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 – 152.5million
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 andpopulation 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 34
Economic 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 birthattendants
•Contraceptive prevalence rate
•Total fertility rate
•Proportion of women 15-49 years who had givenbirth during last 3 years, and made at least oneantenatal care consultation
MGD 6: Combat HIV/AIDS, Malaria andOther Diseases
INDICATORS FOR PAKISTAN
•HIV prevalence among 15-24 year old pregnant women
•HIV prevalence among vulnerable groups (e.g., active sexworkers)
•Proportion of population in malaria risk areas using effectivemalaria prevention and treatment measures
•Incidence of tuberculosis per 100,000 population
•Proportion of TB cases detected and cured under DirectlyObserved Treatment Short Course (DOTS)
Target 5
Reduce under – 5 mortality by two-thirds
Indicators
1990/91
2001/02
2002/03
2005/06
Targets
2011
2015
UNDER 5MORTALITYRATE
140
105
103
80
65
52
INFANTMORTALITYRATE
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 OFSUPPORTIVEENVIRONMENT
Reduce childmortality
Probably
Potentially
Unlikely
Strong
Fair
Weak
Reduce under 5mortality by 2/3
MGD 4: Reduce Child MortalityCapacity for Monitoring and Reporting Progress(MGD Goals Report 2004 – Planning Commission of Pakistan)
Quality andRegularity ofSurveyInformation
Statistical Analysis
Statistics in PolicyMaking
Reporting andDissemination ofInformation
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
2002/03
2005/06
Targets
2011
2015
Maternalmortality ratio
550
350
350-400
300-350
180
140
Births attendedby skilled birthattendants
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 OFSUPPORTIVEENVIRONMENT
Reduce childmortality
Probably
Potentially
Unlikely
Strong
Fair
Weak
Reduce under 5mortality by 2/3
MGD 5: Reduce Maternal MortalityCapacity for Monitoring and Reporting Progress(MGD Goals Report 2004 – Planning Commission of Pakistan)
Quality andRegularity ofSurveyInformation
Statistical Analysis
Statistics in PolicyMaking
Reporting andDissemination ofInformation
Strong
Fair
Weak
Strong
Fair
Weak
Strong
Fair
Weak
Strong
Fair
Weak
Indicators
1990/91
2001/02
2002/03
2005/06
Targets
2011
2015
HIV prevalenceamong 15-24year oldpregnant women
n/a
Nil
n/a
n/a
n/a
Baseline tobe reducedby 50%
MGD 6: Combating HIV/AIDS, Malaria andOther Diseases(MGD Goals Report 2004 – Planning Commission of Pakistan)
MGD 6: Combating HIV/AIDS, Malaria andOther DiseasesStatus at a Glance – Summary of Progress(MGD Goals Report 2004 – Planning Commission of Pakistan)
GOAL/
TARGETS
WILL TARGET BE REACHED?
STATE OFSUPPORTIVEENVIRONMENT
Halt & begun toreverse
HIV / AIDS
Probably
Unlikely
No Data
Strong
Fair
Weakbutimproving
MGD 6: Combating HIV/AIDS, Malaria andOther DiseasesCapacity for Monitoring and Reporting Progress(MGD Goals Report 2004 – Planning Commission of Pakistan)
Quality andRegularity ofSurveyInformation
Statistical Analysis
Statistics in PolicyMaking
Reporting andDissemination ofInformation
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 preventivetreatment
•Poor primary health care services
•Lack of integration of vertical Preventiveprograms
Issues (cont’d)
•Inadequate social sector services delivery
•Professional and managerial deficiencies
•High prevalence of communicablediseases
•Lack of integrated management ofchildhood illnesses
•Malnutrition
•Low skilled birth attendance rate
Issues (cont’d)
•Lack of awareness
•Insufficient accessibility to maternal healthcare services especially emergencyobstetric 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 andPrimary 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 CareSystem
ROLE OF ICT IN HEALTH
•ICTs provide opportunities for individuals,medical professionals and healthcareproviders to
–obtain information,
–communicate with professionals,
–deliver first-line support especially wheredistance 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-makingand 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 improvedinformation systems include:
–development & use of electronic patientrecords
–multi-media decision support systems
–remote monitoring
–updating patient notes using wirelessPersonal Digital Assistants (PDA)
E-HEALTH CHALLENGES
•Creating ICT technologists and technicians inhealth 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 healthcaresector
•Lack of Stakeholder participation
E-HEALTH CHALLENGES
Solutions are needed to solve these challenges.
How can e-health help to meethealth sector challenges?