Health Care System Of Pakistan Research Articles

Importance of Nurses' Eye Witness in Health Care System of Pakistan

Background: Eye witness is an act that helps to provide justice, beneficence, non-maleficence and autonomy to any victim thus prevents misconduct and crimes from the society. Crime is an act of planning, preparing, stealing, harming and destroying individuals, groups or societies rights. Crime is one of the social and ethical issue that is prohibited in every religion and society. Healthcare professionals are suffering from different kind of workplace violence, harassments and abuses by patient attendants. Moreover, taking medicines or equipments from wards, and errors during surgical procedure is again consider crime. Nurses usually deal with issues and situations that have elements of ethical and moral uncertainty. Unfortunately such kind of crimes are not reported and remain unnoticed. It is our responsibility to become eye witness and report all those act which can prevent deviation from the standard of care as well as insure safety of health care providers. Methodology: Data were collected through systematic data search technique. Publication from 2001 to 2018 regarding eye witness were included in this study for review. After in depth screening, 22 articles were finally selected for review. Quality analyses were done according to pre-identified criteria. Result: Findings from retrieved and analyzed articles revealed that individuals cognitive power, confident level and theoretical knowledge is essential to become eye witness of any crime and misdeed. It is also evident from literatures that the outcome of telling lie and become fake eye witness has contextual consequences and punishment is different from context to context and person to person. According to three articles in this review, providing accurate and truth information regarding any crime is our responsibility and every religion possess and direct to provide correct information and become eye witness to prevent such acts which harm others. Conclusion: Nursing profession is facing number of challenges thus bulling and leg pulling is one of the issue which we seen in nursing profession. To take any decision and sharing any misconduct and immoral act by any person or health care providers we must have enough knowledge, confident, cognitive integrity to identify our personal values, moral development and knowledge of ethical theories for decision making in nursing to be a eye witness or not.

Women's choice of delivery site and the surge in private facility-based deliveries in Pakistan: A 28-year trend analysis

ObjectiveThis paper aims at estimating the long-term trends of facility-based and home-based deliveries and identifies the factors associated with the choice of delivery site. Study designSecondary analysis evaluating the trends in the choice of the delivery site by women of reproductive age using Pakistan Demographic and Health Surveys from 1990–91 to 2017–18. Main outcome measuresThe main outcome measure of this study is the choice of delivery site. MethodThis study used data from four waves of Pakistan Demographic and Health Surveys (DHS) corresponding with 1990–91, 2006, 2012–13 and 2017–18. Logistic regression was used for empirical analysis. ResultsThe odds of home delivery significantly came down in 2017–18 relative to 1990–91 (OR = 0.09; 95% CI:0.08–0.12; P < 0.001), growth in the likelihood of institutional delivery shows wide disparities. While the odds of delivery at the public health facility nearly doubled from 1990 to 91 to 2017–18 (OR = 2.12; 95% CI:1.70–2.65; P < 0.001), the odds of delivery at the private health facilities in the same period increased nearly eight times (OR = 7.78; 95% CI:6.45–9.38; P < 0.001). ConclusionResults suggest an investment gap in public health facilities and an inequitable health care system in Pakistan.

Are We Ready For The Paradigm Shift In The Health Care System Of Pakistan?

Pakistan’s health care indicators and accomplishment of its national as well international goals/targets though improving but are lagging the expected achievements.

Healthcare Quality Management System in Pakistan

The competitive healthcare system and healthcare environment, modern hospitals with substantial investment, healthcare reforms, availability of specialized persons in hospital management, health services management, the success of quality management programs in developed nations and high interest of international health organizations like WHO has led the developing countries like Pakistan to pay due attention to quality in national healthcare system. Since the time of independence healthcare system in Pakistan is striving for improvements. Despite of the physical infrastructure and availability of qualified workforce for service delivery there are gaps in strategic and operational planning which resulted in poor quality health services. The leaders in healthcare has little awareness that the quality management is an organized specialty to improve the quality of healthcare. It is need of the hour that healthcare leaders in Pakistan must integrate quality improvement activities in strategic and operational planning process of healthcare system. This the only way to maximize the benefits of healthcare system and restore the rapidly deteriorating public trust.

