Date: 13-11-18  Time: 05:30 AM

Author Topic: Pakistan Health Policy formulation Discussion & Proposals, Basic Health issues.  (Read 13165 times)

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This section is dedicated to develop an understanding regarding Pakistan's basic health issues and finding a road map to a practical and viable health policy through discussion among general population and the health professionals.

Objective: People to Propose Pakistan’s Health Policy

The structure and functional status of our health care services is far below that of today’s world standards. We need to understand the core health issues of our nation and through discussions and input from various quarters we need to formulate a proposal for health policy which could be implemented by our government at appropriate time to uplift the standards and quality of our health care services.

                     Better Health is mandatory for the progress of nation in all fields
Health Issues

Our Health issues are not the same as those of Americans or any other nation. We have to understand and pin point our own particular health issues.

Health Policy

Once we pinpoint our own health issues we can draft a proposal for a Health Policy which would be able to effectively address our core health issues.
How to implement

Once we have a consensus on our core health issues and policy then we can find means of convincing our government to implement those proposals.

Summary of Objectives.

    To impart an understanding of health care system to the public.
    To increase awareness among masses of our health issues.
    To figure out solutions for our health issues through debate among health professionals and general public.
    To find out the means of implementing better health care for Pakistan by influencing Government.

Simplify The Complex Health issue

To Solve any complex problem first simplify it. Presume our health system is a complex problem. Let us simplify it by raising few questions. A quest for the answers will lead us to the solution.

Premise :

1. Better Health is achievable at low expenses without foreign aid

2. A Health policy must address core health issues.

Questions Regarding Health Policy?

  • Who are our Current Health Policy Makers & What is our current health policy?
  • What should be the outline of our Realistic Health Policy?
  • Should main bulk of our health budget go to  secondary and tertiary health care ?
  • What are our main Health issues?
  • Is a common man aware of the Four tiers of Health care Systems?
  • Does he know where exactly to go when he falls sick?
  • What is our Current Health Care Delivery Apparatus?
Health Equation --> Preventive & Primary Health Care?   PHC = LHW   & Prevention = 0 Is Lady Health worker all what primary health care is about ? Is Prevention out of syllabus?

A little cost at preventive &  primary health care can save a lot at advanced care 

Primary Health Care

  • Does Sickness revolve only around delivery, infant care and family planning?
  • By providing the services of LHWs have we fulfilled our obligations of PHC?
  • What is the actual concept of Primary Health Care?
Family Medicine

  • Do we know what is Family Medicine?
  • Are we clear about the importance of the institution of a family physician?
  • Do we know how Family Medicine & Primary Health Care are intertwined?
Preventive Medicine We know the jargon
" Prevention is better than cure"
  • but do we really understand the value of preventive care?
  • Reactive or pro-active?
  • Should we wait for our enemy to strike us and then we will start preparing our defenses?
Damage Prevention and early damage control is always cheaper.   

What is Quackery

  • Do we allow any untrained person to fiddle with our expensive machines?
  • Is our body the cheapest household item so that we let the least trained people fiddle with it?
  • Do we know the role of quacks in spreading current epidemic of Viral Hepatitis?
  • Are we not going to stop health criminals commonly known as quacks?

Is govt not going to put the things right for us?  Should not the sufferers raise their voices now? Must they keep on suffering for ever? Key to solution is awareness of the problem. Become aware of your health issues. Become aware of Health care system. Learn to differentiate between authentic health care systems and fake ones. Promote Health Education.

Healthy Pakistan?  Our dreams have long been stolen. We must get them back. We must get out of despair. We need to act and act now. Our actions will change our tomorrow. We must not remain reactive alone. We need to become proactive.

Following is a general list of important and basic health issue of our public. If you want to add more please feel free to forward your suggestions.

