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Health Situation in Pakistan To have a proper understanding of the health of situation in Pakistan we need to have a look at the situation prior to independence and then have a look at the currant understanding. Prior to Independence The health conditions in British India, prior to to the partition of subcontinent tells a grim story of utter neglect. In the words of Bhore committee "if it were possible to evaluate the loss which this country suffers through the avoidable waste of valuable human material and the lowering of human material and the lowering of human efficiency through malnutrition and preventable morbidity, we feel that the result would be so startling that the country would be aroused and would not rest until a radical change had been brought about". This was the situation at the time of Independence. What Pakistan inherited was worse than India, what Pakistan inherited was worse than India in the face of mass exodus of skilled Hindus and Sikhs personnel and an influx of some 10 million Muslim refugees. In addition most of the health organizations happened to lie on the Indian side of the border. At Independence we only had 1,200 doctors each meant for as many as 60,000 people; 15,000 hospital beds with 48,000 people against each bed. Two medical colleges and less than a dozen training centers for other health staff Not a single rural health center or a Tuberculosis center in the whole country. No pharmaceutical Industry or laboratory to produce even the basic preventive drugs. Only 3 million people had access to safe drinking water It was a vast landscape of filth, disease, malnutrition and mortality under-lined by virtual absence of resources for relief or remedy. Current Situation: The health sector is still characterized by high birth rate, a comparatively low death rate and consequently a high population growth. The infant mortality rate of live births is still high for a country at the stage of development of Pakistan. The major killers in children are Pneumonia and diarrhea, complication of pregnancy in women of child bearing age is very common. Malaria, tuberculosis and drug abuse continue to be a potential threat. Communicable, infectious and parasitic diseases remain to be a severe burden. Pakistan spends less than one percent of its GNP on health in Public Sector which is one of the lowest in the world. The important issues relevant to social development, education, health, water supply and sanitation are provincial responsibilities whereas the decision regarding the budget & allocation of resources are taken by the central government. This creates a gap of understanding regarding the requirements of the provinces, this would have a devastating effect if it is coupled with tensions between center and its provinces. The province of NWFP has suffered this dilemma for most of the post independence era. Pakistan's performance is quite poor in so many social indicators, arguably one of the reason for this is the duality of Pakistani society. The decision makers are from from high income group of the society and turn to private sector for health and education and have negligible contact with inadequacies of the public sector. After reading the above it should not come as a surprise that the role of government sector in provision of health services is much smaller as compared to the private sector. It is estimated that the private sector accounts for 70% of the national expenditure on provision of health services (mainly curative services) In short some of the major problems being faced by the health sector are:
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