Situation Analysis of Health Care System of Pakistan: Post 18 Amendments

Objective of the study: The aim of this paper is to highlight the actions taken by the government in various health performance system domains post 18th Amendment. Methodology: Health system performance domains were identified through the websites of WHO and Eastern Mediterranean Regional Office of WHO (EMRO). Then the actions required in various health system performance domains were identified and the literature related to health system performance domains and 18th Amendment was reviewed through electronic databases and health care acts and related bills of each province. Inter-provincial analysis was done analyzing the vision, mission, aims and objectives of each and every provincial healthcare commission along with the monitoring and evaluation, licensing, governance and complaint systems provided on the respective databases of each province. Results: This will surely help in attaining the access, quality and equity to health care services. Conclusion: The health system is in process of regeneration, with provincial empowerment in the country’s federal system. While 18th Constitutional Amendment has created opportunities as well challenges, but the possible way forward to improve health sector is improving the governance system.

Current management strategies to target the increasing incidence of diabetes within Pakistan.

According to the recently published National Diabetes Survey of Pakistan (NDSP 2016–2017), the prevalence of diabetes is 26.3%. Hence, Pakistan has around 27.4 million people >20 years of age suffering with diabetes. Compared to previous estimation of having around 7 million diabetic patients based on a survey done in 1994–1998, the figures are disturbingly alarming. The four main strategies to tackle the rising incidence of diabetes in Pakistan are as follows: 1) creating multidisciplinary teams through capacity building of the health care professionals (HCPs), including doctors, dieticians, diabetes educators, diabetes foot assistants, and program managers in standardized evidence-based protocols, enhancing their knowledge and skills in managing diabetes and their related comorbidities; 2) promoting primary prevention and awareness all over Pakistan using screening methods such as Risk Assessment of Pakistani Individuals for Diabetes (RAPID); 3) defining strategies for the management and prevention of diabetes and its complication through forums such as the Pakistan Diabetes Leadership Forum (PDLF); and 4) implementing a nationwide diabetes care program including registration, treatment, and referral protocols. The epidemic of diabetes in an under-resourced and overburdened health care system of Pakistan poses a serious challenge not only for the doctors but also for the multiple stakeholders involved in the community systems. There is a need for promoting and screening the population using RAPID and registering people with diabetes through Diabetes Registry of Pakistan (DROP). Future priority areas and interventional strategies shall include the following: implementing a diabetes health care service model in both rural and urban population using evidence-based clinical guidelines along with lifestyle modifications (LSMs) and prevention policies. Current management strategies and proposed future directions may successfully target the increasing incidence of diabetes.

Reputation based Trust Management System for Improving Public Health Care System in Pakistan

Health is the most important facility for the people by the government if it is provided properly.There is a lack of trust among people about healthcare system particularly in public hospitals ofPakistan. People do not trust doctors and hospitals due to poor management and low standardscheck-up by the doctors. This is due to the lack of feedback system which leads to themismanagement of healthcare institutions. In this research, we have developed a reputation-basedfeedback management system that will overcome all the problems related to the trust of the patientsregarding their medical care. This will enhance the system and will let doctors, staff, andmanagement to work honestly to make their repute well.

To Study and Compare Perception of Health Care Professionals Regarding the Role of Pharmacist in Health Care System in Pakistan

&lt;p&gt;The healthcare team is mainly a triad of Physicians, Pharmacist &amp;amp; Nurses. Objective: The purpose of this paper is to help healthcare professionals understand more clearly the role of pharmacists within a health care team, especially inter-professional communication, pharmacists' responsibilities, and availability issues. A total of 200 samples were selected from 4 hospitals which include 100 samples of doctors and 100 of the nurses. Each sample is basically a questionnaire comprising of 23 questions. A total of two hundred questionnaires were distributed and one hundred and seventy-six questionnaires were returned resulting in the response rate of 88%. Pharmacists are being one of the major healthcare professional groups in the world after physicians and nurses are playing a very significant role in health care system. This understanding is a requirement for better communication and collaboration among the professions and for accomplishing the combined goal of better health care system.&lt;/p&gt;

One hundred injured patients a day: multicenter emergency room surveillance of trauma in Pakistan

