Daily Times

The pandemic of the novel coronavirus (COVID-19) has created havoc globally. While the effects of the pandemic are being observed across the wide range of sectors, the disease in particular is testing the nerves of healthcare systems across the globe. COVID-19 has posed huge challenges to fragile states with an inadequate healthcare infrastructure and has also affected the health systems of well-developed nations. This is primarily due to the lack of preparedness to deal with such pandemic. With the confirmed cases in the country rising every day, the healthcare system in Pakistan is stretched to its limits like other countries. It is quite obvious that Pakistan is faced with a mammoth task to respond to the disaster with a weak health infrastructure and funding constraints. To contain virus transmission, although some preventive measures (such as wearing of masks, physical distancing and hygiene practices et.) are being observed among the general public; however, more serious actions are needed across the nation. It is appreciative to see that the National Disaster Management Authority and the key players at the federal and provincial Government are executing public health measures to prevent virus transmission. Health and finance ministries are in complete sync these days instead of being at loggerheads with each other over funding issues. This article is therefore, an attempt to capture some of these dynamics, alongside suggestions for better repositioning of health systems in the country.

COVID-19 has huge implications for national economy and its goal for poverty alleviation

Historically, Pakistan’s healthcare system has been operating with very meager funding allocation (2% versus 10% globally), with a major share of funding going into staff’s salaries. Approved positions of healthcare providers are often not filled due to budgetary constraints. As a result, most of the Taluka Headquarters Hospitals in the country are usually unable to offer their services round the clock. The cracks in the weak health system became public when the country received the shock of COVID-19 cases with severe respiratory problems requiring ventilators and isolation facilities; which were simply non-existent particularly at most of the district level hospitals. This calls more funding resources in our health system to effectively manage with the routine care, and also to be more prepared to deal with outbreaks and such pandemics. In addition, non-health sector industries also became the victim of years of under-investment in health system as the lockdown measures rippled through various sectors and reduced their capability to respond. It is therefore high time for these sectors to also invest more in health of their employees and keep preventive measures at the core of their businesses.

COVID-19 has huge implications for national economy and its goal for poverty alleviation. It is commendable the way in which the country (despite of its meager allocation) rose to the occasion and introduced the ‘Ehsas Programme’ to provide emergency relief to cover 12 million families who have lost their income due to the lockdown. Under the rubric of Ehsaas Program, the eligible households are entitled received Rs12,000 per family and the total estimated budget is Rs144 billion. It is indeed commendable that both the federal and provincial Governments have approached the problem through multi-sectoral strategy. It is also remarkable to witness the rapidness with which the government managed to allocate Rs1.25 trillion which will be spent through a multi-sectoral relief package with an aim to address the challenges arisen due to the outbreak COVID-19 (gulfnews.com). However, funding envelop will indeed needs to be further enhanced to institutionalize these capacities and to ensure that proper investment is made in the monitoring and maintenance of these services during and post coronavirus pandemic.

In order to monitor the rise of infection, the Federal Ministry of Health has developed a highly sophisticated Incident Command & Control system for inter-provincial coordination on COVID-19. District-wise, gender-based and age-specific information is now being collected from the provinces and is being disseminated promptly for careful action. Unfortunately, in spite of the fact that the country is facing many challenges brought upon it by various epidemics, the Pakistan Bureau of Statistics does not seem to be actively engaged.

The COVID-19 pandemic has also drawn attention to the need for inter-country coordination and support for health systems strengthening through strategic action. One of the important areas of investment is aimed at ensuring standard operating procedure for adopting infection control measures not just for hospitals, but also for other sectors. Hospital leadership across the public and private sectors is investing efforts in building the capacity of healthcare providers in infection control protocol and ensuring the availability of personal protective equipment for their staff. It will therefore be in high interest of patients and healthcare providers if such investment is continued in post-coronavirus period also. As this will allow patients under treatment with other infectious diseases and health care providers to have safe environment. Also, as the government is taking action to equip hospitals to manage COVID-19 cases, such initiatives are needed to be sustained in future too to avoid delays in patient care treatment and reduce preventable deaths due to poorly equipped healthcare infrastructure, especially in government managed hospitals in Pakistan. To be continued

Disclaimer: The article express the views of authors only, it doesn’t represent views of an institution with which one of the authors belong.

Nousheen A. Pradhan is the Faculty at Aga Khan University, Pakistan and Dr Rozina Mistry is a Health Consultant.