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STRUCTURE OF HEALTH CARE SYSTEM BY DR CHAMAN LAL PT

Health care systems in Pakistan, DPT community medicine , Quiz Community Medicine DPT,

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STRUCTURE OF HEALTH CARE SYSTEM BY DR CHAMAN LAL PT

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  1. STRUCTURE OF HEALTH CARE SYSTEM By: Dr.Chaman Lal PT B.S.PT, PPDPT (M.Phil Physiotherapy), MPH (M.Phil Public Health), Master in Physical Education & Sports Injuries (UOS), Dip. in sports Injuries, PG in Clinical Electroneurophysiology (AKUH), Registered.EEGT (USA), Member of ABRET, AANEM & ASET (USA), MPPS(PAK), MPPTA(PAK), PhD Physiotherapy Scholar (Malaysia).

  2. BY Dr Chaman Lal PT 2

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  4. HEALTH SYSTEM/LEVELS OF HEALTHCARE • Internationally Recognized Health system / Levels of health care: • An internationally recognized health care delivery system includes four tiers; • 1. Preventive care: The specialists in preventive care plan at Governmental, institutional or community level for controlling preventable diseases. They have special role in maintaining hygiene and sanitation of a community as well as inculcating awareness regarding health and disease in masses. BY Dr Chaman Lal PT 4

  5. HEALTH SYSTEM/LEVELS OF HEALTHCARE • 2. Primary Care: at Primary care level (Family Medicine Specialists/ Qualified Specialist GPs / Simple GPs) treat all the members of a family for most of the common illnesses. They also provide necessary • Health advice and arrange referrals to different specialists at secondary or tertiary health care levels when required. The key element of a primary health care set up is Family Physician. The Doctors working BY Dr Chaman Lal PT 5

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  8. HEALTH SYSTEM/LEVELS OF HEALTHCARE…..CONT’D • 3. Secondary Care: Doctors working in bigger hospitals including medical specialists, surgeons, pediatricians, gynecologists, psychiatrists, ENT specialists, ophthalmologists and other sub specialties provide secondary care. • 4. Tertiary Care: Special with certain subspecialties covering single organ or organ system related diseases provide the tertiary care like Cardiac centers, Burn units, orthopedic units, Kidney centers etc. dermatologists, Hospitals dealing BY Dr Chaman Lal PT 8

  9. BASIC HEALTH ISSUES IN PAKISTAN • Health system has been designed developed and maintained by politicians rather than physicians/ Health professionals. • We have a poorly organized health structure. We need to clearly define the four tier health care system. • Our health priorities are not properly defined. • Lacking of experts in the field of primary health care. • To spend more on secondary and tertiary care centers. • Neglecting Primary and Preventive Health care system. • High cost of Medicines and Procedures. • Lack of Promotion of Research in Medical Field. BY Dr Chaman Lal PT 9

  10. BASIC HEALTH ISSUES IN PAKISTAN….CONT’D • Circulation of Fake Medicine. • Lack of Health education in Community. • Un-Controlled quackery (un-authorized healthcare giving) all over the country. • Gap between our medical training and on ground health issues. • Difference b/w demand and supply of health professionals for different services. • We neither have insight nor physical existence of a properly functioning preventive health care system. • Political Interference. BY Dr Chaman Lal PT 10

  11. Role of Private Health care system • widespread access to care, the private sector presents an opportunity for sustainable scale-up of health care services along-side social and economic development. • Included the scope of private sector agencies are both for profit private providers and NGOs that apply market based delivery. As government fall short of providing approaches to service BY Dr Chaman Lal PT 11

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  13. Role of Private Health care system….CONT’D • widespread access to care, the private sector presents an opportunity for sustainable scale-up of health care services along-side social and economic development. • Included the scope of private sector agencies are both for profit private providers and NGOs that apply market based delivery. As government fall short of providing approaches to service BY Dr Chaman Lal PT 13

  14. Role of Private Health care system….Cont’d Un-fortunately Private sector’s true role was never understood in Pakistan. • To introduce such a health care infrastructure model where all citizens can get better health care facilities in Pakistan. • Only access to health care, even if universal, will have no meaning unless the larger social determinants of health are squarely addressed and issues of ethnicity, caste, class and gender are engaged-with as a society. • With regards to health, we also believe that the private sector should play only a supplementary and never a complementary or competitive role. BY Dr Chaman Lal PT 14

