Health care in Pakistan

Pakistan’s health indicators, health funding, and health and sanitation infrastructure are generally poor, particularly in rural areas. About 19 percent of the population is malnourished—a higher rate than the 17 percent average for developing countries—and 30 percent of children under age five are malnourished. Leading causes of sickness and death include gastroenteritis, respiratory infections, congenital abnormalities, tuberculosis, malaria, and typhoid fever. The United Nations estimates that in 2003 Pakistan’s human immunodeficiency virus (HIV) prevalence rate was 0.1 percent among those 15–49, with an estimated 4,900 deaths from acquired immune deficiency syndrome (AIDS). AIDS is a major health concern, and both the government and religious community are engaging in efforts to reduce its spread.

In 2003 there were 68 physicians for every 100,000 persons in Pakistan. According to 2002 government statistics, there were 12,501 health institutions nationwide, including 4,590 dispensaries, 906 hospitals with a total of 80,665 hospital beds, and 550 rural health centers with a total of 8,840 beds. According to the World Health Organization, Pakistan’s total health expenditures amounted to 3.9 percent of gross domestic product (GDP) in 2001, and per capita health expenditures were US$16. The government provided 24.4 percent of total health expenditures, with the remainder being entirely private, out-of-pocket expenses.

Nevertheless, Pakistan is committed to the goal of making its population healthier, as evidenced by the continuing strong support for the Social Action Program (SAP) and by the new vision for health, nutrition, and population outlined in the government's National Health Policy Guidelines up to 2010. An example of a promising recent initiative is the lady health worker (LHW) community-based program, which is bringing health information, some basic health care, and family planning services to women's doorsteps. Presently, 3,000 women are serving as LHWs in their home villages.

Infectious disease
Communicable diseases such as diarrheal diseases, respiratory infections, tuberculosis, and immunizable childhood disease still account for the majority of sicknesses and deaths in Pakistan.

Dengue fever
An outbreak of dengue fever occurred in October 2006 in Pakistan.

HIV/AIDS
HIV is not a dominant epidemic in the adult population of Pakistan. Nevertheless, coupled with an extremely low awareness of HIV/AIDS in Pakistan, as well as a growing number of cases, the AIDS epidemic is poised to take a hold in Pakistan. The presence of additional risk factors, such as unscreened blood, and low condom use rates, makes the situation fertile for AIDS to become a major public health issue. The National AIDS Programme's latest figures show that around 3,000 HIV cases have so far been reported since 1986, but UN and government estimates put the number of HIV/AIDS cases between 70,000 and 80,000 with the vast majority going unreported due to social taboos about sex, and victims' fears of discrimination.

Maternal care
Maternal health problems are also widespread, complicated in part by frequent births. In fact, Pakistan lags far behind most developing countries in women's health and gender equality: of every 38 women who give birth, one dies. The infant mortality rate (101 per 1,000) and the mortality rate for children under age five (140 per 1,000 births) exceed the averages for low-income countries by 60 and 36 percent, respectively. Although use of contraceptives has increased, fertility remains high, at 5.3 births per woman, and population growth rates are much higher than elsewhere in South Asia. The underlying problems that affect health—poverty, illiteracy, women's low status, inadequate water supplies and sanitation—persist.