Health care system in pakistan

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Health Care systems Pakistan
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Leaning objectives

• The participants will be able to
• Know different partners in health.
• Levels of healthy care with differentiating
  points
• PHC with its functions
• Other sectors than Government in health care
• Summary of health structure and functions

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Partners in Health
Improving Health
Individual / Family
Community
Governments / NGOs / Private
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Health is a state of complete physical, mental,
spiritual and social well being, and not merely
the absence of disease or infirmity
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Government systems in Pakistan

• Federal Government
• Provincial Governments
• Local Governments (started in 2014)
• Each government level has some health
  responsibility

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June 2011

• 18th Amendment in the constitution of Pakistan
• Health POLICY by Federal Government,
  implementation by Provincial Government
• From July 2011 responsibilities and resources
  shifted to provincial Government
• From 2014, Local Governments have an important
  role in health delivery systems???

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Province Department of Health

• Minister and Secretary Health, Policy level
  decisions
• Additional and Deputy S H
• Section officer with support staff and D G
  Health
• (Planning and management)
• Teaching and training institutes
• (Medical colleges, nursing and paramedic training
  schools)
• Meedical Teaching Institutes (HMC, KTH, LRH, ATH,
  GMC, SMC, BMC)

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The Local Government (District Health System) in
the context of devolution after 2014

• Very important
• District Nazim / Deputy Commissioner.
• (Planning, Implementation, Monitoring, data
  collection, analysis, interpretation, evaluation
  and planning)

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Levels of health care

• Primary (BHU, RHC, LHWS ) 60-80 per district
• Secondary (THQ, DHQ hospitals) 1-4 per district
• Tertiary (Teaching hospitals) 1-3 per division

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• L H W 1000 (Health hou)
• B H U 10000
• R H C 30-50 thous.
• TH Q 2 lacs.
• D H Q 10 lacs.

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Divisions and districts in KP

• 1 Peshawar
• 1. Peshawar (Tertiary centres 4 in Govt, 4 in
  Private)
• 2. Nowshehra
• 3 Charsada
• 2 Mardan
• 4 Mardan (Tertiary)
• 5. Swabi
• 3. Kohat
• 6. Kohat (Tertiary centre)
• 7. Karak
• 8 Hangu

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Divisions and Districts in KPK

• 4 Malakand
• 9 Swat (Tertiary centre)
• 10 Shangala
• 11 Lower Dir
• 12 Upper Dir
• 13 Chitral
• 14 Buneer
• 15 Malakand
• 5 Bannu
• 16 Bannu (Tertiary Centre)
• 17 Lakki Marwat

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• 6 Hazara
• 18 Abbotabad (1 Govt, 3-4 Private sector)
• 19 Mansehra
• 20 Battagram
• 21 Haripur
• 22 Kohistan
• 23 Torgahar
• 7 D I Khan
• 24 D I Khan (Tertiary)
• 25 Tank

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Functions of secondary levels(THQ and DHQ
hospitals)

• Managing referrals from PHC
• Surgical / medical interventions (advanced)
• Training for Human Resource for Health (Nurses,
  paramedics,)

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Health care System in Pakistan

• HRD (CME, CPD, CED)
• Specialized Care for referred cases
• Research and Development

CENTRE OF EXCELLENCE
All the three tiers are important
Tertiary Health Care
Primary Secondary Health Care Complex Training
some cadres
District Comprehensive health Care Programme
Primary Health Care
Service Delivery
Community
Community
Community
Diagnose Treatment Ref
Diagnose suspect refer
Diagnose Treat
Detect
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Health systems

• A well-functioning health system working in
  harmony is built on having
• trained and motivated health workers,
• a well-maintained infrastructure, and
• a reliable supply of medicines and technologies,
• backed by adequate funding, strong health plans
  and evidence-based policies.
• https//dogblaze.com/

