This article has been cited by other articles in PMC. Abstract During the past few years, the pharmacy profession has expanded significantly in terms of professional services delivery and now has been recognized as an important profession in the multidisciplinary provision of health care.
Friday, 18 May Failure analysis of health policy of Pakistan This paper will be helpful for the researchers and students of Public Health and Public Policy. The government takes the responsibility to provide free heath care services to the citizens across the country.
The policy is set at the Federal level, which flows down to the Provincial government and is further delivered to the district government, which is responsible for implementation.
The districts do not have any role in the policy making process. There are two major problems associated with health sector in Pakistan. First, the policy process happens at the federal level without involving the provincial and district governments. This paper will analyse flaws in the health policy process and implementation of programs at primary healthcare level and will state the reasons, why primary healthcare is not efficiently and effectively addressing health issues.
It will then propose recommendations for making health policy geared towards preventive care, devolving policy making process to the districts along with its impacts and improving and integrating health program management at the primary healthcare level.
Contextualization of the policy problem Pakistan health policies were formulated in and respectively, which were aimed at addressing the basic health sector problems particularly strengthening of the poor primary healthcare system. There are three levels of healthcare facilities: The second level of healthcare called secondary healthcare facilities are the district headquarter hospitals, and third are Tertiary level healthcare facilities such as federal and provincial teaching hospitals which are meant for preparing medical professionals and research Khanpp.
The main focus of health policy, in Pakistan over the years, has been the restoration of Primary Healthcare System, as an essential instrument, to combat core health issues. But despite reforms, it has not been able to deflect from the biomedical model of curative health. The major flaws in the health policy making process have been the highly centralized policy making process and the large gap between theory and practice Khan and Khan Subsequently, innew healthcare reforms were introduced to address long standing health issues.
Being committed to Millennium Development Goals, Government of Pakistan reiterated the need to focus more on prevention and control of diseases, reproductive health, child health and malnutrition, rather than focusing on the curative aspect. It was decided to gear the thrust of public expenditures towards primary healthcare tier for achieving the health goals.
But the issue of involving the districts and the provinces in the policy making process was once again ignored.
Even the medicine and equipments lists are not finalized by the districts, which undermines the socio-cultural and environmental aspects of medication varying from district to district.
In short, the federal ministry of health along with its Planning and Development Unit formulates policies, which are mainly focused on clinical healthcare, paying less attention to other determinants of health and diseases lying outside the Biomedical model of health Ali and Green et al The role of the provincial government is to pass down the policies to the district governments, which implement them.
Another problem with the whole process is lack of monitoring and evaluation mechanism to assess whether the targets set are being achieved or not.
The tool of monitoring and evaluation for any program is indispensible, which primary healthcare sector lacks in Pakistan Khanpp. Critical Analysis of the issue Reforms to the health policy, introduced inhighlighted the importance of preventive health care model, but everything happened in documentation only.
Practically, the focus is still on curative side, emphasizing the need to increase hospitals and to increase expenditure on purchase of modern technology and equipments, drawing very less attention towards multidimensional health issues such as public health.
The content of the policy shows that the policies and instruments adopted in the document are in line with the same traditional Biomedical model dealing with treatment of the diseases rather than preventing diseases and covering cultural and environmental determinants, to cover health and wellbeing as a whole, in accordance with the modern paradigms.
In addition, it also lacks proper strategies and instruments for the implementation of different programs Siddiqui et al and Khanpp. Health indicators show that Pakistan lags behind in achieving its targets. Its Maternal Mortality Rate and Infant Mortality Rates are high, almost perdeaths and 71 per live births, respectively.
Hepatitis B and C are rampant with almost 3 million cases in the country. Leading causes of morbidity and mortality includes gastroenteritis, respiratory infections, typhoid fever and malaria. Malaria and Poliomyelitis, which have been wiped from almost all other countries of the world, have not yet been eradicated.
Therefore, as evidence suggests, the cost of treating these diseases is many times more than preventing them Khanp. The health policy asserts that the main issues can be addressed at the primary health care level using the primary healthcare institutions as instruments.
Primary healthcare is an intervention at the village and Union Council level: The net of Basic Health Units and other primary level facilities is spread over the country; present in almost every Union Council Khanp.
But these primary care facilities only provide delivery of curative services, completely ignoring the preventive side.
There are certain factors behind the failure of health policy in addressing health problems at the primary care level. The main flaws are categorically analysed as under: Flaws in the planning process There is highly centralized policy making process, which is mainly focused on curative healthcare such as increasing the number of health facilities, constructing laboratories, ambulances and providing modern equipments, without assessing how they will be used by the health professionals, who are not qualified to use the modern equipments, resulting in loss of resources Khan This is what happened, when family planning and population planning programs were being implemented, the religious groups opposed it on the ground that it was contrary to Islamic values, which resulted in failure of the programs.
Conflict of values occurs in terms of cultural and local morals, in implementing policy interventions. The communities find these health initiatives and interventions culturally incompetent and in conflict with their values due to lack of information and wrong perceptions Khanp.Chemistry AP HELP!
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