پاڪستان ۾ صحت
پاڪستان جي آئين مطابق هر فرد جي صحت جي سنڀال ۽ مفت علاج وغيره حڪومت جي فرضن ۾ شامل آهي. پاڪستان جي ٽئين پنج سالا منصوبي مطابق حڪومت اهو عزم ڪري ڇڏيو هو ته 1985ع تائين ملڪ جي سموري آباديءَ کي صحت جا بنيادي لوازمات مهيا ڪيا ويندا ۽ ڪو به شخص طبي مراعات کان محروم نه رهندو. طبي سهولتن جي فراهمي صوبائي صحت کاتي جي ذمي آهي. مرڪزي حڪومت جو ڪم آهي صحت جي پروگرامن جي رهنمائي ڪرڻ. قيام پاڪستان وقت صحت جو قومي معيار نهايت خراب هو. ملڪ ۾ سنديافته ڊاڪٽرن جو تعداد گهٽ هو. اسپتالون نه هيون. دوائن ٺاهڻ جا ڪارخانا نه هئا.
هن وقت ضلعن جي صدر مقامن (شهرن) ۾ وڏيون اسپتالون آهن، جيڪي صحت جي سلسلي ۾ ناڪافي آهن. 1961ع ۾ مليريا جي مرضن ۾ ورتل ٻه ڪروڙ ماڻهو رڪارڊ ڪيا ويا هئا. هڪ اندازي مطابق هن وقت به هڪ لک ماڻهو سلهه جي مرض ۾ مبتلا آهن، پر هن وقت سلهه (ٽي. بي) جو علاج ممڪن ۽ آسان آهي، جيڪو اٺن مهينن جي ڪورس تي مشتمل هوندو آهي ۽ هر تعلقي اسپتال ۾ ٽي. بيءَ جي مريضن کي رجسٽرڊ ڪري مفت ۾ علاج جي سهولت ڏني وئي آهي. انهيءَ جي علاج لاءِ مرڪزي حڪومت جي امداد سان ضلعي بالاڪوٽ ۾ 50 بسترن جو شفاخانو آهي. مرض پيدا ڪرڻ ۾ سڀ کان وڌيڪ دخل ماحول ۾ گندگيءَ جو آهي. 1966ع ۾ صفائيءَ جي هڪ مهم هيٺ صفائيءَ جو پرچار ڪيو ويو، جنهن ۾ تازي هوا، صاف پاڻي ۽ متوازن غذا جي اهميت کان ماڻهن کي روشناس ڪرايو ويو هو. هن وقت پاڪستان سميت پوري سنڌ ۾ جگر جي بيماري هيپاٽائيٽس عام ٿي وئي آهي. جنهن جو سبب ڊاڪٽرن جي چوڻ موجب آلوده (گدلو) پاڻي، انجيڪشنن ۽ بليڊن جو بار بار استعمال ۽ متاثر ٿيل رت جي منتقلي آهي. ان بيماريءَ جا ٽي قسم عام آهن. جن مان اي، بي ۽ سي جي علاج لاءِ حڪومت انتظام ڪيا آهن ۽ هر سرڪاري اسپتال ۾ هينئر ”هيپاٽائٽس ڪنٽرول پروگرام“ تحت مريضن جي مفت ٽيسٽ ۽ علاج ڪيو وڃي ٿو.
جڏهن ته ٻارن کي حفاظتي ٽڪن جو قومي پروگرام، ماءُ ۽ ٻار جي صحت بابت قومي پروگرام ۽ قومي ايڊز ڪنٽرول پروگرام به صحت کاتي جي ترجيحي سرگرمين ۾ شامل آهن.
تنهن کان سواءِ عالمي صحت واري اداري جي تعاون سان ملڪ ۾ پوليو خلاف ڪيترن سالن وئڪيشن ٻارن کي فراهم ڪيون پيون وڃن.