ObjectivesInjuries increasingly contribute to the global burden of disease in low- and middle-income countries. This study presents results from a large-scale surveillance study on injury from several urban emergency departments (EDs) in Pakistan. The objective is to document the burden of injuries that present to the healthcare system in Pakistan and to test the feasibility of an ED-based injury and trauma surveillance system. Study designCross-sectional study conducted using active surveillance approach. MethodsThis study included EDs of seven tertiary care hospitals in Pakistan. The data were collected between November 2010 and March 2011. All patients presenting with injuries to the participating EDs were enrolled. The study was approved by the Institutional Review Boards of the Johns Hopkins School of Public Health, Aga Khan University, and all participating sites. ResultsThe study recorded 68,390 patients; 93.8% were from the public hospitals. There were seven male for every three female patients, and 50% were 20–39 years of age. About 69.3% were unintentional injuries. Among injuries with a known mechanism (19,102), 51.1% were road traffic injuries (RTIs) and 17.5% were falls. Female, patients aged 60 years or older, patients transferred by ambulance, patients who had RTIs, and patients with intentional injuries were more likely to be hospitalized. ConclusionThe study is the first to use standardized methods for regular collection of multiple ED data in Pakistan. It explored the pattern of injuries and the feasibility to develop and implement facility-based systems for injury and acute illness in countries like Pakistan.

Health Care System in Pakistan: A review

Health systems are expected to serve the population needs in an effective, efficient and equitable manner. The factors determining the health behaviors may be seen in various contexts physical, socio-economic, cultural and political. Therefore, the utilization of a health care system, public or private, formal or non-formal, may depend on socio-demographic factors, social structures, level of education, cultural beliefs and practices, gender discrimination, status of women, economic and political systems environmental conditions, and the disease pattern and health care system itself. Policy makers need to understand the drivers of health seeking behavior of the population in an increasingly pluralistic health care system. Also a more concerted effort is required for designing behavioral health promotion campaigns through inter-sectoral collaboration focusing more on disadvantaged segments of the population. The paper reviews the health care providers, the national policies emphasizing health services as well as health care systems in Pakistan and the role of the pharmacist in health care system of Pakistan, health and economics of Pakistan and current budgeting policies and the importance of non government organizations in health care system of Pakistan.

Medication misuse among elderly population in Pakistan.

Medication misuse among elderly population in Pakistan.

Equity, Efficiency and Effectiveness of Pakistani and Srilankan Health Care System: Using Kruk and Freedman Model for Health Care Assessment in Developing Countries

Pakistan and Sri lanka are both developing countries. Both are facing similar challenges as other developing countries are facing, and are situated in the South Asian region. However, the health care system of Srilanka is comparatively better than Pakistan. In this paper health care system of Pakistan and Sri Lanka was compared using Kruk and Freedman model for health care assessment in developing countries. Health care system in Pakistan fails to meet the needs of public health. Allocation of small friction of GDP, poor governance system, lack of regulatory authorities and lack of quality medical education are some of the major issues of Pakistani Health care system. Scarcities of qualified health care workers and imbalance in number of doctor and nurses further deteriorate health care system in Pakistan.

Primary Healthcare System of Pakistan: Challenges to Self-Management of Type 2 Diabetes

This review article is aimed at describing the primary healthcare system of Pakistan and its challenges in the face of epidemic of type 2 diabetes, focusing particularly on the middle-aged population of rural area of Pakistan. The main concern in Pakistan is that its middle-aged population is facing the onslaught of obesity and overweight due to lack of physical activity. In addition unhealthy eating habits making it more difficult for this population to control their weight. All these factors are contributing to a high risk of type 2 diabetes for the population of Pakistan. This article provides insight into the primary health care system of Pakistan and highlights its deficiencies by identifying that its primary healthcare system has a poor utilization of health care services, the poor accessibility to health system and poor management of diabetes by the healthcare system, gender disparity and inequity in the health care system. The primary objective of this study is to provide an overview of self-management of diabetes among the middle-aged population of Pakistan and to identify the overall deficiencies in the primary healthcare system, its delivery and access to the system, barriers to self-management of diabetes and quality of life in that region.

