At over 158 million, Pakistan is the sixth most populous country of the world with its current population growth rate at 1.8 % per annum. With respect to infectious diseases, data from the Pakistan Demographic Surveys (PDS) for the years 1992-2003 show that the percentage of deaths attributed to communicable diseases has decreased from 49.8% to 26.2%; in addition immunization coverage has also increased substantially. However, Pakistan’s key health indicators still lag behind in relation to other regional countries.

Non-communicable diseases and injuries are amongst the top ten causes of mortality and morbidity in Pakistan and accounts for almost 25 percent of the deaths within the country. One in three adults over the age of 45 years suffers from high blood pressure; the prevalence of diabetes is reported at 10 percent; whereas 40 percent men and 12.5 percent women use tobacco in one form Fiscal year 2006-07 has witnessed an impressive increase in health sector allocation, rising from Rs.40 billion to Rs.50 billion (0.57%of GDP), thus registering a growth of 25 percent over the last year. Health expenditures have doubled during the last seven years; from Rs.24 billion in 2000-01 to Rs.50 billion in 2005-06

The state attempts to provide healthcare through a three-tiered healthcare delivery system and a range of public health interventions. The former includes Basic Health Units (BHUs) and Rural Health Centers (RHCs) forming the core of the primary healthcare structure. Secondary care including first and second referral facilities providing acute, ambulatory and inpatient care is provided through Tehsil Headquarter Hospitals (THQs), and District Headquarter Hospitals (DHQs) which are supported by tertiary care from teaching hospitals. There are seven hospitals under the control of Federal Government located in Islamabad, Rawalpindi and Karachi. There are tertiary care hospitals in all the provinces including those with the status of teaching hospitals, which are under the administrative jurisdiction of provinces. However, recently four hospitals in NWFP and three in Sindh have been granted autonomous status. Throughout the country, the vast network of health care facilities include 924 hospitals, 5336 BHUs and Sub- Health Centers , 560 RHCs, 4712 Dispensaries, 906 MCH Centers and 288 TB Centers. These healthcare facilities show an improvement over the previous year as the totalnumber of healthcare facilities during 2005-06 was 12,637. During 2006-07, these healthcare facilities have increased to a total of 12,726. The detail about the human resource available within the country up till 2006 is provided in Table12.4. There has been a gradual improvement in the number of doctors, dentists and nurses over the years. doctors, dentists, nurses and LHVs have doubled in the last one decade and accordingly population per doctor, per dentist, per nurse etc. have all registered a significant improvement.

The targets for the health sector during 2006-07 included the establishment of 30 Rural Health Centers (RHCs), 70 Basic health Units (BHUs) and up gradating of 25 existing RHCs and 50 BHUs. The manpower target included the addition of 5050 new doctors, 460 dentists, 2600 Nurses and 5500 paramedics. The plan called for training 500 traditional birth attendants and 500 Lady Health Workers during 2006-07. Under the preventive program, about 8 million children were targeted to be immunized and 24 million packets of Oral Rehydration Salt (ORS) were to be distributed during 2006-07 by the EPI Program. The health program during the current fiscal year has realized, on average, 80 percent of its physical targets (up to March 2007). The highest achievement of 99 percent has been obtained in the health human resource development especially doctors, followed by the provision of ORS (96 percent) and immunization coverage (94 percent). The sub- sector wise achievement has been recorded as 80 percent for RHCs and 90 percent for BHUs. It is encouraging to note that the achievements obtained so far are in the close vicinity of the targets.

Federally-led national program

•  The National Program for Family Planning and Primary Health Care
•  The Expanded Program for Immunization
•  The National HIV/AIDS Control Program
•  The National Tuberculosis Control Program
•  The National Malaria Control Program
•  The National Nutrition Program
•  The Women Health Project

Newly launched program in the public sector (2005-07)

•  The National Program for Prevention and Control of Blindness
•  National Program for the Prevention and Control of Hepatitis
•  National Neonatal, Maternal and Child Health Program

Rural Health Programme

• New Basic Health Units (BHUs)
• New Rural Health Centres (RHCs)
• Upgradation of existing RHCs
• Upgradation of existing BHUs