صحت جي خدمتن جو ڍانچو
[سنواريو]- اصل مضمون جي لاءِ ڏسو پاڪستان ۾ صحت جي سار سنڀال
پاڪستان ۾ صحت جي سار سنڀال جو هڪ مخلوط نظام آهي، جنهن ۾ سرڪاري انفراسٽرڪچر، پيرا اسٽيٽل هيلٿ سسٽم، خانگي شعبو، سول سوسائٽي ۽ مخير حضرات شامل آهن. پاڪستان ۾ علاج جو متبادل ۽ روايتي نظام به ڪافي مقبول آهي. سال 2011ع ۾ ملڪ ۾ 18هين ترميم ذريعي هڪ اهم آئيني سڌارو آندو ويو، جنهن جي نتيجي ۾ صحت واري وفاقي وزارت کي ختم ڪيو ويو ۽ بعد ۾ اختيارن کي صوبن ڏانهن منتقل ڪيو ويو، جنهن جي نتيجي ۾ صحت جي بنيادي ڍانچي ۽ ماليات جي حوالي سان وڌيڪ اختيار صوبن کي ڏنا ويا.
صحت جي خدمتن جي حوالي سان وڌندڙ شعور کي نظر ۾ رکندي قومي صحت جي خدمتن، ضابطي ۽ رابطي جي وزارت جي سال 2011ع ۾ قائم ڪئي وئي هئي. هن اداري جي قيام جو بنيادي مقصد هڪ صحت جو نظام مهيا ڪرڻ هو جيڪو موثر، برابري، پهچ ۽ سستي صحت جي خدمتن تائين رسائي فراهم ڪري. ۽ پڻ، عوامي صحت جي شعبي ۾ قومي ۽ بين الاقوامي تعاون سان گڏ آبادي جي ڀلائي جي هم آهنگي. اهو پڻ دوا جي قانون ۽ ضابطن کي لاڳو ڪيو. صحت جي سار سنڀار پهچائڻ واري نظام ۾ رياست ۽ غير رياستي شامل آهن؛ ۽ منافعو ۽ نه منافعي جي خدمت جي فراهمي لاءِ. ملڪ جي صحت واري شعبي کي نشانو بڻايو ويو آهي شهري-ڳوٺاڻن تفاوتن ۾ صحت جي سار سنڀار جي ترسيل ۽ صحت جي افرادي قوت ۾ عدم توازن، پردي جي علائقن ۾ ناکافي صحت مينيجرز، نرسن، پيرا ميڊيڪل ۽ ماهر پيدائش حاضرن سان. پاڪستان ۾ صحت جي سار سنڀار جي چيلنجز ۾ پڻ مسئلا شامل آهن جهڙوڪ ناکافي بجيٽ مختص، طبي ماهرن جي گهٽتائي، غير معياري جسماني انفراسٽرڪچر، تيز آبادي ۾ واڌ، جعلي ۽ مهانگيون دوائون، پيرا ميڊيڪل عملي جي گهٽتائي ۽ غير لائسنس يافته عملي جي موجودگي.
has a mixed health system, which includes government infrastructure, para-statal health system, private sector, civil society and philanthropic contributors.[1] Alternative and traditional system of healing is also quite popular in Pakistan.
The country undertook a major constitutional reform in 2011 with the 18th amendment, which resulted in abolishment of Ministry of Health and subsequent devolution of powers.As a result, more powers were given to provinces regarding health infrastructure and finances.[2] In keeping with the increased awareness regarding health services Ministry of National Health Services, Regulations and Coordination was formed in 2011. The main purpose of establishing this body was to provide a health system that gives access to efficient, equitable, accessible & affordable health services. And also, national and international coordination in the field of public health along with population welfare coordination. It also enforced drug laws and regulations.[3] The health care delivery system includes both state and non-state; and profit and not for profit service provision. The country's health sector is marked by urban-rural disparities in healthcare delivery and an imbalance in the health workforce, with insufficient health managers, nurses, paramedics and skilled birth attendants in the peripheral areas.[4] Health care challenges in Pakistan also include issues such as inadequate budgetary allocation, shortage of medical professionals, substandard physical infrastructure, rapid population growth, counterfeit and expensive medicines, shortage of paramedical personnel and presence of unlicensed practitioners.[5]
Sources of health expenditure in Pakistan was mostly "out-of-pocket" spending around 66% followed by the Government health spending at 22.1% in 2005.The situation has improved slightly now with out-of-pocket spending estimated to be 54.3% in 2020 followed by Government health spending of 35.6%.[6]
Primary Health Care
[سنواريو]Primary Healthcare system is the very basic health system for providing accessible, good-quality, responsive, equitable and integrated care. Primary healthcare in Pakistan mainly consists of basic health units, dispensaries, Maternal & child health centers and some private clinics at community level. In Sindh (Province in Pakistan), Primary healthcare activities are supported by government itself but managed by external private & non-government organizations like People's primary healthcare initiative, Shifa foundation, HANDS etc. A major strength of government's health care system in Pakistan is an outreach primary health care, delivered at the community level by 100,000 Lady Health Workers and an increasing number of community midwives, among other community based workers.[7]
Secondary Health Care
[سنواريو]It mainly includes tehsil & district hospitals or some private hospitals. Tehsil & district hospitals (THQs & DHQs) are run by the government, the treatment under government hospitals is free of cost.