Career Promotions: A Challenge for Nurses in the National Health Care System of Pakistan

Career Promotions: A Challenge for Nurses in the National Health Care System of Pakistan

To serve or to leave: a question faced by public sector healthcare providers in Pakistan.

BackgroundThe availability of properly trained and motivated providers is a prerequisite for provision of easily accessible healthcare. Pakistan has been listed by the World Health Organization in its World Health Report 2006 as one of 57 countries with a critical health workforce deficiency. This study examines the factors associated with the willingness of public sector healthcare providers to leave government service and recommends measures that can be adopted to attract and retain staff in the country’s public healthcare system.MethodsA stratified, random sampling methodology was adopted to recruit a nationally representative sample of 1,296 public sector healthcare providers, including paramedics, medical doctors, and specialists. A semi-structured questionnaire was used to interview these providers. Logistic regressions measured the association with determinants of their willingness to leave the public health sector for better prospects elsewhere.ResultsA third of all healthcare providers who were interviewed were of the view that, provided the opportunity, they would leave government service. The odds of willingness to leave service were highest among providers from the region of Azad Jammu and Kashmir (adjusted odds ratio [AOR] = 4.33; 95% CI, 2.49–7.54) followed by the province of Balochistan (AOR = 4.21; 95% CI, 2.41–7.33), and the region of Gilgit Baltistan (AOR = 3.34; 95% CI, 1.67–6.67). Providers who expressed dissatisfaction in the manner their performance was evaluated and those who were dissatisfied with the current salary, each had higher odds of considering leaving government service (AOR = 1.67; 95% CI, 1.18–2.40 and AOR = 2.03; 95% CI, 1.47–2.81, respectively). Providers who reported experiencing interference in their work by influential politicians of the area were more inclined to leave (AOR = 1.44; 95% CI, 1.05–1.98).ConclusionThis study clearly highlights the need to implement more focused strategies in the public healthcare system in Pakistan in order to build sufficient staff motivation and prevent providers from leaving government service. In order to improve coverage of healthcare services in Pakistan, the government will have to introduce more focused interventions to attract and retain healthcare providers, especially in remote and rural areas of the country.

Geographical Information System Utilization in Health Care System of Pakistan

Geographical Information System (GIS) is computer software used for collection, storage, transformation, retrieval and display of geo spatial data from the real GIS world. The geographical data represent the real world in terms of their position with respect to a known coordinate system, their attributes and their geographical relationship with other objects. GIS utilization is being recognized as having the potential to improve the health of that specific population. GIS contributes in policy making, monitoring, implementation, and research in health sector. Need of population according to information provided by the GIS can be determined, which gives a quick and comprehensive review of regional and geographical health problems so that policy makers can utilize this for policy making and for forecasting the epidemics and other community health problems by using GIS. GIS system is a powerful and effective tool for creating intelligent/guide maps for, e.g., location of local health facilities, trauma centers, and specialized hospitals. It’s easy to purchase the GIS (hardware and software), but its proper utilization is a big task for the organizations to achieve their specific goals.

Traditional management of diabetes in Pakistan: Ethnobotanical investigation from Traditional Health Practitioners

Ethnopharmacological relevanceThe uses of anti-diabetic plants are well anchored in the traditional health care system of Pakistan. To the best of our knowledge, this is the first ethno-botanical study about the uses of plants for the treatment of diabetes. The aim of the study is to record indigenous knowledge on anti-diabetic plants from Traditional Health Practitioners (THPs) and diabetic patients. In addition, it is aimed to ascertain and validate the traditional uses of anti-diabetic plants by citing pharmacological activities and phytochemical constitutes from previously published literature. Materials and methodsThe ethno-medicinal data was documented during 14 field surveys, each comprising of 10 days, from 3 regions of Pakistan (Islamabad, Khyber Pukhtoonkhwa and Deserts of Sindh). In total, 113 THPs and 44 diabetic patients were interviewed using open-ended and semi-structured questionnaires. Quantitative indices, including Relative Frequency of Citation percentage (RFC %) and Disease Consensus Index (DCI) were calculated. The documented data is authenticated by comparing with 28 published articles on ethno-botanical aspects and many pharmacological studies. ResultsIn total, 120 plant species belonging to 50 families were reported. The ethno-botanical results indicated that Moraceae (11 species); herb (56 reports) is dominant life form; the leaves (56 reports) are the most used plant part and decoction (24%) is the preferred mode of preparation. The quantitative analysis shows that RFC% ranges from 14 to 42 and DCI varies from 0.15 to 0.74. By comparing to previous studies, 64 species are reported new in traditional treatment of DM; 40 species are new to pharmacological evidence and 3 species are new to phytochemical studies. ConclusionsThis study recoded the significant indigenous knowledge about anti-diabetic plants among the THPs and diabetic patients in Pakistan. This type of ethno-botanical knowledge on traditional use of anti-diabetic plants is an important step in designing detailed pharmacological and clinical trials for Diabetes Miletus treatment. It is recommended that further pharmacological and phytochemical analysis should be conducted on those species which lack previous references in literature and have highest Frequency of Citation (FC), Disease Consensus Index (DCI) and Relative Frequency of Citation percentage (RFC%).