  15. Private Healthcare system in Pakistan • The Private sector in Pakistan is varied with no defined structure, weak regulations exists in this sector. • Descriptive situation of the Private Health care sector in Pakistan: 1. Health infrastructure 2. Types of Health facilities 3. Informal Structures 4. Allopathic Service Providers 5. Non Allopathic Service providers 6. Traditional. BY Dr Chaman Lal PT 15

  16. Private Healthcare system in Pakistan Health Infra structure • The private Health Infrastructure is not well-organized. • The wide range of disparity in health care provision in the private sector. • Ranging from Hi Tech regular Hospitals with all necessary provisions to a general store providing healthcare. BY Dr Chaman Lal PT 16

  17. Types of Health Facilities Regular hospitals: Fully equipped with necessary staff, supplies, equipment, transportation, skilled staff and can be compared to any teaching hospital of the public sector. Nursing Homes in Pakistan Nursing homes are maternity homes and generally are not well versed in providing most of the primary health care services and even not equipped for new born care. BY Dr Chaman Lal PT mostly acting as 17

  18. Types of Health Facilities Clinical Set up in Pakistan Clinics are generally owned by a single person who is sole proprietor of this healthcare providing structure. • There are some very good clinics run by specialists well equipped and providing quality services but these are in limited number. • Mostly situated in Metropolitan areas where people are well aware of the quality of the health services. • But the Conditions of the most of the clinics is pathetic due to weak regulatory system. Informal structure • Informal structure don’t act primarily as health care provider and even are not legally authorized for this, but even then this practice exist. • These are general store, Karyana merchants, and Pan-wala also providing medicines for minor diseases. BY Dr Chaman Lal PT 18

  19. Allopathic Service Providers Allopathic service providers are divided into three groups: • Qualified • Semi- qualified • Non- qualified BY Dr Chaman Lal PT 19

  20. Qualified • Qualified Services Providers include MBBS and Specialists. • They are mostly providing services at private hospitals Medical centers /nursing homes and at their Clinics. Semi Qualified • The semi Qualified health care providers include LHVs, LHWs etc. • They are having some training and diploma as recognition. • They are trained for specific purpose and have their limitations with respect to health care service provision. • But mostly performing the functions of qualified doctors without enough knowledge. Non-Qualified • Non qualified service providers include dispensers, Ward boys and peon etc. • Any other person having some experience working with qualified health care provider for a short time. • The pharmacist lying in this category providing consultancy and dispensing are also non-qualified persons. BY Dr Chaman Lal PT 20

  21. Non-Allopathic Service providers • Homeopaths, Hakims, Pehlwans and Jirhas. • Acupuncture and Chinese Medicine treatment Provider. Traditional Health Care providers • About 70% of the population, particularly in rural areas use traditional and complementary/alternate Medicine. • The Govt. of Pakistan has issued the Unani, Ayurvedic and Homeopathic System of Medicine Rules of 1965. • Under this Act courses in homeopathy provided by recognized institutions must be four years in duration, culminating in a qualifying examination. BY Dr Chaman Lal PT 21

  22. Governmental Responsibility The Private sector’s dominance in the health sector needs to be recognized by policy makers. • Private Provision could Government sources to provide subsidized care to low income groups. • Vertical programs such as EPI, Family Planning, TB control etc need to be expanded to include Private Sector. • The field of Family Medicine needs to be properly high- lighted promoted and utilized by Government to the best of its advantages to public. • Quackery and Un- authorized health care giving should be penalized under the law. be financed through BY Dr Chaman Lal PT 22

  23. Responsibility of Private Healthcare Sector Must properly analyze the ethical and Professional Competency standards of our private healthcare sector. • Must make a full audit of all the existing private practice outlets. • Must also look into the possibilities of govt. and Private partnership. • Should clearly define our health issues, Health priorities and health policy. • Must have full Time properly functioning Public Health Department at all levels. • Must eliminate quackery in all forms. • Should adopt the concept of affordable treatment for all. BY Dr Chaman Lal PT 23

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