Tertiary Health Care
[سنواريو]It include both private and government hospitals, well equipped to perform minor and major surgeries. There are usually two or more in every city. Most of the Class "A" military hospitals come in this category. Healthcare and stay comes free of charge in government hospitals. There is also a 24 hours emergency care that usually caters to more than 350 patients every day.[8]
Other health related services
[سنواريو]The government of Pakistan has also started "Sehat Sahulat Program", whose vision is to work towards social welfare reforms, guaranteeing that the lower class within the country gets access to basic medical care without financial risks.[9] Apart from that there are also maternal and child health centres run by lady health workers that aim towards family planning and reproductive health.[10]
Pakistan is the fifth most populous country in the world with population approaching 225 million.[11] It is a developing country struggling in many domains due to which the health system has suffered a lot. As a result of that, Pakistan is ranked 122nd out of 190 countries in the World Health Organization performance report.[12]
Life expectancy in Pakistan increased from 61.1 years in 1990 to 65.9 in 2019 and is currently 67.94 in 2024 .[13] Pakistan ranked 124th among 195 countries in terms of Healthcare Access and Quality index, according to a Lancet study.[13] Although Pakistan has seen improvement in healthcare access and quality since 1990, with its HAQ index increasing from 26.8 in 1990 to 37.6 in 2016.[14] It still stands at 164th out of 188 countries in terms of United Nations Sustainable Development Goals and chance to achieve them by 2030.[13]
According to latest statistics, Pakistan spends 2.95% of its GDP on health (2020).[6] Pakistan per capita income (PPP current international $,) is 6.437.2 in 2022[15] and the current health expenditure per capita (current US$) is 38.18.[16] The total adult literacy rate in Pakistan is 58% (2019)[16] and primary school enrollment is 68%(2018).[16] The gender inequality in Pakistan was 0.534 in 2021 and ranks the country 135 out of 170 countries in 2021.[17] The proportion of population which has access to improved drinking water and sanitation is 91% (2015) and 64% (15) respectively.[18]
The Human Rights Measurement Initiative[19] finds that Pakistan is fulfilling 69.2% of what it should be fulfilling for the right to health based on its level of income.[20] When looking at the right to health with respect to children, Pakistan achieves 82.9% of what is expected based on its current income.[20] In regards to the right to health amongst the adult population, the country achieves 90.4% of what is expected based on the nation's level of income.[20] Pakistan falls into the "very bad" category when evaluating the right to reproductive health because the nation is fulfilling only 34.4% of what the nation is expected to achieve based on the resources (income) it has available.[20]
خانداني منصوبه بندي
[سنواريو]پاڪستان ۾ وڌندڙ آبادي هڪ مسئلو بڻجي ويو آهي. اقتصاديات جي ماهرن، اقتصادي ترقيءَ جي هر پهلوءَ تي غور ڪيو. هنن جي رٿا موجب تيزيءَ سان وڌندڙ ڄم جي روڪ به اقتصادي خوشحاليءَ جو هڪ حصو آهي. ان جو مقصد اهو هو ته پاڪستان جي آباديءَ ۾ عمر جي ناهمواريءَ کي ختم ڪيو وڃي. 1970ع تائين خوراڪ جي معاملي ۾ ملڪ کي خود ڪفيل بنايو وڃي. نه فقط موجوده آمدنيءَ کي برقرار رکجي، بلڪه منصوبه بنديءَ هيٺ آمدنيءَ ۾ اضافو ڪيو وڃي. هن وقت آهستي آهستي شهر توڙي ٻهراڙيءَ جي ماڻهن خانداني منصوبه بنديءَ جي فائدن کي سمجهيو آهي. هن وقت به سرڪار پاران ليڊي هيلٿ ورڪرز جي ذريعي گهر گهر ماڻهن ۾ خانداني منصوبه بنديءَ بابت آگاهي ڏيڻ جو سلسلو جاري آهي.
