Healthcare delivery System plays a vital role in socio-economic development, and it directly links with the overall economy of a country. The more manpower feels healthy, the more growth and economic activities would take place. Generally, Pakistan’s healthcare system consists of the private and public sectors. Most people facilitate private hospitals or medical clinics due to non-functionality and unavailability of health facilities in government hospitals.
Human Development Index in Pakistan indicates the lowest level, particularly for the health and education sectors. According to UNDP, the 2019 report that Pakistan ranks at 152 out of 189 countries with 0.5 HDI (Human Development Index) value, which put it in the middle human development category. Similarly, the total expenditure of public health sector is 2.8 (% of GDP) with the life expectancy at birth 67 (years), mortality rate, infants per (1,000 live births) is 61.2, infants lacking immunization (% of one-year-old) is 17, whereas diseases such as HIV (% ages 15-49) is 0.1, and Malaria incidence (per 1,000 people at risk) is 4.9.
According to the Pakistan constitution’s 18th Amendment, the provision of health is the responsibility of provincial governments except in the capital-administered areas.
Balochistan the largest province of Pakistan, is facing a dismal situation in the health sector due to government negligence, failure, and mismanagement. It is observed that the current healthcare system doesn’t meet public’s needs for quality health treatment. As a result, the province receives fatal diseases such as (malnutrition, maternal health, malaria, HIV, AIDS, and other critical diseases). And, most of its interior districts are lacking health facilities. At the same time, non-government organizations are working and supporting the government of Balochistan with their limited resource in healthcare services. Balochistan Rural Support Program (BRSP) has been working in healthcare services, including (malaria, nutrition, and disability) since 2007 at 25 districts of the province. The organization aims to reduce poverty by providing access to quality health services in Balochistan and the government. In the health sector, BRSP’s approach based on the following three major components.
- To provide access to quality health facilities, specifically in the rural areas of the province.
- To support the government in health management and policies.
- To educate communities about health-related issues.
Providing access to quality health services
BRSP has taken numerous steps and implemented various projects related to health at the different sphere of time such as People’s Primary Healthcare Initiative (PPHI) initiative, Reproductive Health, MCH, and Nutrition, Food Assistance for Assets (FFA), Support to Persons with Disabilities (PWD), Malaria Control Intervention, Polio Eradication, at targeted districts of the province. According to organization’s senior manager on health (malaria, nutrition, and disability) section Siraj Ghori that till now we strengthened 717 Basic Health Units (BHUs) via primary healthcare project by regulating staff, provision of modern medicines, capacity building of health workers, improvement of the physical infrastructure of health units and ensured need-based health services at different communities.
He added that under People’s Primary Healthcare Initiative (PPHI), more than 2,000,000 people got facilitated throughout the province. For malaria prevention, BRSP has distributed 124,000,000 Long Lasting Insecticidal Nets (LLIN) in 10 widespread districts. Similarly, 100,000 individuals treated through Mobile Service Units (MSUs). In Reproductive Health, MCH, and Nutrition Section, BRSP immunized 5,009 children and women in health facilities separately. Moreover, 15,562 Malnourished children & pregnant women were screened and provided health treatment accordingly.
In Food Assistance for Assets (FFA) project, which is an initiative of World Food Program (WFP) to support vulnerable people for immediate food needs with cash or food transfer, BRSP with the financial support of WFP (June to September-2019) assisted around 94,054 people (13,631 families) including 47,967 women of drought-affected areas in Tehsils Gulistan and Dobandi, at district Killa Abdullah. A total of 12,293 participants received cash-based amounts to PKR.117.040 million (USD-731,500).
