Protecting Pakistan's health during the global economic crisis

Abstract

The world is facing an unprecedented global economic crisis, with many countries needing to reconsider their level of health care spending. This paper explores the many consequences of the global economic turndown on Pakistan's health, including reduced government and donor spending and increased poverty with the consequent diversion of funds away from health. Nevertheless, these challenges may provide opportunities not only to mitigate the adverse effects of the economic crisis but also to institute some muchneeded reforms that may not receive political support during more affluent times. Our suggestions focus on setting priorities based on the national disease burden, prioritizing prevention interventions, demanding results, curbing corruption, experimenting with innovative funding mechanisms, advocating for increased funding by presenting health spending as an investment rather than an expense and by selected recourse to civil society interventions and philanthropy to bridge the gap between available and needed resources. RÉSUMÉ Le monde fait face à une crise économique sans précédent. En conséquence, de nombreux pays doivent réviser leur niveau de dépenses de santé. Le présent article étudie les nombreux effets de la récession économique mondiale sur la santé au Pakistan, notamment les réductions des dépenses du gouvernement et des bailleurs de fonds et l'augmentation de la pauvreté en raison de l'important détournement des fonds du secteur sanitaire. Toutefois, ces difficultés sont l'occasion non seulement de limiter les dégats de la crise économique, mais aussi d'instaurer des réformes indispensables qui ne recevraient pas d'appui politique lors d'une période prospère. Nos suggestions sont axées sur l'établissement de priorités en fonction de la charge de morbidité nationale ; la sélection des interventions prioritaires ; l'obligation de résultats ; la lutte contre la corruption ; l'expérimentation de mécanismes de financement innovants ; le plaidoyer pour une hausse des fonds en présentant les dépenses de santé comme un investissement plutôt que comme une dépense ; et un recours occasionnel à des interventions de la société civile et à la philanthropie pour combler le fossé entre les besoins et les ressources disponibles.

A case study of outsourced primary healthcare services in Sindh, Pakistan: is this a real reform?

“…This is mainly because of inappropriate human resource management policies and regulations in Pakistan, which has eventually led to a complete lack of accountability and a laid back attitude among the physicians and other staff of primary health care, in particular [17,18]. …”

“…In BHUs administered by the district government, unavailability of physician was one of the major complaints which is also reported in another study conducted in the Attock district, Pakistan in which 20% of the respondent claimed that physicians were unavailable at BHUs and rural health centers. This is mainly because of inappropriate human resource management policies and regulations in Pakistan, which has eventually led to a complete lack of accountability and a laid back attitude among the physicians and other staff of primary health care, in particular [ 17 , 18 ].…”

Public healthcare in Pakistan: a people management solution?

“…Clearly, against this background, introducing a HPWS into Pakistani hospitals faces a number of challenges. First, there are a range of basic HRM challenges in tertiary hospitals including poor recruitment processes, lack of training opportunities, limited career and promotion opportunities, unattractive salary packages and poor supervision (Abdullah et al 2014;Government of the Punjab 2012;Jooma, Khan and Khan 2012;Kurji, Premani and Mithani 2016;Sayani and Feroz 2017). These challenges are further exacerbated by a chronic shortage and limited capabilities of health professionals (World Health Organization 2010.…”

“…Second, at the hospital level, recruitment is a problem because of the centralised provincial administrative control over appointments and postings (World Health Organisation 2017) leading to delayed recruitment on vacant positions, and creating further problems for already overstretched hospitals (Callen et al 2013). Third, salary levels are a source of tension between health professionals and management and many clinicians also work in the private sector (Jooma, Khan and Khan 2012). As a result, employees often give priority to their private work and this can compromise their work for the public sector (Government of the Punjab 2012), often resulting in absenteeism (Callen et al 2013).…”

The Impact of New Global Economic Crisis on the Social Function of Spas and Climatic Resorts in Serbia

“…The impact of the global economic crisis on the health care systems of many countries worldwide also affected the health system of Serbia. The European Observatory on Health Systems and Policies and the World Health Organisation with their Regional Office for Europe and with support of other offices all over the world, prepared case studies complement with broader analysis which summarizes official data sources and the results of a survey of key informants about the impact of the financial crisis on the health system (Stamatović et al, 2010;Jooma & Khan, 2012;Batenburg et al, 2014;Nolan et al, 2014;Taube et al, 2014;Maresso et al, 2015). The impact of the economic crisis in Serbia is unambiguous as Bartlett (2009), Ćurković (2010) and Antevski (2010) argued and also it is clearly presented in Таble 1, which refers to GDP, employment and unemployment rates.…”