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