Blindness and visual impairment are major causes of noncommunicable diseases in Pakistan. Two national population-based blindness surveys conducted in 1988 and 2002-04 demonstrated a reduction in prevalence of blindness from 1.78% to 0.9% with a significant drop in cataract blindness as a result of accelerated nationwide interventions and eye care integration in primary health care. In addition, between 2006 and 2008, 88 facilities were upgraded as a result of the national eye health programme. These measures resulted in a 279% increase in eye outpatient attendances and a 375% increase in eye surgeries performed. Investment in human resources development and policy change contributed significantly to the sustainability of the programme. Key challenges facing the programme include aligning national eye health strategies with health system strengthening informed through health systems research. This paper attempts to document this extraordinary success.
Of the 10 million annual deaths of children below five years of age, four million are neonates. Pakistan's neonatal mortality rate of 54/1000 live births, which accounts for 57% of the under-five mortality, the contraceptive prevalence rate stagnating at 30%, the meagre number of deliveries assisted by skilled birth attendants (39%) and the low coverage of cost-effective child survival interventions hamper the achievement of Millennium Development Goals (MDGs) 4 and 5. The Government launched the national maternal, neonatal and child health programme in 2007 to promote access to evidence-based cost-effective interventions; strengthen district health system capacities; empower communities; expand the community midwives' cadre; and promote utilization of essential services. This paper reviews the implementation of the programme and the likelihood of attaining the MDG4 and 5 targets by 2015, and provides strategic directions for scaling-up programme implementation.
The Health Services Academy has launched a 12-month postgraduate diploma course in medical entomology and disease vector control. The objective is to create a core of experts trained to prevent and control vector-borne diseases. The course is a response to the serious health and socioeconomic burden caused by a number of vector-borne diseases in Pakistan. The persistence, emergence and re-emergence of these diseases is mainly attributed to the scarcity of trained vector-control experts. The training course attempts to fill the gap in trained manpower and thus reduce the morbidity and mortality due to these diseases, resulting in incremental gains to public health. This paper aims to outline the steps taken to establish the course and the perceived challenges to be addressed in order to sustain its future implementation. 1Medical Entomology and Disease Vector Control, Health Services Academy, Islamabad, Pakistan (Correspondence to H. Rathor: hamayun_r@ hotmail.com RÉSUMÉ Les Health Services Academy [Académie des services de santé] ont lancé un diplôme postuniversitaire d'une durée de 12 mois dans le domaine de l'entomologie médicale et de la lutte contre les vecteurs de maladies, dans le but de constituer un noyau d'experts formés à la lutte contre les maladies à transmission vectorielle. Cette formation est une riposte à la lourde charge sanitaire et socioéconomique que représentent un certain nombre de maladies à transmission vectorielle au Pakistan. La persistance, l'émergence et la réapparition de ces maladies sont essentiellement attribuées au manque d'experts formés à la lutte contre les vecteurs de maladies. La formation vise à combler ce manque et à réduire ainsi la morbidité et la mortalité dues à ces maladies, entraînant de ce fait une amélioration croissante de la santé publique. Le but de cet article est de mettre l'accent sur les mesures prises pour mettre en place la formation et les défis à relever pour soutenir sa future mise en oeuvre.املتوسط لرشق الصحية املجلة عرش السادس املجلد اإلضاىف العدد S77
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