Health for all: E-health in Pakistan prospective
HUMAN HEALTH is one of the fundamental needs for normal existence. In Pakistan, the existing health system is not capable enough to provide adequate services for the growing population. Such a sorry state of affairs can be attributed to some key issues associated with health sector from very beginning. Deficiency of funds, limited access to health services and their insufficiency, extreme poverty, ignorance and lack of awareness among the masses and poor health infrastructure have been identified as fundamental problems in the way of improving public health. These problems still stand and militate against the government efforts to make the health sector efficient. Previous national health policies were formulated in 1990 and 1997 to form the basis for the development of the country. These policies aimed to address the basic problems in the health sector by strengthening the healthcare system on the basis of Primary Health Care (PHC) and bringing about the needed reforms in all areas of health. However, due to reasons of improper implementation and gaps in action on the decided agenda by the successive governments, these policies did not meet their objectives.
The problems faced by the health sector were; poor management of health services; poor quality of services; low utilization of healthcare facilities at PHC level; absenteeism and unprofessional attitude of staff; shortage of resources, supplies, medicines etc; lack of basic facilities like transport, communication, safe water, sanitation, electricity, security etc; administrative delays; lack of incentives for staff to improve performance; lack of career structure for doctors, paramedics, nurses, and other health staff; lack of accountability of staff to communities; inefficient use of resources; unresponsiveness to community needs; over-centralization; corruption; lack of supportive supervision/monitoring and external interference.
A large number of problems and inadequacies in the health sector relate to the lack of adequate finances. This partly explains the poor quality of health services, over-burdened outdoors, out of order equipments, insufficient medicines, and the relatively small number of beds, doctors and paramedic staff for patients in hospitals. At the same time, however, there is a whole set of problems, which relates to the utilization of resources that are made available. It is widely believed that whatever limited resources are allocated to the health sector is not efficiently and optimally utilized.
Using mobile/wireless information and communication technologies (ICTs) has transformed healthcare operations not only in developed countries, but also the developing ones. This application of ICT in healthcare has been termed e-Health. The importance of e-health is further confirmed by the fact that in May 2005 the World Health Assembly of the World Health Organization (WHO) had endorsed a resolution on e-health that invites all the member states to develop their own national e-health strategies and accordingly established the Global Observatory for e-health. The International Telecommunication Union (ITU) established ITU-T Study Group 16 Work on e-health to handle the standardization of multimedia systems to support e-health applications. According to WHO, the use of ICT in health is not merely about technology, but a means to reach a series of desired outcomes, such as;
• Health workers making better treatment decisions;
• Hospitals providing higher quality and safer care;
• People making informed choices about their own health;
• Governments becoming more responsive to health needs;
• National and local information systems supporting the development of effective, efficient, and equitable health systems;
• Policymakers and the public becoming more aware of health risks; and
• People having better access to the information and knowledge they need for better health.
The healthcare system in Pakistan comprises the public as well as private health facilities. In the public sector, districts have been given power of developing their own strategies, programmes and interventions based on their local needs. The human resource available for healthcare registered till December 2009 in the country included 139,555 doctors, 9,822 dentists and 69,313 nurses. The current population-doctor ratio is 1,183 persons per doctor and 16,914 per dentist. Healthcare is also provided to the public through vast health infrastructure facilities now consisting of 968 hospitals, 4,813 dispensaries, 5,345 Basic Health Units, 572 Rural Health Centers and 293 TB Centers etc. However, the healthcare system as a whole needs to be strengthened further at all levels. The future development of any technology obviously does not occur in a vacuum, making accurate forecasts and predictions even more difficult. The social and cultural milieu may alter, limit, or even prevent development of new ideas and technology development as well as the acceptance and/or implementation of both. E-health has potential to benefit the Pakistani people healthcare system in term of preventive care and disease treatment.