions, activities, and budgeting.
Planning aids monitoring and evaluation of health activities in districts.

Healthcare System: Effectiveness

Effectiveness depends on the availability and accessibility of human resources, materials, and finances.
A balanced healthcare system provides a continuum of services throughout a person's life cycle, encompassing health promotion, disease prevention, diagnosis, treatment, and rehabilitation.

Pakistan Indicators

Population under 15 years: 34%
Population over 60 years: 7%
Infant mortality rate/1000: 55
Maternal mortality rate/100,000: 280
Crude birth rate/1000: 30
Crude death rate/1000: 6.3
Fertility Rate (F.R): 3.2
Immunization coverage: 65%

Pakistan Diseases

Communicable, MNCH, and Nutritional diseases: 41%
Non-communicable diseases: 59% (Breakdown of non-communicable diseases: CVDs 21%, Injuries 16%, Cancer 6%, Diabetes 2%, Respiratory diseases 7%, Other chronic diseases 7%)

Health Workforce

Registered Doctors (2012): 2,47,566; (2023): 1,52,368
Registered Dentists (2012): 27,428; (2023): 11,649
Registered Nurses (2012): 1,02,855; (2023): 77,683
2017: Population per Doctor: 997; Population per Dentist: 10,658; Population per Bed: 1584

Organization of National Health System in Pakistan

The Ministry of Health oversees both public and private sectors, with Public-sector divided into health regions.
The private sector consists of for-profit and not-for-profit organizations (NGOs, philanthropists).

Healthcare System in Pakistan (Public v Private)

Before 2011 amendments, the healthcare mainly operated through the Ministry of Health, however, with the amendments, responsibility shifted to provincial Health Departments.
Currently, the private sector accounts for approximately 80% of outpatient visits.

Health Care Delivery System of Pakistan

A diagram illustrates the structure with Federal, Provincial, Ministries, and private sector organizations like hospitals, clinics and individual practitioners.

Government Commitment in Changes in National Health Policy

Pakistan initially focused mainly on curative services.
The Alma-Ata Declaration shifted the focus toward primary healthcare.
Provision of PHC services has reached 70% of the rural population.

Partnership in MDGs

Pakistan became a signatory to the United Nations' Millennium Development Goals.
Increased collaborations between UN organizations, the Pakistani government, and private donors.
Projects include National TB control program, family planning, and school nutrition.

Government Vertical Programs

Pakistan launched Expanded Program on Immunization (EPI) in 1978 and partnerships with Global Alliance for Vaccines and Immunization (GAVI).
The Lady Health Worker training initiative aims to improve primary healthcare services in underserved areas, primarily women and children.

Health Financing

Current Health Expenditure: 2.95% of GDP (2020).
The out-of-pocket system is the most significant funding mechanism.
Private insurance, external funding, and NGOs play a part alongside general taxation.
70% of the population seeks healthcare treatments within the private sector.

Health Financing (Internal and external)

Key internal entities in Pakistan's healthcare system are NGOs, like HANDS, Shiffa Foundation, and Aga Khan Health Services Pakistan (AKHSP).
Major external funding comes from USAID, and the UK Department for International Development.
Funding contributes to various health programs such as National Tuberculosis Control Program and the HIV/AIDS program.

Health Financing (Coverage)

A circle graph visualizes the coverage percentage by different stakeholders in Pakistan.
Significant proportions are covered by un-funded members of different organizations.

Tiers of Public HC Delivery System

Pakistan has a tiered system of healthcare delivery.
- Tertiary care is provided by teaching hospitals (30 in Pakistan).
- Secondary care is at District/Tehsil Headquarters.
- Primary care includes Basic Health Units, Rural Health Units, and outpatient departments.

Primary Healthcare

Pakistan has a large infrastructure for primary healthcare.
- Basic Health Units (BHUs)
  - Rural health centre (RHCs)
These facilities have roughly 100,000 lady health workers across Pakistan providing health services to communities.

Secondary Healthcare

The PHC services are supported by numerous hospitals, located at tehsil and district levels for referrals. (989 THQ/DHQs hospitals).

Tertiary Healthcare

There are 30 teaching hospitals in Pakistan, predominantly focusing on curative services.

Service Delivery Organization

Pakistan has public health services arranged for preventive and promotive activities (often through PHC centers and outreach activities).
Curative and rehabilitative services are primarily delivered via secondary and tertiary care facilities.

Private Sector

Rising population pressures encourage a greater role by the private health sector to address increased demand.
private hospitals, clinics and diagnostic labs are rapidly emerging and complementing the existing public sector facilities.

Health System Medical products & Technologies

Pakistan's pharmaceutical industry is expanding, with 411 registered manufacturing businesses and 30 multinationals.
Public health facilities face frequent issues with medicine shortages partly due to the insufficient medical equipment, which are often not maintained and updated.

Health System Information, Communication & Technology

After devolution, the health information architecture in Pakistan has become fragmented.
Vital registration and reporting of notifiable diseases are lacking nationally.
However, some private health sectors and armed forces hospitals are well-equipped, and HMIS (Health Management Information Systems) is present.

Strengths of Health System of Pakistan

Pakistan has a well-developed outreach-based system for primary healthcare via Lady Health Workers (LHWs), Lady Health Visitors (LHVs), and Community Midwives (CMWs).
Public-Private Partnerships (PPPs) have demonstrated positive results. (e.g., National TB Control program).
The role of the provincial governments in delivering healthcare services has increased.
Pakistan has achieved considerable success in realizing the MDG targets.

Weaknesses of Health System of Pakistan

The health system's governance is fragmented, and accountability is a key issue.
Accessibility to healthcare services varies geographically and is not uniform.
There are infrastructure shortcomings and insufficient resources (including medicine, equipment, personnel).
Limited spending on healthcare affects access and quality while financial burden on individuals is extremely high.
Existing data collection and reporting on public health are fragmented, and there are insufficient resources.

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Description

Test your knowledge on key health statistics and policies in Pakistan with this quiz. Questions cover population demographics, healthcare delivery systems, and important health indicators. See how well you understand the challenges and strengths of health care in the country.