The link between poverty and health is well established worldwide, but the connection is both direct (lack of access to health services) and indirect (lack of awareness about health-related issues). Poverty helps produce ailments and ill-health pushes people towards poverty. It is a vicious cycle. Socioeconomic conditions create situations that can lead to ill-health.
Pakistan is attributed to the lack of access to basic health care services, poverty, lack of health infrastructure and personnel, illiteracy, women’s low status, inadequate water supplies and sanitation.
Pakistan was not a healthy state to begin with. Its sickness began even before its birth. It inherited a legacy of sickness and suffering, a burden of high mortality and morbidity coupled with a poorly developed infrastructure to address the health needs of the growing population.
In the urban areas, access to health care clinics and facilities is not a problem, though the general state and quality of public services is very poor.
On the other hand, in the rural areas, people live far from hospitals and basic health care units. Health facilities for rural poor in our country in the present state are in total disarray. The private sector does not find it financially viable to set up medical facilities in villages. The Basic Health Units and Rural dispensaries, set up by the provincial and district governments in some villages, mostly have no doctors and the patients are left to the mercy of dispenses or quacks. The young doctors do not want to work in these locations because of lack of proper residential and other infrastructure. Buildings of many of these facilities are in a dilapidated state.
These state run institutions do not even have minimum medical equipment like X -ray machines or other equipment prescribed in their own policies. They do not have ambulance facilities to take patients requiring emergency treatment to a hospital. Non-availability of medical advice and medicines to the poor from these institutions has led to rise in mortality rates as well as increase in incidence of diseases.
There is a need to change all these things, perhaps something could be fixed and here I have laid down some recommendations.
First, Governments at national and provincial levels should allocate a greater proportion of funds for healthcare.
Second, the emphasis of healthcare should shift from tertiary care to preventive and primary healthcare.
Privatized health should be encouraged to promote competition in the public sector, but the state should be vastly engaged too.
Generic medicines should be allowed because the cost of branded medicines has been rapidly increasing, but should have to keep close check on those generic brands for quality assurance and standards.
Health-related awareness programs through media and schoolbooks should be launched to address social and cultural dynamics of health. The campaigns should focus on preventive strategies.
The public environment needs to improve for better hygienic conditions, as clean drinking water should be provided to general public across the country including rural areas.
Although, Pakistan has not the problem of open air defecation, like in India, but good personal hygiene practice should be followed, like taking bath, brushing the teeth, washing hands before eating anything, changing into clean clothes, turning away from other people and covering the nose and mouth with a tissue or the hand when coughing or sneezing.