How ‘Naya’ is Pakistani PM Imran Khan’s rhetoric on health?
In his inaugural speech to the nation, Pakistan’s newly elected prime minister laid out a broad and ambitious agenda to tackle the issues pertaining to health disparity and inequality in the country. It was especially heartening to hear that child stunting (the impaired growth and development of children resulting from poor nutrition, repeated infection and other factors) and maternal health feature high on Imran Khan’s list of priorities.
A report published by the UNICEF states that one in every 22 newborns dies in Pakistan. As a result, the country ranks poorly on the global index of infant and neonatal mortality, lagging behind some African countries that have a lower per-capita income.
Fetal growth restriction, micronutrient deficiencies, suboptimal breast feeding, low birth weight, and a lack of skilled birth attendants are among the leading causes for this high neonatal and infant mortality rate in Pakistan. More than 80 percent of newborn deaths could be prevented by improved access to well-trained midwives, clean drinking water and breastfeeding within the first hour of birth.
However, all is not all doom and gloom for Pakistan. According to the Key Indicators Report of the 2017-18 Pakistan Demographic and Health Survey, the nutritional status of children in the country has improved sharply over the past five years. It found that the percentage of stunted children declined from 45 percent in 2012-13 to 38 percent. A similar downward trend was also observed in underweight children, from 11 percent to 7 percent. Hence it is pertinent to commend the efforts of the previous administration in this area.
The economic co-benefits of investing in early childhood health should not be overlooked or underestimated. According to Professor James J. Heckman — the Henry Schultz Distinguished Service Professor of Economics at the University of Chicago, and an expert in the economics of human development — in his summary document “The Economics of Human Potential”, the best way for a country to reduce deficits and strengthen the economy is by investing in quality early childhood development, in terms of health and education.
Taking this argument further, Farhan Majid, a health economist at the Baker Institute of Public Policy, is of the view that for every rupee invested in stunting reduction, Pakistan will earn 30 rupees back. Demographically, Pakistan has 25 million children 5 years old or younger, so the cost-to-benefit ratio of such an investment is essential for the development of the country.
While the prime minister has addressed a wide range of health-related issues, he has so far neglected to mention a way forward to achieve his goals and what out-of-the-box plans he has that his predecessors failed to implement.
Dr. Mehreen Mujtaba
Khan also pledged to form a task force to improve the conditions of government hospitals across the country. He said health insurance cards would be introduced entitling holders to medical treatment worth PKR 550,000 ($4,500) annually. Bearing in mind the out-of-pocket expenditure on health incurred by the poor, this is a positive step towards providing them with relief.
Pakistan’s health crisis is a sad reality, despite the fact that health is a basic human right. By making healthcare a priority, the newly elected PM’s vision for bringing about social reforms is a commendable effort. However, at present the government lacks the resources to implement Khan’s vision of a world-class healthcare system. While the prime minister has addressed a wide range of health-related issues, he has so far neglected to mention a way forward to achieve his goals and what out-of-the-box plans he has that his predecessors failed to implement.
Secondly, it is a virtue to give credit where it belongs. The previous government was already doing a lot of what Khan is claiming he will achieve. The ball was set rolling under the aegis of his predecessor, Nawaz Sharif, who when launching the National Health Program in 2015 stated: “We have no option but to make this program a success.” Under the scheme, free treatment was offered for chronic conditions such as cardiovascular diseases, diabetes, renal failure and cancer. Health insurance cards were issued offering treatment worth PKR 300,000 a year, with PKR 1 billion set aside in the budget to launch the scheme on a pilot basis. In 2017, Prime Minister Shahid Khaqan Abbasi directed the Ministry of National Health Services to expand the program.
In terms of achieving improvements to health indicators, therefore, the groundwork has already been carried out for the new government. It just needs to take it a step further by expanding the outreach of these policies to every corner of the country, including far-flung and underdeveloped areas — it does not have to reinvent the wheel. Taking a page from the good practices of the previous government, as well as regional success stories, I am sure we can achieve the World Health Organization’s Sustainable Development Goal 3: to ensure healthy lives and promote well-being for all at all ages.
• Dr. Mehreen Mujtaba is a freelance consultant working in the areas of environment and health. She has a keen interest in climate change and its effects on population health and human security.