PRS9 - Self-Medication and Associated Health Care Costs- A Survey In The Urban And Rural Population of A Major City In Pakistan

Self-medication in both rural and urban population in Pakistan is an increasingly growing concern. Both literate and illiterate people irrespective of age and gender practice self-medication, which is in more than 50% of cases inappropriate. The aim of this study was to survey over-the-counter availability of medicines and self- medication pattern among the rural and urban population of Karachi, Pakistan. Over 1300 volunteers of ages (between 20-80 years) and both genders were surveyed for their self-medication pattern. Medicines were grouped as antimicrobials and non-antimicrobials. 93% of volunteers confirmed the practice of self-medications and the frequency was higher in females (57%) as compared to males (43%), and the pattern was same in both urban and rural environment. The general symptoms for which medicines were taken included head ache (80%), body pain (67%), fever (40%), disturbed bowel (83%) and flu/cough/cold (72%). Among the non-antimicrobial medicines, the most frequently used groups were aspirin, paracetamol, chlorpheniramine, pseudoephedrine, ibuprofen and metronidazole. 13 % of the individuals confirmed adverse effects of the medicines. Among the antimicrobial drugs, only antibiotics were taken, and almost all classes and generations of antibiotics were taken. Oral formulations of penicillins, quinolones, and cephalosporins were frequently used as compared to other classes of antibiotics. However, not a single example of intravenous and intramuscular antibiotics was observed. 43% of the individuals confirmed that antibiotics were ineffective in their condition. The unregulated over-the-counter availability of medicines and the practice of self-medication are increasingly growing threats to the health care system in Pakistan. The inappropriate medications not only add to mortality and morbidity, but also cause increased cost of treatments. Such habits must be shunned through legislation and community awareness.

A Qualitative Analysis of the Perception of Academic Pharmacists Regarding their Role in Healthcare System of Two Pakistani Cities

Purpose: To investigate the role and perception of academic pharmacists regarding their role in the healthcare system of Pakistan. Methods: Qualitative methodology was used to explore the perception of academic pharmacists, and semi-structured interview was used to collect the data. The study was conducted in the cities of Islamabad and Lahore, Pakistan from April to June 2011. Results: On the basis of the interview guide, thematic content analysis yielded five major themes: 1) the need for a more comprehensive pharmacy curriculum; 2) perception of pharmaceutical care in Pakistan; 3) collaboration with other healthcare professionals; and 4) strategies to improve the status of pharmacist. Conclusion: There is a necessity for curriculum alignment, which is considered important to enhance pharmacy practice activities, as this will ultimately yield several benefits for pharmacists, including job satisfaction.

Status of General Practice and Challenges to Healthcare System of Pakistan

This article provides insight into the status of general practice in Pakistan and challenges to its health care system. The country ranked 122nd on the overall health system attainment and ranked 7th in the world on diabetes prevalence. The public sector health care system in Pakistan is encountered with many problems such as structural fragmentation, resource scarcity, inefficiency and lack of functional specificity, gender insensitivity and inaccessibility. The general practice status in Pakistan requires immediate attention to face the challenges created by chronic diseases in the country. Of particular mention are the patient-doctor interaction, healthcare system delivery, access to the doctors and better utilization of primary health care services.