Challenges and Opportunities in Health Governance Post 18th Amendment

HEALTH STATUS IN BALOCHISTAN

Balochistan is Pakistan’s least-developed province with a high rate of maternal mortality, illiteracy, unemployment, poverty, gender disparity, insurgency and brutal killings.

Inflexible social customs and practices are widely blamed for the plight of women and poor health services in Balochistan but other reasons are prominent.

Challenges influencing Health Services

Strong tribal influence due to illiteracy, poverty and lack of awareness.

Poor law and order situation is poor, scaring doctors to work in far flung areas.

27 doctors killed, 16 kidnapped, over 40 tortured

Over 100 doctors, including 20 specialists, have left the province because of security issues.

73 doctors suspended, 500 doctors salary stopped for the reason of demanding security

Complete strike in private and govt. sector for more than 60 days.

Comparison of National with Balochistan data

NATIONAL Maternal Mortality Rate

272/100,000 live births

Neonatal Mortality rate 54/1000 live births

Child Mortality rate 89/1000 live births

Total Fertility Rate 3.07 children per woman

Population growth rate 1.8%

BALOCHISTAN MMR = 600 to785/100

000 Live births

NMR = 72/1000 Live births

CMR = 94 to128/1000 Live births

Total Fertility Rate 5.4 children per woman

Population growth rate 2.7%

Challenges

People living in mountains and far flung areas have no access to heath facility.

75000 villages are without proper road network.

Non- functional heath centers and lack of equipment for emergency services.

Non- availability of gynaecologist and other specialists in the periphery

Lack of human resource especially female staff and inadequate capacity and skills.

ChallengesInadequate Family planning services

Lack of human resources especially female staff, along with inadequate capacity and skills.

Inadequate Family planning services especially access and coverage

What's need to be done?Improvement needed in:

1. Availability of competent midwives and skilled birth attendants.

2. Activation of BHU and RHCs.3. Availability of Emergency Obstetric Care services

for women.4. Good road network in urban and rural areas.5. Helpline and Flying squad to save maternal life.6. Power devolution up till the district level7. Integration of services; family planning, PPHI,

neonatal etc.8. Nutrition advice services9. Birth preparedness counseling

Thank you