- ↑ Sahoo, Pragyan Monalisa; Rout, Himanshu Sekhar (2023-08-01). "Analysis of public health-care facilities in rural India". Facilities 41 (13/14): 910–926. doi: . ISSN 0263-2772.
- ↑ "Final Report of Implementation Commission.pdf" (PDF). ipc.gov.pk.
- ↑ "Ministry of National Health Services Regulation and Coordination". www.nhsrc.gov.pk/.
- ↑ "www.who.int" (PDF). وقت 13 December 2007 تي اصل (PDF) کان آرڪائيو ٿيل.
- ↑ Newspaper, the. "Poor health facilities". DAWN.COM. حاصل ڪيل 2023-09-18.
- ↑ 6.0 6.1 "Global Health Expenditure database". WHO - Global Health Expenditure Database.
- ↑ Jooma, Rashid (2014-04-01). "Political Determinants of Health: Lessons for Pakistan". Pakistan Journal of Medical Sciences 30 (3): 457–461. doi: . ISSN 1681-715X. PMID 24948958.
- ↑ "Health System Profile - Pakistan". World Health Organization. وقت 9 April 2020 تي اصل کان آرڪائيو ٿيل.
- ↑ "About The Program". Sehat Sahulat Program.
- ↑ Siddiqi, S.; Nishtar, S.; Hafeez, A.; Buehler, W.; Bile, K. M.; Sabih, F. (2010). "Implementing the district health system in the framework of primary health care in Pakistan: can the evolving reforms enhance the pace towards the Millennium Development Goals?". Eastern Mediterranean Health Journal 16 (Supp): 132–144. doi: . PMID 21495599.
- ↑ Wang, Haidong; Abbas, Kaja M; Abbasifard, Mitra; Abbasi-Kangevari, Mohsen; Abbastabar, Hedayat; Abd-Allah, Foad; Abdelalim, Ahmed; Abolhassani, Hassan et al. (October 2020). "Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019". The Lancet 396 (10258): 1160–1203. doi: . ISSN 0140-6736. PMID 33069325.
- ↑ "World Health Organization Report" (PDF). حاصل ڪيل 17 March 2023.
- ↑ 13.0 13.1 13.2 "The Lancet: Pakistan faces double burden of communicable, non-communicable diseases, and persistent inequities | The Institute for Health Metrics and Evaluation". www.healthdata.org. حاصل ڪيل 2023-09-19.
- ↑ "Pakistan ranks 124 among 195 countries in healthcare". The Frontier Post. وقت 8 July 2019 تي اصل کان آرڪائيو ٿيل. حاصل ڪيل 10 September 2019.
- ↑ "GDP per capita, PPP (current international $) - Pakistan | Data". data.worldbank.org. حاصل ڪيل 17 March 2023.
- ↑ 16.0 16.1 16.2 "World Bank Open Data". World Bank Open Data. حاصل ڪيل 2023-09-19.
- ↑ Nations, United. Specific country data (Report). United Nations.
- ↑ "Gapminder Tools". www.gapminder.org. حاصل ڪيل 17 March 2023.
- ↑ "Human Rights Measurement Initiative – The first global initiative to track the human rights performance of countries". humanrightsmeasurement.org. حاصل ڪيل 2022-03-26.
- ↑ 20.0 20.1 20.2 20.3 "Pakistan - HRMI Rights Tracker". rightstracker.org. حاصل ڪيل 2022-03-26.