Analysis of National

Health Policy 2001

Group: 1
Uroosa Khalid
Saddaf Amna
Naeem Asim

Contents
Introduction
1. Key Features
2. Vision
3. Concretising the vision

Key Area no: 1

1. Implementation Modalities
2. Targets and time frame

Context
Key Actors
Policy Process
My Analysis/Views
Concluding Remarks

Statistics

Health conditions in Pakistan are poor, and health indicators are

unfavourable. According to the World Development Report 2005,
Pakistan experiences problems of higher child mortality (an infant
mortality rate of 74 per 1000 and a mortality rate of 98 per 1000 among
the under fives) and maternal deaths (16,500 annually) as compared to
other neighbouring countries of the South Asian region (World bank,
2005).

Key Features
Health investments part of poverty alleviation plan
Policy paradigm shift for greater concentration from
tertiary to primary and secondary care
Good governance as a key to health sector reform and
to achieve quality health care

Vision
Health for all
Protect masses from hazardous diseases
Promote Public Health
Upgrade Curative and Care facilities
Focussed interventions to enhance equity, effectiveness
and efficiency
Fedral govt will play a supportive and co-ordinative role,
provincial govts would have to make concrete and
consistent efforts to improve infrastructure and services

Concretising the Vision

10 specific areas have been identified

1. Reducing widespread prevalence of communicable diseases
2. Addressing inadequacies in primary & secondary health care services
3. Removing professional deficiencies in District Health System
4. Promoting greater gender equity
5. Bridging nutrition gaps in vulnerable groups
6. Correcting urban bias in health sector
7. Regulation of private sector
8. Mass awareness in Public health issues
9. Improvements in Drug sector
10.Capacity building for health policy monitoring

Contd
In all the mentioned areas strategic objectives have
been identified and implementation modalities are
determined.
Time frame has also been incorporated
This policy will be a set of guidelines and objectives
for provinces while designing and implementing plans
in health sector.

Key area no: 1

Reduce the Widespread Prevalence of Communicable
Diseases (i.e EPI cluster of childhood diseases T.B, Malaria,
Hepatitis-B & HIV/AIDS)

Implementation Modalities
Preventive and promotive health would be a national plan
Planning, monitoring, evaluation, training and research would be
fedral subject while service delivery would be Provincial responsibility
Hepatitis-B vaccine would be included in EPI from July 2001
EPI facilities like cold chain will be strengthened in provinces by GAVI
grant over the next 5 years
Polio days will be continued to be observed till WHO polio free country
certification by 2005
Mothers will be immunized against neonatal tetanus in 57 high risk
districts of the country in next 3 years.

Contd
National TB control program will be started according to DOTS
1. Training of fedral, provincial and district level managers
2. Case detection through sputum smear technology
3. Observed treatment of patients
4. Standardized drug regeime
5. Operational research

Contd
New National Malaria control program will be started
1. Malaria Microscopy through upgraded basic health facilities
2. Early diagnosis with prompt treatment
3. Mass spraying will be replaced by selective sprays

Contd
HIV/AIDS program will be enlarged to include
1. Prevention of AIDS through health education
2. Surveillence system
3. Early detection of sexually transmitted infections
4. Improved care of affected persons
5. Promotion of safe blood transfusion
6. Uniform law to establish Blood Control authorities in provinces

Targets and Time Frame

85% Immunization coverage by 2003-04 and full by 2010
Polio cases will be reduced to less than 30% by 2003 and WHO
polio free certification by 2005
70% Hepatitis B coverage till 2002 and full coverage by 2003,
17.3million doses annually in next 5 years
Full TB DOTs coverage by 2005, detection rate 70%, cure rate
85% and overall 60% decreased prevalence by 2010
Malaria cases will be reduced by 50% till 2010, Plasmodium
Falciparum cases will be kept less than 40% of all malaria cases

Policy Cotext
Policy was formulated during a martial law
Purely formed by technocrats
No political input was there
Stakeholders were not taken on board
Sanctions due to Nuclear tests and Military Coup
Heavy International Aid post 9/11
Unions were not allowed at that time

Key Actors
Fedral Government
Provincial Governments
District Governments
Donors and Aid agencies (i.e GAVI, USAID)
Health Professionals
Private Sector

Policy Process
As there was dictatorship going on, in order to gain
Public support and good will no other tactic is as
appealing as health so the regeime identified the
prevailing health issues and formulated an ambitious
health policy
Implementation was not that much tricky as in
monarchy top-down approach was taken and
executive orders were given right from the top till the
bottom of hierarchy.

My Analysis/Views
Content of policy was appropriate
Goals were quiet ambitious
Team was also competent
Top down approach was an issue
Stakeholders were not taken into confidence
Later on political involvement hampered progress
Post 9-11 law and order situation created many hurdles
Lack of accountability was a major flaw
Adhocism was promoted rather than institutionalization and
sustainability

Contd
No strategy to control population
No family planning
No strategy to outreach the remote communities
No strategy to integrate community into health
interventions and campaigns
Lack of attention on tertiary care

Concluding Remarks
Overall the policy was appropriately formulated but it
didnt prove to be a great success story due to poor
law and order, lack of community participation,
authoritative style of governance, poor accountability,
non functioning democracy, lack of sustainability and
opportunism.
A lot of work was done in health sector but the quality
of infrastructure and equipment was compromised
due to immence corruption and political favouritism.

Contd
We were far away from meeting the MDGs
Polio cases were not controlled rather they were
increased.
Non communicable diseases emerged as a monster n a
huge burden on crippling economy
Healthcare spending remained below half of what it
should be
No proper mechanism was developed to respond and
investigate an outbreak

Failure

The priority actions for key area 1 of reducing prevalence of

communicable diseases were immunization interventions and screening
with treatment thus completely ignoring environmental and social
determinants of health.

Indeed, immunization is important in combating disease but there is also

a need to pay attention to other determinants of health particularly
environment and lifestyle .

The policymakers have neglected (or only paid scant attention to) the
important principles of HFA such as equity, participation and
collaboration.