  • We have a poorly organized health structure. We need to clearly define the four tier health care system and reorganize our health apparatus accordingly thus enhancing its credibility as well as functional capability.
  • Our health priorities are not properly defined. We work in a reactionary way in response to issues. That is why our health machinery is mainly controlled through a plethora of various programs instead of a general purpose & competent health provision system. We should clearly define our Health issues, Health priorities and Health policy.
  • We neither have insight nor physical existence of a properly functioning preventive health care system. Instead of an adhoc service we must have full time properly functioning public health departments at all levels.
  • We neither have insight nor physical existence of properly functioning Primary Health care facilities.  We lack experts in the field of Primary health care. The field of Family medicine needs to be properly highlighted, promoted and utilized by govt to the best of its advantage and to the advantage of public.
  • We like to spend more on secondary and tertiary care centers while neglecting primary and preventive care systems although by spending less on preventive & primary health care we can save a lot on secondary and tertiary level treatment.
  • Majority of our public belong to socioeconomic strata that cannot afford the costly medicines and treatment procedures. We must endeavor to reduce the cost of medicines and procedures. We should work around the system to accommodate everyone under health umbrella. We should quit the concept of free treatment. We should adopt the concept of affordable treatment for all.
  • Promotion of Research in Medical Field towards self reliance on production of pharmaceuticals and medical equipment is a must to reduce the cost of treatment.
  • There is a circulation of fake medicines, poor regulation & standardization of pharmaceuticals. More authenticity & Transparency needs to be imparted to pharmaceutical standardization, licensing and control procedures.
  • Quackery should be clearly defined and assumed to be a crime and therefore it should be stopped forthwith.
  • Our Public lacks health education. A national health education curriculum should be devised that should enable every citizen to know certain dos and don'ts regarding health. Public should also be made aware of legitimate / illegitimate and scientific /unscientific methods of treatment.
  • A gap exists between our medical training focus and our on ground health issues. Training structure & Curriculum of our medics/paramedics should be revised in the light of our own socioeconomic environments. Instead of blindly following books of foreign authors we should endeavor to prepare our own curriculum corresponding to our own needs through specially designated institutions/bodies by incorporating the services of existing bodies.
  • Demand and supply of health professionals for different services has not been properly worked out resulting in gross discrepancies at various health care giver levels. A statistical analysis in realistic terms of availability of health professionals in comparison to actual needs is needed and directed efforts are required to equate the availability of manpower to actual demand.
Health Care System; Tier wise approach.

We have to clearly define the functional tiers of health care   system i.e. Preventive, Primary, Secondary and tertiary level health care systems.  Proper functioning of each of the earlier tiers will result in tremendous decrease in work load and expenditure at the next level.

Preventive care
  • Central preventive research & policy making wings should be established at federal and provincial levels. These central wings will keep on evaluating the health priorities and prevalent disease patterns   and will thus formulate policies for intervention methodologies.
  • Implementing departments of preventive health should be restructured/established at District and Tehsil levels. These implementing organs will carry out their functions independently as well   as in coordination with staff of RHCs, BHUs  and LHWs.
Primary care
  • First level standardized treatment facility should be designed for   whole country and placed according to the pockets of population.
  • For rural level BHUs and RHCs already exist which only need a revision of their structure and functional capabilities.
  • For urban areas health units similar to BHCs should be created and   placed at different location to cater for public needs. This will not only save people from unnecessary travelling but also decrease the load   on bigger hospitals thereby increasing their efficiency and quality of service.
  • The basic health facilities should be well equipped in the light of modern development in health technology to provide good quality basic diagnostic as well as treatment facilities to the public near their doorstep.
Secondary care
  • Tehsil and district level hospitals along with multiple big city   small hospitals providing treatment facilities in different specialties for both outdoor as well as indoor cases. Their functional capabilities need to be assessed individually and rectified accordingly.
Tertiary care
  • Teaching hospitals in big cities providing state of art health facilities in different specialties are already working.  A thorough analysis will pinpoint the weaknesses which will be corrected accordingly.
  • A study is required to estimate the actual requirements of centers of excellence specialized in individual disorders like cardiac centers, burn centers, kidney centers, cancers hospitals etc. Any deficiencies in their structural or functional capabilities thus found could be addressed accordingly.
  • Through implementation of general policy recommendations as   discussed at other places in this document a significant improvement in functional capabilities of these health facilities is expected.
Prime Targets

keeping in mind the core health issues we have to clearly define the targets that we desire to achieve through a directional health policy. Once we have defined our targets we will be able to discuss ways to achieve them.

Please carefully read this provisional list of our health targets, debate them and add new targets to the list which you find important but missing in this list.

