Health system preparedness in Pakistan for crisis management: a cross-sectional evaluation study

Abstract

Background: The World Health Organization (WHO) has strongly advocated health systems' preparedness for effective management of crisis situations globally for more than two decades. Pakistan is known for its high vulnerability to hazards and lack of coping and adaptive capabilities. Health systems' preparedness for locales with such high-risk profile is essential, yet there is a dearth of studies addressing the status of such preparedness in the country. Aims: This study aimed to assess the status of preparedness of health-system components for crisis management in the most disaster prone districts of Pakistan. Methods: A purposive sample of 12 of the most disaster prone districts in two provinces of Pakistan was evaluated for preparedness using the WHO's toolkit for assessing health-system capacity for crisis management. Six core functions of the Health Systems Framework, with a total of 229 indicators, were evaluated at the district management as well as secondary and tertiary health care facilities level. Proportions of indicators prepared were calculated and preparedness was classified as Acceptable (≥ 66%), Partial (36-65%) or Inadequate (≤ 35%). Results: Seventy-two percent, 95% Confidence Interval [46.0, 90.0] of indicators in these most vulnerable districts were evaluated as partially or inadequately prepared for appropriate management of crises. Even the highest scoring core function, Leadership and Governance was partially prepared with a score of 53.6% (52.4, 54.9). Process elements were found to be less prepared compared with structure components. Conclusions: Federal level strategic planning, implementation, management and follow-up aimed at ensuring health-systems' preparedness need to be reviewed and strengthened.

An assessment of existing surge capacity of tertiary healthcare system of Khyber Pakhtunkhwa Province of Pakistan using workload indicators for staffing need method

“…The results shows an insufficient surge capacity which stems from the shortage of doctors and nurses and is a major cause for concern for the health system decision-makers and hospital managers. Our study further augments the finding of the study conducted by Zia et al that showed that the secondary health care system of KP province has poor preparedness for disaster management [ 46 ]. This highlights a critical fault in the overall health system of the province.…”

Knowledge, attitude and perceptions about Crimean Congo Haemorrhagic Fever (CCHF) among occupationally high-risk healthcare professionals of Pakistan

“…Since emergency HCPs frequently encounter CCHF patients and have a high chance of percutaneous infection, 46% of HCPs in our study believe that Pakistan's health will not be able to cope appropriately if such an incident occurs in the same way as Haq et al reported the incompetence of Pakistan's healthcare system in dealing with health emergencies [39]. The majority of study subjects agreed that animal herders and having pets increased risk of CCHF infection, just like Georgian and Turkish studies [8,40,41].…”

Knowledge, attitude, and practices of Community pharmacists about COVID-19: A cross-sectional survey in two provinces of Pakistan

“…A recent study conducted in China reported that the majority of the respondents (97.1%) were confident and agreed that their government can win the fight against COVID-19 [12]. Lack of confidence among the participants in our study may be due to the lack of basic health facilities, recommended policies, unavailability of proper medical equipment, political up-downs, financial crisis, and de-stabilized economic condition of Pakistan to cope with such outbreak [10]. Additionally, about 36.10% of the respondents disagreed that the Pakistani populations have sufficient information.…”

“…According to the WHO report on May 18, 2020, Pakistan has 42125 confirmed cases and 903 deaths due to the COVID-19 [5]. Pakistani health care system faced a lack of basic health facilities, recommended policies, unavailability of proper medical equipment, financial crisis, and a limited number of health care professionals to handle such outbreak [10]. There is limited availability of community pharmacists in Pakistan and also their role is not properly defined [11].…”