Rising health systems requirements in Europe ,compounded by welfare or insurance funded healthcare structure and swamped by an influx of refugees from conflict zones of the Arab world, face immense pressures to adapt their outlay patterns to altering demographics, swelling disease burdens, patient empowerment and adoption of innovative digital health technologies. In response a European Health Parliament (EHP) appeared on the horizon in 2014 as an initiative to connect health care professionals for sustainable, actionable and innovative healthcare resolution in complementing Europe’s health policy. The corporate component consists of the College of Europe, Johnson & Johnson, European Patients Forum and EU40. Annually healthcare professionals congregate on a platform to pool their varied expertise and exposure to develop policy recommendations conjointly with the European Commission in Brussels.
While presenting at a Congress in Madrid this spring about controversies in Neurology I was struck by this emerging theme which I felt should appeal to health professionals as an initiative that could be replicated in Pakistan as a low cost, manageable yet thrilling innovative practice. In Pakistan the productivity of our workforce is lower then many countries in the developing world attributable to health issues despite instances of public sector institutes offering cardiology, oncology, renal and rehabilitation specialized facilities. Pakistan’s health care system in the public sector to which the majority gyrate has largely devolved to the provinces with a marginalized role of the federation and continues to be beset with multiple socio-economic challenges, including a rise in non-communicable diseases, healthcare costs and funding deficiencies and an increasing geriatric population with special health care needs population.The overall dismal positionsees spending on health restricted to US$ 37 per capita being even less than that recommended at US$ 44 per capita in conformity with guidelines of WHO. This is the bare minimum amount supposed to be expended on health services deemed to be essential as per WHO recommendations.In Pakistan 0.42 % of GDP is allocated to health in financial year 2016 and for the fiscal ending 2017 level of expenditure amounted to Rs.133.9 billion.The healthcare system of Pakistan continues to groan and creak under an unresponsive, bureaucratic oversight, lacks innovation and more significantly the quality of healthcare (QoH) is markedly lower then that of the private sector. The distinction between public and private sector healthcare in Europe is comfort and reduced waiting times whereas in Pakistan the difference is discriminatory QoH. Health insurance coverage is limited to the class which can afford it above a certain income level and for the ordinary citizens the recourse is public sector hospitals with compromised QoH.
Pakistan’s health care system in the public sector to which the majority gyrate has largely devolved to the provinces with a marginalized role of the federation and continues to be beset with multiple socio-economic challenges, including a rise in non-communicable diseases, healthcare costs and funding deficiencies and an increasing geriatric population with special health care needs population
Seminars and health conferences in Pakistan routinely lambast the 18th Amendment to the Constitution of the Islamic Republic of Pakistan without appreciating that primary health care is a local issue. Participants at health conferences do not propose in pragmatic terms how affordable health innovation digital or otherwise can enhance effectiveness and quality of the existing healthcare system. The EHPon the other hand consistently targets gaps in healthcare,proposes improved processes, regulatory environment and services for policy makers to be innovative how healthcare is delivered. The federal ministry in Pakistan concerned with health services can play its due role and arrange an annual ” Health Week ” brainstorming platform of public and private sector health academia to debate and formulate proposals to enhance QoH.
This initiative would invariably attract the technical expertise of international health organizations due to transparency. National health policies in most countries in the region are admittedly to some extent influenced by priorities of international health organizations such as UNICEF and WHO. It is imperative for effected countries to interact with such health supportive organizations so to involve them in international arrangements and donor supported capacity enhancement for improvement in basic health delivery services and outreach to the common man. Sponsoring of such a national or international platform could be through the aegis of organizations and leveraging through social media networks not necessarily corporates.
Incentivizing through establishing of an integrated platform by pooling of human health resources can be the next generation of health innovations instead of health awareness campaigners and health policy makers working in silos. Pakistan is the sixth most populous country in the world with an integrated contiguous land and a health platform with the secretariat being the federal government can conceivably spur the executive and legislative in launching healthcare solutions to ensure citizens of Pakistan however placed have access to QoH in order to boost individual and national productivity so as to exploit the potential of the citizens.The productivity of labor in Pakistan is compromised with a significant cause being stunted growth, frequent illness with the malnourished population being susceptible to disease and individuals suffering from any disease or disability facing discrimination at the time of seeking employment or admission in educational institutions. Enhancement infinancing for public health will indeed pay dividends in the developmental paradigm and contribute towards socio -economic betterment and poverty alleviation .
The author Nazia Mumtaz is PhD Rehabilitation Sciences, has done Fellowship in Clinical & Research Neuro Rehabilitation, Department of Rehabilitation Medicine from Seoul National University Hospital, South Korea