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Pakistan’s Health Status: Past, Current and Future

Pakistan’s Health Status: Past, Current and Future. Presentation by Dr. Fariyal Fikree of the Population Reference Bureau, November 1, 2007. Burden of Disease . Source: Mathers, Lopez & Murray, Burden of Disease Volume, 2006. Age Pyramid - 2000. 35,093,285 Ages 15-49. 33,127,740

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Pakistan’s Health Status: Past, Current and Future

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  1. Pakistan’s Health Status:Past, Current and Future Presentation by Dr. Fariyal Fikree of the Population Reference Bureau, November 1, 2007 © 2006 POPULATION REFERENCE BUREAU

  2. Burden of Disease Source: Mathers, Lopez & Murray, Burden of Disease Volume, 2006. © 2006 POPULATION REFERENCE BUREAU

  3. Age Pyramid - 2000 35,093,285 Ages 15-49 33,127,740 Ages 15-49 © 2006 POPULATION REFERENCE BUREAU

  4. Age Pyramid – 2025 58,998,903 Ages 15-49 62,386,844 Ages 15-49 © 2006 POPULATION REFERENCE BUREAU

  5. Family Planning Trends: 1990 - 2007 • Source: Pakistan Demographic & Health Survey (1990-91) • Pakistan Demographic & Health Survey (2006-07 © 2006 POPULATION REFERENCE BUREAU

  6. Child Health Trends: 1990 - 2007 • At 12 months (BCG, measles and three doses of DPT and polio) • Birth to 5 years to a health provider or facility • Source: Pakistan Demographic & Health Survey (1990-91) • Pakistan Demographic & Health Survey (2006-07) © 2006 POPULATION REFERENCE BUREAU

  7. Maternal Health Trends: 1990 - 2007 • At least once by a health professional • Various sources (WHO, National Institute Population Studies) • Source: Pakistan Demographic & Health Survey (1990-91) • Pakistan Demographic & Health Survey (2006-07 © 2006 POPULATION REFERENCE BUREAU

  8. Age Pyramid - 2000 16,914,726 Ages 35-74 16,872,637 Ages 35-74 © 2006 POPULATION REFERENCE BUREAU

  9. Age Pyramid - 2025 38,481,889 Ages 35-74 37,383,943 Ages 35-74 © 2006 POPULATION REFERENCE BUREAU

  10. Imploding Health Care Needs: Non-Communicable Diseases and Injuries • Very high mortality - a quarter of total deaths • Rapidly rising morbidity: • One in three adults over the age of 45 suffers from hypertension • Prevalence of diabetes – 10% • Tobacco Consumption – 40% of men; 12.5% women • Cancers: Breast, lung and oral cavity • Hospital visits: 25% are related to injuries © 2006 POPULATION REFERENCE BUREAU

  11. Health Delivery System Integrated Rural Health Complex Health Care Providers PopulationServed Specialists, Doctors, Nurses, Paramedical Staff Referral Centers Tertiary Hospitals Specialists, Doctors, Nurses, Paramedical Staff District Headquarters Hospital 100,000 – 300,000 Doctors, Nurses, Paramedical Staff Rural Health Centers 25,000 – 50, 000 Paramedical Staff 5,000 – 10,000 Basic Health Units © 2006 POPULATION REFERENCE BUREAU

  12. Meeting United Nations Standards for Safe Motherhood; Multan District, 2003. • Excludes tertiary hospital • Includes tertiary hospital • Per 500,000 population Fikree FF, Mir AM and ul-Haq I.  She may reach a facility but will still die!  An analysis of quality of public sector maternal health services, District Multan, Pakistan. Journal of Pakistan Medical Association  2006; 56(4): 156-163 © 2006 POPULATION REFERENCE BUREAU

  13. Health Systems Constraints: Infrastructure and Resources • Infrastructure: • Physical buildings • Water, electricity and disposal/incineration • Human Resources: • Skilled Health Care Providers • Training institutions • Retention • Equipment & Supplies: • At Basic Facilities • Secondary Level Facilities © 2006 POPULATION REFERENCE BUREAU

  14. Conclusions • High and growing burden of disease • Inadequate Health Care Services to meet current and future growing demands • Broader Question: • Where to focus attention/investment? • Social Needs – education, health, employment, justice © 2006 POPULATION REFERENCE BUREAU

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