Strengthening health system building blocks: configuring post-COVID-19 scenario in Pakistan

Abstract

Aim: To gauge the level of preparedness of health system of Pakistan in the wake of Corona Virus Disease 2019 (COVID-19) pandemic. Background: The global COVID-19 outbreak and its subsequent repercussions and implications, after being declared as a pandemic by the World Health Organization (WHO), exposed all the inherent, lingering, and acute shortcomings of the health systems in many developing countries and Pakistan was no exception. Methods: A detailed literature review was done which included peer-reviewed articles on COVID-19 and health system, published in local and international journals, WHO and World Bank’s publications, and the documents and official reports of the government. Focus was to glean and cite strategies adopted by the developing countries in response to COVID-19 and to see the applicability of those which are feasible for Pakistan. Findings: Level of preparedness was minimal and the response to manage the outbreak was weak. Based on toll of the cases and number of deaths, this public health threat turned out to be a catastrophe beyond the controlling authority and capacity of the health system, and hence other sectors and agencies had to be engaged for devising a concerted and integrated response to deal with the emergency. Governance was disorderly, financing was inadequate, human resources were not trained, supplies and logistic were not stocked, information system was patchy, and research capacity was limited, and most of all the service delivery was in a biggest chaos of times. COVID-19 demanded to re-configure the health system of Pakistan. Conclusion: Improving the emergency preparedness of the hospitals is the foremost and an urgent need. A strong national public health system in Pakistan is needed to rapidly investigate and analyze the reports, assess the magnitude of the public health risk, share real-time information, and implement public health control measures in a concerted and systematic demeanor.

Approaches to Health Efficiency across the European Space through the Lens of the Health Budget Effort

“…In his opinion [ 36 ], the COVID-19 experience brings to the attention of global decision-makers the improvement of the health framework, the strengthening of national public health systems, the identification of health risks and the increase of awareness of these risks, so that events of pandemic magnitude can be better addressed and more efficiently managed.…”

Reasons behind declining of cases during the COVID-19 wavelets in Pakistan: public healthcare system or government smart lockdown policy?

“…The aim of their contingency facilities was to battle coronavirus in an emergency under District Health Authority (DHA) such as rooms in hotels and hostels, school buildings, mosques, and community centers 25 . During the third wave, the existing healthcare facilities are going through immense pressure because of the rapid increase in COVID cases on daily basis and this has caused a large number of patients to be waiting for beds in public hospitals' emergency wards 26,27 . Amidst the current crisis, the National Institute of Health 28 , established a continencies plan and Federal and provincial governments were issued guidelines for home-based quarantine at both divisions and sub-divisions level regarding disinfectants, protective clothing, disposal of waste, medicine supplies, communication with the outer environment, care of children, and care of caregivers.…”

Universal health coverage in Pakistan: is the health system geared up to take on the challenge?

“…UHC index (which is computed as the geometric mean of 14 tracer indicators of health service coverage) for Pakistan has risen from 23 in 2000 to 45 in 2017, on a scale of 100 [18]. Similarly, a strong national public health system in Pakistan is needed to assess the magnitude of public health risks, share real-time information, and implement public health control measures in a concerted and systematic demeanor [19]. There is still a long way to go in terms of improving access, utilization and eventually the desired health outcomes.…”