23/12/2025
Revitalizing Pakistan's Health Care System is Imperative
To transform Pakistan's healthcare system into a robust ecosystem, it is essential to transcend mere infrastructure development and address the entrenched disparities between rural and urban healthcare delivery. The envisioned framework for 2025 and beyond necessitates a stratified, technology-driven, and equitable model.
1. Multi-Tiered Structural Reform
A well-functioning healthcare system operates as a seamless continuum, where patients receive treatment at the most appropriate level, thereby preventing the overcrowding of major city hospitals.
Primary (Village/UC) | BHUs often lack adequate staffing and basic medications.
The "Smart BHU" Model: Digitize patient records and empower Lady Health Workers (LHWs) with diagnostic tablets.
Secondary (Tehsil/District) | THQs/DHQs are overwhelmed by routine cases.
Specialized Hubs: Convert DHQs into specialized centers for Maternal Health, Pediatrics, and Basic Surgery.
Tertiary (City/Advanced) | Major hospitals are utilized for minor ailments.
Excellence Centers: Implement strict referral-only entry policies, focusing exclusively on complex surgeries, oncology, and neurosurgery.
2. Strategic Reform Pillars
A. Digital Health & Telemedicine (Bridging the Rural-Urban Gap)
Pakistan's geographical constraints render physical access challenging. The "Village-to-Consultant" link can be established through:
Tele-Clinics: Establish high-speed internet links at Rural Health Centers (RHCs), enabling village patients to consult specialists in Karachi or Lahore via video conferencing.
Centralized EMR (Electronic Medical Records): Implement a "National Health ID" for every citizen, ensuring their medical history is accessible from village clinics to city hospitals.
B. The "Human Resource" Renaissance
The "Brain Drain" poses a significant threat. To cultivate a healthy system, it is essential to:
Provide Hardship Allowances: Offer substantial financial and career incentives for doctors and nurses serving in remote areas like Tharparkar or Chitral.
Develop Mid-Level Providers: Train and license "Medical Technologists" to handle routine care in villages, supervised remotely by doctors.
C. Financing: From "Out-of-Pocket" to Universal Coverage
With 4.4% of Pakistanis facing poverty due to health costs, the Sehat Sahulat Card must be expanded into a sustainable Universal Health Coverage (UHC) model:
Preventative Focus: Shift insurance coverage to include annual check-ups and screenings, rather than solely hospital stays. "Healthy" systems prioritize disease prevention, reducing the burden of expensive emergencies.
Public-Private Partnerships (PPP): Permit private hospitals to manage failing public BHUs under strict government KPIs.
3. Preventive over Curative (The Cultural Shift)
A system is not "healthy" if it solely treats the sick. It is essential to reform the Public Health sector:
Water & Sanitation: 80% of diseases in Pakistan are waterborne. Health reform must incorporate the Ministry of Water/Sanitation to eliminate the source of the burden.
Nutrition Integration: Stunting affects nearly 40% of children. Integrating nutritionists into every RHC is crucial for long-term national health.
Immediate Next Steps
District-Level Autonomy: Grant District Health Officers (DHOs) financial authority to address local issues without awaiting provincial approval.
Referral Gatekeeping: Enforce a rule where patients cannot enter a Tertiary hospital without a referral from a Primary center (except emergencies).