Investing in community healthcare

Improving and enhancing access to quality healthcare ranks among the most pressing global challenges. While overcoming this challenge is important in its own right, it is also important to be cognisant of its spill-over effect on other development indicators. For instance, a healthy population is a key determinant of economic growth. This in turn directly impacts a country’s human development indices and its ability to fight impending challenges such as climate change and poverty. Staying ahead of the challenge is also considered key when battling disasters and making populations more resilient. Owing to the interconnectedness of healthcare to other development indicators, advancement in this domain is considered fundamental to the realisation of the United Nations Sustainable Development Goals (SDGs).
However, Pakistan faces a major challenge in terms of making access to health and related socio-economic indicators accessible to its people. The fact that 39 percent of the population lives in multidimensional poverty does not help the cause.
To provide a quick snapshot, the Maternal Mortality Rate Index (MMRI) ranks Pakistan at 139 out of 179 countries. Similarly, Pakistan’s current Infant Mortality Rate (IMR) stands at 56.88 deaths per 1000 live births – the 18th worst globally. Owing to a lack of nutrition four out of ten children under five years of age in Pakistan are stunted while 17.7 percent suffer from muscle wasting. Only 20 percent of Pakistanis have access to safe drinking water. These disturbing physiological health indicators coupled with socio-economic deprivation in turn have huge mental health consequences. Pakistan’s mean overall prevalence of depressive disorders and anxiety stands at a staggering 34 percent.
That said, it is important to acknowledge that the government of Pakistan has made important progress in making health and nutrition accessible to its people. In 2018-19, Public Health Foundation, Khyber Pakhtunkhwa initiated major Public-Private Partnership (PPP) initiatives by outsourcing certain facilities at primary and secondary healthcare levels in distant areas of the province. The pilot initiatives provided significant results, paving the way for a new chapter in healthcare delivery within the province. One such example is that of the state-of-the-art Hospital Nistadbad which was established and managed by the Medical Emergency Resilience Foundation (MERF) in partnership with the International Rescue Committee (IRC) and funding from the European Union. The hospital remains operational even after the conclusion of the project.
There might then be a lot of value to learn from various approaches that focus on integration and strive to offer a combination of healthcare facilities that are specific to the most urgent needs of a given area. For instance, in 2021, The International Rescue Committee (IRC) with support from the European Union and partnership with the provincial government and MERF launched an intervention to provide essential primary healthcare services in the Newly Merged Districts (NDMs), i.e., Orakzai and South Waziristan. The project adopted an integrated approach focusing on the provision of health (including maternal, newborn, and mental health), nutrition, and WASH services. In doing so, on one hand, the intervention has served over 150,000 people including children and adolescents, pregnant and lactating women, and the elderly. On the other hand, the project has also shown success in changing people’s perceptions about healthcare services so that they are more inclined to access the formal healthcare system.
Pakistan requires a targeted approach to serving the most vulnerable with a special focus on making health and nutrition-related services accessible to its most vulnerable including women, children, refugee populations, and previously conflict-affected communities. The realisation of this mandate is necessary to propel the country towards economic development and ensure that the country can meet its global commitments under the Sustainable Development Goals.

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