1. Implement and strengthen the four tier health care provision system.
2. Give special emphasis to the roles of properly structured and implemented preventive and primary health care facilities.
3. Provide health education for all through educational system and electronic media.
4. Judiciously use our budgetary resources for health services with a premise that small expenditure on preventive and primary care can save a huge sum at secondary and tertiary levels.
5. Switch the basic concept from free treatment to affordable quality treatment for all.
6. Enhance national capabilities of producing pharmaceuticals and medical equipments.
7. Promote genuine research in medical field for the good of our public.
8. Re-align the professional training structure of medics and paramedics to better serve our socio-economic fabric.
Health Priorities

Like defining our health targets we must also set our priorities right. To set the priorities right we mean to put the targets in right order so that the thing which matters most must be dealt with first.

  • We need to set the health priorities and goals in proper perspective according to our own socio-cultural circumstances for each of the health care tiers.
  • We have always witnessed an influence of VIP culture whether it comes to bureaucracy or politicians. The VIPs do not need preventive and primary health care systems. They need Specialists for each of their health issues. They need state of the art health facilities. It is commonly witnessed that during visits of higher officials the primary health care facilities and preventive health departments are skipped and only state of the art equipment dealing with tertiary health care facilities and concerned departments are highlighted. This pleases the visitors and brings good name to the hospital administrators. At the same time they effectively keep preventive and primary health care facilities hidden to conceal their pathetic state of affairs. It is for this reason that although we have an absent preventive and a crippled primary health care facility, we have an advanced secondary and tertiary health care apparatus.
  • For delivering quality health to all and to get the best results out of our limited health budget we must judiciously incorporate and invigorate the primary and preventive health facilities.
  • Fewer amounts spent at Preventive and primary levels will save huge expenditures at secondary and tertiary levels.
Setting straight our Quacks dominated Primary Health Care Sector   
  • Lady Health Worker Program is not the Primary health care as is touted by our government. We have to clear our minds that this is a short focus & limited mandate program. Actual requirements of primary health care are far more than this program and labeling LHW program as primary health care is either a big conceptual error or deliberate deception attempt. We must consider re invigoration of BHUs and RHCs as actual Primary health care organs. Institutions of similar capabilities must also be started in cities to provide 100% coverage to the population and at the same time to share the workload of larger hospitals in the cities.
  • How to make BHU work.
    • First of all we need to create a situation in which we can have   doctors willing to work and willingly work at BHUs. For that matter we will have to make their job socially respectable, professionally   satisfying and financially rewarding.
    • We need to define the service carrier structure of doctors as well   as staff. We must also make the mechanism of rewards and accountability   crystal clear. There should be no dead ends in the carrier ladder.   Anyone who wants to excel in his carrier at any time during his service   should struggle to fulfill the prerequisites. Primary health care along   with Preventive care should be clearly defined as specialties and given   appropriate service incentives through well defined service structure so   that people adopt these as carriers rather than as transit affair.
    • 2 years mandatory service at BHU should become part of a structured postgraduate training program.
    • The initial bond of service for doctors as well as medical technicians should be that of a short service without long term benefits. That bond will be renewed only if the person proves his worth through qualifying courses and service record. The availability of room   in organization will also be a consideration for extension of service   tenure thereby regularizing it
    • Appropriate recreational facilities should be provided in collaboration with rural uplift programs/ social action programs & tourism promoting organizations.
    • As a practical social uplift of the locality, setting up of the   residential colony of the members of village uplift committees in the   same premises along with BHU, cottage industry, school, business training programs and law enforcement unit can be considered with pros and cons.
    • The technical staff must be given similar incentives. Appropriate incentives will call in better lot for these services.
  • Revision of functional capabilities of BHU & therefore its staff   as well as equipment is long overdue. A basic health facility should be   mandated to provide certain basic diagnostic and treatment facilities.   Due to easy accessibility and lower cost of equipment and technology,   several diagnostic and therapeutic facilities must be incorporated in   our basic health units. These facilities should include:
    • Basic clinical laboratory tests.
    • X-ray facility
    • ECG facility.
    • Ultrasonography. (doctors should receive one month course in USG during their house job)
    • Minor surgical facilities.
Provision of above mentioned facilities at the basic health unit   levels will boast the functional capabilities as well as moral of staff   and dependent population to enormous degrees. The patients many a times   have to travel long distances just to get these basic investigations   done. They also spend huge amount of their hard earned cash on traveling expenses as well as in billings of private investigation   facilities. Provision of these facilities to public on the basis of cost   of material plus maintenance will benefit the public a great deal but   will put very little extra load on health budget. Due to availability of   these facilities at BHUs the doctors will feel greater confidence and professional satisfaction while working here.