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THE DECLARATION OF ALMA ATA 1978 Health for all
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Health For All (1978) the attainment by all
peoples of the world, a level of health that will
permit them to lead a socially and economically
productive life.
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PRIMARY HEALTH CARE (PHC) Primary Health Care is
essential health care based on practical,
scientifically sound and socially acceptable
methods and technology, made universally
accessible to individuals and families in the
community through their full participation and at
a cost that the community and country can afford
to maintain at every stage of their development
in the spirit of self-reliance and
self-determination.
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Functions or elements of PHC

• Education on health problems and how to prevent
  and control them. P
• Development of effective food supply and proper
  nutrition. P
• Maternal and child healthcare, including family
  planning. P
• Adequate and safe water supply and basic
  sanitation. P
• Immunization against major infectious
  diseases. P
• Local endemic diseases control. P
• Appropriate treatment of common diseases and
  injuries. C
• Provision of essential basic medication. C

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Elements of P H C

• 1. EDUCATION
• Education regarding common diseases in the
  catchment population may reduce the occurrence of
  disease.
• (measles, polio, malnutrition, taking medicine of
  hypertension preventing stroke / heart attack
  etc)

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2. PROPER NUTRITION Nutrition is another
essential component of health care. WHO works to
prevent malnutrition and starvation and to
prevent many diseases and afflictions. (Nutrition
during pregnancy, breast feeding, young children
supplementary balanced diet, low salt diet)
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Malnutrition Predisposing Factors
Mothers Education More common in
illiterate mothers Socioeconomic conditionsMore
common in poor (Clustering) land less laborers
Malnourished mother at young age
Baby Girl malnourished
children
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3. CLEAN WATER SANITATION Clean water and
basic sanitation can reduce the spread of disease
. A supply of clean, safe drinking water, and
basic sanitation measures regarding trash, sewage
and water cleanliness can significantly improve
the health of a population, reducing and even
eliminating many preventable diseases.
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4. MATERNAL CHILD HEALTH CARE (MCH) Ensuring
comprehensive and adequate health care to
children and to mothers, both expecting and
otherwise, is another essential element of
primary health care. By caring for those who are
at the greatest risk of health problems, WHO
helps future generations have a chance to thrive
and contribute globally. Sometimes, care for
these individuals involves adequate counseling on
family planning.
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5. IMMUNIZATION By administering global
immunizations, WHO works to wipe out major
infectious diseases, greatly improving overall
health globally.
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6. LOCAL DISEASE CONTROL Prevention and
control of local diseases is critical to
promoting primary health care in a population.
Many diseases vary based on location. Taking
these diseases into account and initiating
measures to prevent them are key factors in
efforts to reduce infection rates.
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7. ACCESSIBLE TREATMENT Getting health care
quickly is important Another important component
of primary health care is access to appropriate
medical care for the treatment of diseases and
injuries. By treating disease and injury right
away, caregivers can help avoid complications and
the expense of later, more extensive, medical
treatment.
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8. DRUG PROVISION Proper medication By
providing essential drugs to those who need them,
such as antibiotics to those with infections,
caregivers can help prevent disease from
escalating. This makes the community safer, as
there is less chance for diseases to be passed
along.
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What is Universal Health Coverage (UHC)?

• UHC means that all individuals and communities
  receive the health services they need without
  suffering financial hardship.
• It includes the full spectrum of essential,
  quality health services, from health promotion to
  prevention, treatment, rehabilitation, and
  palliative care.

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• UHC enables everyone to access the services that
  address the most important causes of disease and
  death,
• and ensures that the quality of those services is
  good enough to improve the health of the people
  who receive them.

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Protecting from poverty

• Protecting people from the financial consequences
  of paying for health services out of their own
  pockets reduces the risk that people will be
  pushed into poverty because unexpected illness
  requires them to use up their life savings, sell
  assets, or borrow destroying their futures and
  often those of their children.

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• Good health allows children to learn and adults
  to earn,
• helps people escape from poverty, and provides
  the basis for long-term economic development.

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References

• www.dogblaze.com
• Go to animal and veterinary
• www.dogblaze.com/can-dogs-eat-eggplant/
• The Healthful Alternative Dog and Cat Diets

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Thank you