Commendably for it, the government has started to pay serious attention to the achievement of UN's anti-poverty Millennium Development Goals (MDG) to which Pakistan is a signatory. A few days ago, President General Pervez Musharraf had announced a plan to provide clean drinking water to all by 2007; he has now approved a national strategy to revamp the primary health care system in order to extend health cover to people at the grass roots level by June 2007.
He said at a meeting - also attended by Prime Minister Shaukat Aziz - in Islamabad last Friday that the strategy would be helpful in meeting the MDG, since besides provision of safe drinking water, these include reducing infant mortality rate and controlling diseases like malaria. As it is, mortality and illness rates are higher among the poor - the majority of whom lives in the rural areas - than in the better off sections of society.
Obviously, this is so because they lack both access and the means to afford health care facilities. Many people die from common, curable diseases simply because medical help is unavailable to them.
So far as the MDG regarding infant mortality is concerned, Pakistan presents a particularly bad picture. Its rate for infant deaths is one of the highest for developing countries.
According to the Economic Survey 2004-05, figures for infant mortality for the year 2003, were 74 per 1000 and mortality rate for children under five years of age was even worse at 98 per 1000. Which should be a grave matter of concern for the government. The minimum it is expected to do is to ensure that all people have access to basic health facilities.
It is good to note, therefore, that as per the strategy approved by the President it has been decided to reactivate some 5000 basic health units (BHUs). In order to function effectively these units would require a big injection of funds by the government and/or donor agencies.
The federal government has decided to extend a one-time financial assistance of Rs 300 million for the implementation of the national strategy which, aside from reactivating the BHU system, also aims to focus on capacity building and improving organizational structure through provincial as well as district support units.
Considering the magnitude of the task the money seems to be a lot less than sufficient. Notably, the BHU system has been in place for a long time, yet it has failed to make a major difference for the target population mainly because of problems related to financial constraints.
The biggest problem has been the reluctance of doctors to go and serve in the rural areas since, they have been rightly complaining, the rural health care centres are devoid of essential medical equipment and facilities. The other cause of their reluctance is the lack of better pay incentive. Thus they are not to blame if they find service in the rural areas unrewarding both on professional and personal levels.
The government needs to equip the BHUs with necessary facilities and offer special financial incentives to doctors to go and serve in the rural areas. With regard to administrative matters the government has decided to take some important steps. The current District Health Administration is to be revamped under the new name of District Health Management System. Though the provinces are expected to own up the programme, oversight is to be maintained by a national steering committee co-chaired by the President and the Prime Minister. With such a high level monitoring system in place, it can be hoped that the country would indeed be able to improve both access and affordability of basic health care for the ordinary people.