Pakistan's healthy life expectancy ( HALE) is 55 years for males and 56.8 years for females ( WHO) , making us 125th . According to our health performance , we are ranked 85th ; where as the over all health system performance , bestows us a rank of 122 nd ! Pakistan has one of the largest populations ( within top 10) within the developing world. Hence, the population has a greater prediposition to certain diseases and hence, health systems may find limitations along several issues.
In order to achieve better quality outcomes we will need a improved quality of access to a better quality system. In order to measure quality accurately we will need access to accurate data.
So safe to say: we need a health sector reform. The overall goals of Health Sector reform are to enhance efficiency of the health care system, both technical and allocative; to improve the quality of services; and/or to generate new resources for the system. Pakistan has so far introduced little fundamental change in its health care system.
The extremely precarious and deteriorating economic reality in Pakistan alone demands such restructuring and reorganization of its health care system. Basic performance indicators of the health system also point to this need.
The goals of health sector reform are to improve the technical and/or allocative efficiency of the health care system, enhance the quality of services, and make the system more equitable. It has numerous dimensions - from financing to organization of services to the package of services to be delivered.A policy, legislative, regulatory and institutional overhaul in health has been long overdue.
(According to Dr Sania Nishter's published comment 2008) , it is important to recognise that the health status of populations has a direct correlation with the level of public spending on health. However, it is not just the aggregate level of spending, but the percentage of GDP allocated for health adjusted for inflation and population growth, and its translation into per-capita public expenditures relative to private expenditures that gives a somewhat truer picture of the state’s investments in health. Here, it is acknowledged that Pakistan’s aggregate level of allocation for health has increased considerably over the last decade, with further increases in this budget representing a positive trend. However, changes in health allocations as a percentage of the GDP have remained unremarkable; over the last 10 years this has ranged from 0.67 percent to 0.8 percent. The internationally recommended number is 4 percent of the GDP.
In 2008 , the public sector spends $4 per capita on health annually, as opposed to the internationally recommended $34 per capita, the minimum required to provide essential health services in developing countries. Clearly, this huge gap needs to be bridged.
Approximately 70 percent ( in 2008) of healthcare in the country is financed through out-of-pocket payments made to health providers at the point of care. This is the most inefficient and inequitable way of financing healthcare. Ideally, health should be funded through public sources, which include revenues, social health insurance or other means of pooling, such as social protection.
The classical budgetary disparity evidenced in priorities for allocating resources for preventive healthcare is obvious. According to the Federal Bureau of Statistics’ Pakistan Demographic Survey, it is documented that more than 50 percent of deaths are due to non-communicable diseases (NCDs). However, as opposed to this, only 0.66 percent of the total healthcare budget has been allocated for the prevention of these diseases. NCDs, a collective name given to the diseases of the heart, diabetes and some lung conditions and cancer, incur significant costs in healthcare, undermine income-generating capacities of the productive workforce and have the potential to perpetuate acute poverty crises.
Hence, as we see ,there's many factors well beyond the quality of the health care system that contribute to these lagging rank: persistent poverty in the country ; chronic un- and underemployment; high levels of income and status inequality; and high levels of social stress and insecurity.
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