Pakistan

Pakistan is the seventh most populous country in the worldPakistan is the seventh most populous country in the world

Pakistan – A Preview Total Population – 152.5 million

Male : Female Proportion – 52 : 48

Urban : Rural Proportion – 33.4: 66.6

Population Density / Sq. Km – 187/person

Demographic IndicatorsPakistan is categorized by high mortality and

population growth rates

• Total Fertility Rate 4.07

• Crude Birth Rate 28

• Population Growth Rate 1.92

• Infant Mortality Rate 82

• Under 5 Mortality Rate 98

• Maternal Mortality Ratio 350

• Contraceptive Prevalence Rate 34Economic survey of Pakistan 2004 - 05

MGD 4: Reduce Child Mortality

INDICATORS FOR PAKISTAN

• Under-five mortality rate

• Infant mortality rate

• Proportion of fully immunised children (12-23 months)

• Proportion of children < 1 yr immunised against measles

• Prevalence of under-weight children (under 5 yrs)

• Lady Health Workers’ coverage of target population

MGD 5: Improve Maternal Health

INDICATORS FOR PAKISTAN

• Maternal mortality ratio

• Proportion of births attended by skilled birth attendants

• Contraceptive prevalence rate

• Total fertility rate

• Proportion of women 15-49 years who had given birth

during last 3 years, and made at least one antenatal

care consultation

MGD 6: Combat HIV/AIDS, Malaria and Other Diseases

INDICATORS FOR PAKISTAN

• HIV prevalence among 15-24 year old pregnant women

• HIV prevalence among vulnerable groups (e.g., active sex

workers)

• Proportion of population in malaria risk areas using effective

malaria prevention and treatment measures

• Incidence of tuberculosis per 100,000 population

• Proportion of TB cases detected and cured under Directly

Observed Treatment Short Course (DOTS)

Target 5 Reduce under – 5 mortality by two-thirds

Indicators 1990/91 2001/02 2002/032005/06Targets

2011 2015

UNDER 5 MORTALITY RATE

140 105 103 80 65 52

INFANT MORTALITY RATE

102 77 75 63 50 40

MGD 4: Reduce Child Mortality(MGD Goals Report 2004 – Planning Commission of Pakistan)

MGD 4: Reduce Child MortalityStatus at a Glance – Summary of Progress

(MGD Goals Report 2004 – Planning Commission of Pakistan)

GOAL/TARGETS

WILL TARGET BE REACHED?STATE OF

SUPPORTIVE ENVIRONMENT

Reduce child mortality

Probably Potentially Unlikely Strong Fair Weak

Reduce under 5 mortality by 2/3

MGD 4: Reduce Child MortalityCapacity for Monitoring and Reporting Progress

(MGD Goals Report 2004 – Planning Commission of Pakistan)

Quality and Regularity of

Survey Information

Statistical AnalysisStatistics in Policy

Making

Reporting and Dissemination of

Information

Strong Fair Weak Strong Fair Weak Strong Fair Weak Strong Fair Weak

Target 6 Reduce maternal mortality by three quarters

Indicators 1990/91 2001/02 2002/032005/06Targets

2011 2015

Maternal mortality ratio

550 350 350-400 300-350 180 140

Births attended by skilled birth attendants

18% 40% 40% 75% 90% >90%

MGD 5: Reduce Maternal Mortality(MGD Goals Report 2004 – Planning Commission of Pakistan)

MGD 5: Reduce Maternal MortalityStatus at a Glance – Summary of Progress

(MGD Goals Report 2004 – Planning Commission of Pakistan)

GOAL/TARGETS

WILL TARGET BE REACHED?STATE OF

SUPPORTIVE ENVIRONMENT

Reduce child mortality

Probably Potentially Unlikely Strong Fair Weak

Reduce under 5 mortality by 2/3

MGD 5: Reduce Maternal MortalityCapacity for Monitoring and Reporting Progress

(MGD Goals Report 2004 – Planning Commission of Pakistan)

Quality and Regularity of

Survey Information

Statistical AnalysisStatistics in Policy

Making

Reporting and Dissemination of

Information

Strong Fair Weak Strong Fair Weak Strong Fair Weak Strong Fair Weak

Indicators 1990/91 2001/02 2002/032005/06Targets

2011 2015

HIV prevalence among 15-24 year old pregnant women

n/a Nil n/a n/a n/aBaseline to be reduced

by 50%

MGD 6: Combating HIV/AIDS, Malaria and Other Diseases

(MGD Goals Report 2004 – Planning Commission of Pakistan)

MGD 6: Combating HIV/AIDS, Malaria and Other Diseases

Status at a Glance – Summary of Progress (MGD Goals Report 2004 – Planning Commission of Pakistan)

GOAL/TARGETS

WILL TARGET BE REACHED?STATE OF

SUPPORTIVE ENVIRONMENT

Halt & begun to reverseHIV / AIDS

Probably Unlikely No Data Strong Fair

Weak but

improving

MGD 6: Combating HIV/AIDS, Malaria and Other Diseases

Capacity for Monitoring and Reporting Progress (MGD Goals Report 2004 – Planning Commission of Pakistan)

Quality and Regularity of

Survey Information

Statistical AnalysisStatistics in Policy

Making

Reporting and Dissemination of

Information

Strong Fair Weak Strong Fair Weak Strong Fair Weak Strong Fair Weak

Issues

• Inadequate budgetary allocation

• High population growth rate

• High fertility rate

• Focus on curative medicine than the preventive treatment

• Poor primary health care services

• Lack of integration of vertical Preventive programs

Issues (cont’d)

• Inadequate social sector services delivery

• Professional and managerial deficiencies

• High prevalence of communicable diseases

• Lack of integrated management of childhood illnesses

• Malnutrition

• Low skilled birth attendance rate

Issues (cont’d)

• Lack of awareness

• Insufficient accessibility to maternal health

care services especially emergency

obstetric care

• Lack of sex education for HIV/AIDS

Advantages / Strengths

• Health System Infrastructure

• Improving fiscal environment

• Functional community-based LHWs

• Devolution

• Poverty-alleviation strategies

Government Programs - Health

• National Program for Family Planning and Primary Health Care

• Food and Nutrition

• Women Health Project

• Reproductive Health Project

• Expanded Program on Immunization

• National Maternal and Child Care Program

NCHD – Health ProgramsFocus is on ensuring access to health services

• Primary Health Care Extension

• National ORS Campaign

• National School Health Program

• Strengthening of Primary Health Care

System

ROLE OF ICT IN HEALTH

• ICTs provide opportunities for individuals, medical professionals and healthcare providers to

– obtain information,

– communicate with professionals,

– deliver first-line support especially where

distance is a critical factor and

– promote preventive medicine programmes.

APPLICATION OF ICT IN HEALTH• At Referral Hospitals/Regional Hospitals/

District/Sub-district Health Centres, ICT enable:

– more effective planning, decision-making

and monitoring

– improved shared service operations

– greater access to more reliable health &

population data

– more effective resource management

APPLICATION OF ICT IN HEALTH (Cont’d)

• Particular value for patients from improved information systems include:

– development & use of electronic patient

records

– multi-media decision support systems

– remote monitoring

– updating patient notes using wireless

Personal Digital Assistants (PDA)

E-HEALTH CHALLENGES

• Creating ICT technologists and technicians in health sector at all levels

• Attitudes about use of ICT/e-health technologies• Time - Man’s greatest enemy• Achieving consensus• Lack of investment in technology in healthcare

sector • Lack of Stakeholder participation

E-HEALTH CHALLENGES

Solutions are needed to solve these challenges.

How can e-health help to meet health sector challenges?