 Community Medicine or Public Health  Remains the most Neglected Social service by Government   
  • We have totally forgotten at our national health policy level that “Prevention is better than cure”
  • We don’t have any properly functioning preventive health care   system. Instead of relying on adhoc ism  we must have full time properly   functioning public health departments at all levels.
  • At the central level the preventive health wing of health ministry   will carry out research in the disease prevalence and the possible   prevention methods for each of them. In the light of findings of its   research this central prevention wing should prepare its action plan to   control prevalent diseases/health hazards.
  • District/Tehsil preventive health departments will be the implementing units which will to carry out essential disease control procedures in the light of central preventive wing’s directions. These implementing organs will carry out their functions independently as well   as in coordination with staff of RHCs, BHUs  and LHW. One of the staff   members of BHUs could be a representative of district/tehsil preventive   health department having received additional training in desired   preventive tasks.
  • Staff for malaria control program or any other task related with   preventive health wherever present will be made part of the preventive   health structure and will be utilized in a bigger sphere of preventive   health thereby effectively utilizing their services.
  • The central research wing should be receptive to any useful input   from anyone down the ladder which can help in establishing methodologies   for controlling/eradicating certain prevalent diseases/health hazards.

   Training of health care professionals must focus on our sociocultural setup

  • We must redefine the training structure & curriculum of doctors   as well as paramedics according to our own social and health/disease   statistics.
  • Efforts are needed to pump in desired strength of health professionals in health delivery system to meet the goals of delivering quality health service. Any deficiencies can be met through creating additional training slots. The trainees at various levels provide a very   useful work force so we should never hesitate in opening additional   training slots whenever needed. Any surplus amount of trained   professionals can later be easily diverted to other countries and that   will generate handsome foreign exchange as compared to sending unskilled   labor.
  • We should abolish open merit system for girls and boys and revive   the previous quota system for girls. The government spends a significant   amount on the training of doctors but most of our Female doctors do not   continue their profession after marriage. Similarly female doctors do   not perform duties at BHUs which reduces the actual availability of   trained doctors especially for service at rural health facilities.   Resultant the amount spent on the training of such female doctors goes   down the drain. Only those girls should be admitted to govt medical   colleges who sign a bond to serve for a minimum of 5-7 years at   appropriate govt health facilities. If by training more male doctors we   get surplus doctors then we can facilitate their expatriation through   MOUs with different govts which will generate Foreign Exchange for us.
  • 2 years mandatory service at BHU should become part of a structured   postgraduate training program. Targets to be achieved and tasks to be   performed during the tenure must be clearly defined. Supervision of that   service tenure must be carried out at regular intervals through   specially designed methods for ensuring proper output of doctors during   that tenure. The doctor after 2 years experience at a BHU will become   eligible to appear in an intermediary module. Qualifying it in addition   to points attained through assessments during that service tenure will   entitle him for a one year training program at a teaching hospital. In   case of joining the specialty of Family medicine this whole tenure will   be counted towards total training requirement for specialization while   in case of joining other specialties this time period will only   partially be counted towards total training req of specialty provided   the doctor achieves certain targets related to his own specialty during   the tenure. After that the doctor will be eligible to appear for MCPS.   If desirous to go for fellow ship then he will need to enter another 2 year program at Teaching hospitals + BHU rotations (1 year each). The doctors thus trained will be given appropriate Promotion and salary incentives according to their professional competence.  The organization of training structure on these lines for primary health care specialists will provide us a work force of expert and dedicated professionals who can make our dreams of a quality primary health care facility for all come true. As a further incentive any doctor who gets an appointment in BHU will automatically become eligible to enter into the training program of CPSP from the same date after registering with   them. He will however have to clear FCPS-I within a particular time   frame to be eligible for appearing in next modules.