In Support to Persons with Disabilities (PWD) section, BRSP first started working for Persons with Disabilities (PWDs) in 2016 under the project Balochistan Community Development Program (BCDP) funded by European Union in 40 Union Councils of four districts of the province including Zhob, Loralai, Jhal Magsi, and Khuzdar. This specific project supported marginalized segments of society with life-changing stories. According to organization’s focal person on (PWDs) that we provided assistive devices to 616 (PWDs) including 150 wheelchairs, 50 tricycles/handcycle, 50 crutches, 40 white canes, 120 hearing aids, 195 artificial limbs/hands, one electric bed and 10 modified 70 cc motorcycles.
In June 2017, the project further supported and extended to an additional 171 Union Councils of seven districts (Jhal Magsi, Khuzdar, Killa Abdullah, Loralai, Pishin, Washuk, Zhob) under the launching of Balochistan Rural Development and Community Empowerment Programme (BRACE) by European Union. In the second phase, BRSP identified about 44,885 PWDs by the Poverty Score Card (PSC) census with 70,901 different disabilities, which is 2.91 % of the total population.
After validation, a total of 4,400 PWDs selected from 211 Union Councils of seven targeted districts. Similarly, funds allocated for the provision of assistive devices accordingly. As a result, 3,484 assistive devices have been provided to 2,893 PWDs (32% women), including wheelchairs 650, tricycles 250, hearing devices 800, crutches 200, orthotic and prosthetic support to 1,584.
On the other hand, BRSP has also initiated a healthcare program (facility of 3D technology) for PWDs belonging to border districts of Balochistan This specific health facility which is being introduced at Al-Khidmat Hospital Quetta, deals with orthotic and prosthetic support to PWDs. The project funded by PATRIP Foundation. Similarly, Pakistan Poverty Aviation Fund (PPAF) and Chal Foundation support BRSP in health facilities for PWDs in targeted districts of the province Dera Bugti and Pishin, respectively.
In Malaria Control Intervention Program, BRSP under DMC is providing Malaria’s Prevention and Control health facilities at 25 Rural Health Centers (RHCs) of the province.
Supporting government in health management and policies
BRSP is supporting the government of Balochistan in health management and capacity building training. Till now, the organization has trained health staff throughout the province.
According to BRSP’s health section senior manager Siraj Ghori a total of 2,899 healthcare professionals trained on Malarias’ treatment, diagnosis, emergency, newborn care, and health hygiene facilities. Moreover, 1315 health staff have been trained on MIS reporting and surveillance of uncomplicated malaria case management under the said guidelines and instructions of WHO for malaria disease. Apart from this, he added BRSP is supporting the government’s primary healthcare system, such as Basic Health Units (BHUs), Rural Health Centers (RHCs), and District Head Quarters (DHQs) in health-related management issues. He added that our primary focus is rural health development in the province, and we are utilizing funds with the financial support of our donors.
Educating communities about health-related issues
The organization also educates communities, specifically rural populations, via advocacy sessions about different diseases and quality health facilities. Until now, 750,000 individuals got awareness sessions on Malaria Prevention, HIV/AIDS, Hepatitis, and Nutrition. Moreover, 13,982 community organization (CO) members got sensitized through 624 sessions on health services. Similarly, 148,477 youth and adolescents have been engaged through 1049 infotainment activities. Apart from this, BRSP also facilitated 1,103 people through 65 counseling sessions on Reproductive Health (RH) and health issues. Besides, 27,000 married couples were sensitized through 14,000 RH counseling sessions.
Summing up, the organization provides health facilities to people in 25 districts with its limited resources of donors. Still, the province is presenting a dismal picture of the healthcare system that doesn’t meet the demands of its citizens for standard and quality health treatment. Therefore, it’s the responsibility of the government of Balochistan to join hands with BRSP for quality health interventions in the province.
Also, Read: How Baluchistan in combating with the pandemic
Shams Ullah Durrani is a media scholar and environmentalist. He has five years of working experience in the development sector. He has worked on several projects such as inter-faith harmony, peace is possible, and Green Balochistan Tree Campaign. He is currently working with the Balochistan Rural Support Program (BRSP). His area of interest is Media Research, Climate Change, and Peace & Conflict Journalism.