NISHTAR PROVIDES EVIDENCE BASE FOR HEALTH SYSTEM REFORMS IN PAKISTANTo prevent cardiovascular disease, countries need adequate health systems. But adequate health systems do not just appear out of nowhere; they require a lot of inputs. One important prerequisite is adequate health information. In other words, countries first must know what is ailing their people. Are they too heavy? Are they too physically inactive? Do they smoke too much? Endowed with a base of knowledge, countries can then begin to construct health systems that are suitable to their needs. Dr Sania Nishtar, President and Founder of Heartfile in Pakistan, puts the challenge succinctly: “What gets measured gets done”. Sound health systems is ultimate goalDr Nishtar wants Pakistan to have adequate health systems, and not just ones able to prevent cardiovascular disease, which is the country’s biggest killer. She wants Pakistan to confront the range of grave communicable and noncommunicable diseases, from AIDS, cancer and diabetes to polio and tuberculosis. That is why she wrote “Health Indicators of Pakistan,” the second in her Gateway Papers series. It is a collation of available health statistics in Pakistan. As such, it represents a first for her country. She hopes that it will serve as an evidence basis for health reform and as a template for periodic reports on health by Pakistan’s government. Gateway Paper 2 was launched on 26 June 2007 in Islamabad with the participation of Prime Minister Shaukat Aziz, Health Minister M. Nasir Khan and Acting World Health Organization Representative Rayana Bouhaka. Paper shows need to improveThe paper shows that there have been improvements in Pakistani health in many areas. For example, maternal and infant mortality have decreased over the last 60 years and immunization coverage has increased. On the other hand, it also shows that Pakistan lags, even in comparison with other low-income countries. For example, it indicates that Pakistan has far to go toward the adequate testing for and treatment of tuberculosis, and that poliomyelitis continues to claim too many victims. In addition, it shows that Pakistan spends only 0.67% of its gross domestic product on health. Of particular note, it shows that noncommunicable diseases account for 54.9% of deaths, as opposed to infectious diseases, which account for 26.9% of deaths. Nearly a quarter of its adults have high blood pressure. Forty-one per cent of its men and 6.9% of its women smoke. Twenty-eight per cent of urban and 23% of rural Pakistanis are overweight. The unmistakeable implication, she says, is that noncommunicable diseases, including heart disease and stroke, need more attention. Substantial gains possible“Aiming for further improvements will only be possible by making strategic choices and investments and by restructuring the mode of social service delivery, of which health is a part,” she said. “Health systems are critical to the entire discussion,” she added. “Prevention of cardiovascular disease cannot be delivered unless we talk in terms of strengthening health systems.” The former Chairwoman of the World Heart Federation’s Foundations Advisory Board said that she chose the term “Gateway” for her papers to reflect her contributions to national health policy setting from outside the governmental sector. Her first Gateway paper was entitled “Health Systems in Pakistan – A Way Forward”. It was intended be a road map for health reforms in Pakistan. The third will focus on specific recommendations to reform the health sector, she said. Heartfile an established leaderHeartfile is known for its innovative work to catalyze change in Pakistan’s health sector. The nongovernmental organization previously spearheaded Pakistan’s National Action Plan on Non-Communicable Diseases Prevention, Control and Health Promotion. Visit Heartfile’s web site. | |||||||
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