  • A plan for proper training of health technicians working at rural   health facilities is desirable. These people should get initial training   at some training centre for three months which will cover theoretical   aspects of basic nursing skills, human anatomy and physiology. Then they   will receive on job training at BHUs under supervision of doctor and   senior technicians for two years (One year at low salary and the second   year at raised salary). During that period they will be required to   prepare for basic exam. If they qualify the exam at that level then they   will be given the designation of regular short service technical staff   rather than trainee.  After qualifying that exam they will be given one   year on job training at a bigger hospital. The doctor will receive   credit for appropriately training nursing staff. These trainings will be   organized at district level and appointment of staff will be within   district. Survey of the existing health facilities will be carried out   so as to incorporate teaching classes within the buildings of already   existing hospitals etc so as to avoid extra unnecessary expenditures.    Any technician who is desirous to enter into a specialty will be able   to do so through entrance exams and service records instead of sifarish.
Cost vs Affordability of Health Care.
   Well planned efforts are required to reduce the cost of medicines and other health care facilities.
  • Abolishing the concept of free treatment. The concept of free   treatment for all in a welfare state seems to be a popular voice. Once   started none of our govts had the strength to revise it. This concept is   impractical and has several ills. We can easily see that this system is   mostly not working. In fact the concept of free medicines is one of the   causes of failure and bad reputation of our govt health facilities. It   is clearly not possible to provide free medicine to all the patients   reporting at govt hospitals under our current economic situations.
    • Whatever medicine is provided to the govt health facilities is   selectively utilized by the health authorities at their own discretion.   Others are routinely asked to purchase their own medicines. This creates   a sense of frustration among public who think that they are being   deceived.
    • Concept of free medicine prompts those people to report sick who do   not have a definite reason to do so. This puts unnecessary burden on the   govt health facilities.
    • Due to limited budget the govt health facilities always remain short   of staff as well as equipment. Similarly these facilities are always   short of budgets to carry out necessary building and equipment   maintenance. On the other hand the dependent population keeps on   increasing day by day. All these factors accumulate into a poor quality   and inefficient health service. This is a recipe of disaster. We have to   say goodbye to it one day, the earlier we do it the better it is.
  • Adopting affordable treatment for all.  We must replace the concept   of free treatment with that of affordable treatment for all. Let us look   into its feasibility and action plan.
    • The govt will provide staff for its health facilities.
    • The govt will purchase medicines out of a specially prepared   essential medicines list from the least cost bidder in open bids amongst   licensed pharmaceuticals. Those medicines will be marked and labeled   for govt hosp use only. The same will be provided to public on the   procurement cost basis without profit. At the same time govt should   establish its own production units for producing essential drugs.
    • Health facilities will charge patients a small token fee for each   visit which can be set somewhere between Rs 10 & Rs 100. All the   procedures whether diagnostic or therapeutic on each visit will be   provided to the public on a nominal cost. The cost of each procedure   would be calculated on the basis of cost of materials to the govt plus a   little percentage for maintenance of equipment, while cost of trained   staff will be out of govt pocket.
    • The Funds generated out of Medicines will be utilized to procure   more medicines and the funds generated through procedures will be used   to procure more material for procedures and maintenance of equipment.
    • The funds generated through token fee will be used to carry out the ongoing maintenance of health facilities.
    • Due to this model people with genuine reason will usually be reporting sick to govt health facilities.
    • As people will have to pay for the medicines so they will not like to stock these as bounties.
    • As govt will be eased out of its expenditures on medicines so it   will be able to direct its resources in employing more staff and   maintaining or upgrading structure and equipment of health facilities.   This will result in better quality and efficiency of health service.
    • As this model ensures presence of medicines in govt health   facilities round the clock so it will be a plus point in attracting   doctors towards rural health facilities because many of the doctors have   an argument that it is useless to serve in BHUs which don’t have any   medicines or equipment.
