Health

Pakistan’s healthcare crisis
Sara MalkaniUpdated June 27, 2016
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The writer is a lawyer practising in Karachi.
The writer is a lawyer practising in Karachi.
IN Pakistan, the most important aspect of well-being is also the most neglected. In its 70-year history, Pakistan’s successive governments — civil and military — have not made health a priority. It is woeful that discussions around health policy receive little to no space in the agenda of political parties. And while the media tends to report heavily on specific heath-related crises — such as the spread of polio and child deaths in Thar — meaningful debate around the causes of abysmal health services is virtually absent.

The result of this apathy is appalling health indicators. The infant mortality rate in Pakistan is 66 per 1,000 births, compared to 38 in India and eight in Sri Lanka. Life expectancy in Pakistan for women is 67 years, as compared to 73 in Bangladesh and 78 in Thailand. The maternal mortality rate in Pakistan is 170 per 100,000 live births, in contrast to 30 in Sri Lanka and 20 in Thailand.

The indifference of Pakistan’s government to health is reflected in the fact that Pakistan spends a mere 0.9pc of its GDP on health. Only two countries, the Democratic Republic of Congo and Bangladesh, have a lower ratio of GDP to health spending.

Another indication of the government’s neglect is the fact that public expenditure on health accounts for a little over one-third of Pakistan’s total health expenditure. Pakistan’s citizens rely heavily on private healthcare, which they avail primarily through out-of-pocket payments. This is in stark contrast not only to the developed West, but also to developing countries such as Thailand and Sri Lanka, where public expenditure accounts for most of health spending. The poor quality of government provided health services in Pakistan is the major reason behind the large role played by the private sector in healthcare.

Behind the dismal numbers lie heartbreaking stories of lives ruined and cut short due to the unavailability of affordable and quality healthcare. An unhealthy population with severely diminished capabilities cannot substantially contribute to the economy. Health indicators suggest that it is the lack of accessible healthcare — not terrorism, drones or the energy crisis — that is the greatest adversity facing Pakistan. And although healthcare is certainly linked to problems of corruption and security, there is no reason why healthcare should not be made an immediate priority, rather than placed on the back burner of policy discourse.

The fact that Pakistan is a developing economy with resource limitations is not an excuse when we look to other low-income countries that have made great strides in healthcare in the last few decades. The experiences of these countries provide illuminating lessons that should be applied in Pakistan.