HEALTHCARE IN PAKISTAN

Sanaa AslamMsc. DPH StudentKings’ College LondonNov2012

COUNTRY PROFILE

U.S. CENSUS BEAUREU . International database [online] . Available. http://www.census.gov/population/international/data/idb/region.php?N=%20Results%20&T=13&A=separate&RT=0&Y=2012&R=-1&C=PK [Accessed].

COUNTRY PROFILE

WHO 2007. Health Systems Profile-Pakistan. World Health Organisation-Regional Office for the Eastern Mediterranean (WHO/EMRO).

ORAL HEALTH

• Mean DMFT score- National

Age (yrs) Decayed (D)

Missing (M)

Filled ( F ) DMFT

12 1.01 0.18 0.04 1.23

15 1.44 0.36 0.14 1.94

35-44 4.64 2.93 0.45 8.02

65+ 4.44 12.85 0.44 17.73

BILLIE,K., ASLAM, M. Oral Health in Pakistan: A situation analysis [online]. Available: http://www.fdiworldental.org [Accessed].

• 50% of children 12-15 years are caries free, 97% of all carious lesions remain untreated

ORAL HEALTH

BILLIE,K., ASLAM, M. Oral Health in Pakistan: A situation analysis [online]. Available: http://www.fdiworldental.org [Accessed].

• Poor periodontal condition• Percentage of individuals with CPITN score-National

Age (yrs)

Healthy (score0)

Bleeding (score1)

Calculus (score2)

Periodontal Pocket 4-5mm (score3)

Periodontal Pocket> 6mm (score4)

Excluded

12 28.10% 33.70% 20.90% 0.60% 0.10% 16.60%

15 26.50% 27.60% 28.70% 1.60% 1.10% 14.50%

35-44 16.80% 22.50% 33.90% 10.20% 6.70% 9.90%

65+ 6.20% 6.30% 31.40% 17.90% 17% 20.40%

ORAL HEALTH

• Prosthesis requirementsAge 65+, 65% require a prosthesisAge35-44,30% require a prosthesis

• Enamel fluorosis69% of examined population had no fluorosis • Oral CancerTobacco use, men 34% and women 12%Oral cancer 5 year prevalance: men 17133, women 19556

HEALTHCARE SYSTEM: ORGANISATION

TERTIARY FACILITIES

SECONDARY CARE: Tertiary health quarters,

District health quarters

PRIMARY CARE:

first level healthcare facilities e.g. basic health units, rural health units, dispensaries

HEALTHCARE SYSTEM: DELIVERY

RESOURCES & FINANCING

• 1978, primary health care was integrated in the entire system

• 972 hospitals, 4842 dispensaries, 5374 basic health units, 909 maternity and child health care centers

• 149,201 doctors, 10,958 dentists, 73,244 nurses• Population and health facilities ratio: 1,206 persons per

doctor, 16,426 persons per dentist and 1,665 persons per hospital bed

• Two principle modes of financing– Out of pocket fee based– General taxation

ORAL HEALTHCARE SYSTEM

• Public and private• Public oral healthcare system is integrated in

the general health care system• Financing and fee structure:Public: govt. taxation and fee per itemPrivate: out of pocket, private insurance arrangements, fee per item and/or fee per hour

DENTAL CARE PROFESSIONALS

PROVINCE MALE FEMALE TOTALPUNJAB/FEDERAL AREA

1167 806 1973

SINDH 902 837 1739KPK 548 256 804BALOCHISTAN 109 31 140AZAD KASHMIR 105 43 148FOREIGN NATIONALS

237 67 304

TOTAL 3068 2040 5108

Number of dental surgeons in Pakistan

• 15-20 Dental hygienists in two institutes• 800 Lab. Technicians• 40,000 + un-qualified dental practitioners (quacks) • 0 Dental nurses and therapists

FUNCTIONS & TARGET POPULATIONS

• Preventive programs• Community outreach programs• Restorative services• Surgical services• Public oral healthcare system: basic and cost effective interventions, for everyone• Private oral healthcare system: high quality delivery of cost effective interventions for everyone