    • For those people who cannot afford even a token money a system of   zakat should be invoked and their payments should be tackled under zakat   heads.
    • Similarly Emergency cases will not be charged any amount beforehand.   They can be put into the categories of affording or zakat afterwards.
    • This is a technically feasible and highly practical model as   compared to the existing one. In the existing model we have assigned   impractical goals to the health care system as we are not giving them   the required budget to meet the goals. The reason of failure in our   current system is basically more related to unrealistic health policy   rather than the corruption or mismanagement of health care givers. The   currently proposed system ensures realistic tasks and availability of   proper resources, so only honest and dedicated implication is required.
Code of Conduct, charter of duties & accountability mechanisms for health professionals
  • A charter of duties for each and every member of health provision   facilities should be formulated after thorough deliberation.  The same   should be made easily accessible for public.
  • Code of conduct for each and every member of health provision facilities should be defined in clear terms.  The same should be made easily accessible for public.
  • Devising proper accountability mechanisms for the health staff and   strengthening it is mandatory to keep its efficiency at desired levels.   For establishing any effective accountability procedure it is a must to   remove political influence.
  • The objective is to enhance the functional capabilities of health   services along with uplifting their quality, while retaining the honor   of profession.       
 How to achieve a Peoples Friendly flourishing Pharmaceutical sector in Pakistan.   
  • Strategies should be adopted to curtail the very high profit margins   in pharmaceutical sector through introducing healthy competition   without affecting open market or quality of products.
  • Any deals with foreign pharmaceuticals/Legislation against public interest should be carefully revised.
  • A central drug research institution should be established. It should   bring within its jurisdiction the present redundant national drug   testing laboratories thus reinvigorating them. The same institute should   commence study of new drugs especially through testing the old traditional medicines. In this way any effective traditional medicines   would be properly identified and put into use.
  • Proper structuring and revision of policies regarding pharmaceuticals.
  • Efforts are needed to control circulation of fake medicines.
  • All pharmaceutical manufacturers, importers, exporters should be   properly licensed after thoroughly assessing their production units and   manufacturing standards. Only those companies who fulfill the desired   standards of production should be allowed to bring their products to   market.
  • A fool proof and crystal clear mechanism for assessment of pharmaceutical manufacturing, storage, transport and marketing must be established.
  • As drugs can freely circulate in different parts of country after   manufacturing at a particular location so their control must become a   federally administered subject.
  • A Federal government official Pharmaceutical website designed to   clearly provide all the pharmaceutical related information for health   sector as well as public must be made. A complete list of licensed   Pharmaceutical companies must be available there.  The website must also   contain pharmaceutical related laws, policies, production standards,   standards assessment system, procedure for getting license, and   complaint cell regarding any pharmaceutical malpractice that comes into   notice of any citizen.
  • The revision of standard assessments must be carried out annually by   a well paid, competent team of honest members whose identity is not   made public. Multiple teams thus created will be assigned different   regions annually on random selection basis. These revisions must be   accordingly published in the proposed website regularly.
  • The surprise checking teams will either be given legal powers or   they should include a magistrate so as to summarily deal with the offenders by imposing penalties ranging from confiscation of stocks to imposition of fines or imprisonment in case of case of criminal acts of   faltering medicines or knowingly supplying/Marketing faltered medicines.
  • Prohibition of unauthorized sale of medicines. A list of over the   counter medicines should be decided and freely circulated among pharmacies. Sale of any other medicines must only be through authorized prescriptions.
 Population Planning is must to achieve social & Economic uplift of Pakistan     
  • Reinvigorate the drive to control population explosion through following successful model of Bangladesh.
  • Religious and cultural hindrances to implementation of this program   should be addressed through proper deliberations and dialogues with   concerned quarters.
  • We have to assess and redefine the structure and functional capabilities of LHWs program. We must also look into the failure areas in availability/ provision of contraceptive devices/facilities to the general public through regular public surveys.

   General population of Pakistan relies heavily on the private sector to meet its needs of health care   
  • We must properly analyse the quantum as well as ethical and professional competency standards of our private health sector.
  • We must make a full audit of all the existing private practice outlets, properly register them and establish an efficient monitoring system.
  • We must also look into the possibilities of govt and private partnership possibilities.
  • A system of leasing out may also be considered but not at the cost of public agony.

   Medical and Surgical Equipment Manufacturing in Pakistan   
  • Local   industry related to medical fields i.e. medical equipment   /pharmaceuticals etc must be encouraged to enhance their production   through several incentives helping them to generate more income through   exports / tax incentives/ energy cost incentives, but at the same time   they should be duty bound to provide the same to local market at minimum   profit margins.
  • A special institution of Electro medical   research and production should be established which should carry out   feasibility studies regarding home production of various electro medical equipments. This institution should gradually first streamline and promote those local pvt electro medical manufacturers who are already doing certain activity on self initiative. The institution should motivate others in pvt sector to join the electro medical production grid. The institute should also establish capabilities of manufacturing electro medical equipment through its own enterprise of public pvt partnership.
  • We must abolish quackery in all forms.
  • We have got unanimity of opinion regarding crimes against personal   property and body but we are confused in case of crimes against personal   health.
  • Quackery should be clearly defined. Laws should be promulgated to   define authorized as well as unauthorized health care. Quackery and unauthorized health care giving should be penalized under law.
  • A doubting attitude like “this may work” at official level must now be stopped forthwith.
  • Only scientifically proven methods must be allowed practice.
  • Modern medicine is now EBM (Evidence based medicine). Today only those drugs/Medical Procedures which bring evidence of efficacy and safety are allowed.
  • Any traditional methods of treatment if claimed to be effective must   be brought before a central research institution to verify their validity. Only after getting proper evidence regarding their efficacy/safety those methods will be authorized.
  • There are numerous health hazards of inappropriate health practices   which include; injudicious use of medications causing organ damage as   well as creating resistance to multiple organisms in case of antibiotics, spread of infections though indiscriminate use of injections, delay in reaching appropriate diagnosis and thus appropriate treatment resulting in disease aggravation, creating misconceptions in   public regarding health issues for the sake of financial gains which in   turn create negative trends among public regarding health.
Public Health Education
  • Health Education: No mechanism exists to properly educate masses   about health related issues in a systematized manner. Any education   given so far is in context of a particular program with focus on   selective points like malaria control, population planning etc.
  • A mandatory health education curriculum for the masses should be   prepared which should be brief and to the point but still comprehensive   enough to cover a basic knowledge of health and disease, hygiene and   sanitation, common locally prevalent diseases, preventive health,   structure and responsibilities of health care system. This curriculum   should be taught to masses through electronic media as well as through   inclusion into educational syllabus.
  • People are confused regarding selection of health care facility due   to lack of proper education on the subject. Devising proper health care   system and thoroughly introducing it to public through media campaign   can make the public aware of scientific and non-scientific treatment   methods. People are intelligent enough to realize that they should use   the latest technological advancement for facilitating their day to day   needs, but when it comes to health they are still having so many   superstitions and misconceptions that they very frequently utilize   inappropriate, unproven and hazardous methods for their treatment.
  • There are many elements in our society which keep on enforcing as   well as propagating these false beliefs through propaganda for the sake   of monetary gains. It thus becomes a prime responsibility of state to   educate the masses regarding scientific/unscientific & legitimate/illegitimate systems of health care.
Institutionalized Medical Research to focus on Indigenous Health Issues of Pakistan   
  • We need to initiate and promote fruitful medical research with a special emphasis on solving our indigenous health related issues. New institutions need to built and existing institutions need to be strengthened.
  • CPSP is already stimulating the medical fraternity towards research.   It is required to realize that productive research is what we really   need. We need that kind of research which can be used to benefit our   public by revising treatment concepts, facilitating treatment procedures   or reducing treatment costs. Govt should also establish a central   medical research center which should not only itself carry out various   research projects but it should also facilitate other non governmental   bodies involved in medical research.
  • A Study into causative mechanisms of the commonly prevalent disease   patterns in our masses is required to reach effective plans for   addressing those. Mostly these stem from poor health education, social   stresses, unhygienic living environments, malnutrition and ill designed   physical activities.
Public Education Regarding Food and Nutrition Concepts and Quality Control of Supplies   
  • People should be educated in the concepts of balanced and healthy   diets and they must now be brought out of the spheres of outdated   concepts of cold and warm foods.
  • A healthy diet is mandatory for proper health. Provision of   unadulterated healthy food for all and sundry must be the prime objective of our government.
  • Laws in dealing with food and medicine adulteration if required must be promulgated at the earliest and implemented forcefully.
  • Adulteration in food is not only done by local offenders it has been   reported several times in media that several multinational companies   are involved in this practice especially in products like milk and other   packed food items. It has also been reported that several such   companies pick up their expired stocks from European countries and after   packing them in fresh packs with new expiry dates sell them in our   country. Such practice should be seriously looked into and dealt with   accordingly.
Mental Health is included in WHO Definition of Health     
  • Mental and psychological health of individuals is very much related to the socioeconomic environments.
  • Through efforts in economic uplift, provision of social amenities,   social justice, national security etc we can do a lot in reducing the   stresses. This will thus improve the psychological health of individuals   who will  become more energetic,   motivated and productive components of the society.
  • Health Education plays a vital role in understanding the stress generating phenomena and their management. With proper health education people can be motivated to participate in diffusing the tension and stress from the social atmosphere and thus making the community interactions healthy and ensuring a better mental health of individuals.

« Last Edit: April 11, 2014, 08:43:59 PM by Administrator »