The Boulevard of Health System Strategies
By Dr. Hafeez Ullah
With the increased significance of health systems, provinces are formulating strategies that are fruitful and important for their health systems within limited resources. Gilgit-Baltistan with its newly formed setup should also be thinking of strategies that might be beneficial for its health sector reforms. With the help of some technical healthcare professionals and experts in the department, the current government of Gilgit Baltistan has the ability to devise a futuristic strategy for its healthcare professionals and allied health workforce by taking inputs from healthcare experts, which will have long lasting positive impact in coming years on health sector of the region.
Health workforce in Pakistan is the spine and strength of health systems and economic growth. Well-functioning health systems ensure healthy societies, which then become gadget for economic development. A sick society never comes out of the malicious circle of poverty. Investments in health workforce and related professions have also produced millions of job opportunities in the country, continues to contribute in the economic development. However, the severe shortage of qualified healthcare professionals and health workforce has negatively impacted the health sector over the years in Pakistan, and is one of the reasons of poor health related outcomes and poverty.
In 2018, Ministry of National Health Services, Regulations and Coordination called upon a series of consultative meetings for the first time on the topic of Human resources for health (HRH), to devise a unified strategy at national and provincial level. The purpose was first of all, a situation analysis of the current health workforce in the country. The bleak picture showed that there is scarcity of doctors, severe shortage of nurses, midwives, and lady health workers (LHWs). There is unjust geographical distribution of health workforce between urban and rural areas, imbalanced skill mix, inadequate skills acquired by the health workforce, poor job satisfaction, work environment and out-migration were the key factors for health systems poor performance.
Firstly, the forum identified that there is no reliable, up to date data on the current health work force in the country, and HRH registry in provincial and national level for both public and private health sector. There is no proper Human resource information system in provincial health departments which can collect accurate and timely reliable data that can be utilized at national level and provincial level decision making and planning.
Secondly, the forum also had discussion on the different degree programs of healthcare professionals with their short comings in the curriculum regarding emerging international standards of academia of different health professions. The available data up till 2017 on human resource for health in the provinces was discussed with detail triangulations for analysis, which showed that the country is facing severe shortage of health work force in all categories according to its current and future needs.
The set of objectives included planning and development capabilities of health work force, investment in health labor market, build capacities of institutions at provincial and national level and strengthening of data collection, processing and dissemination of information to meet the health needs, maximum improvements in health outcomes, effective training and leadership and monitoring and ensuring accountability at various levels of the health systems.
The forum built a consensus on above said objectives and devised strategic directions for the provinces to follow on the road map up till 2030 with target setting. This was a great leap forward in terms of health sector contemplation approach, so that the critical issue of shortage of human resource for health can be addressed with the new needs of the time.
With this conducive environment at national level, Gilgit Baltistan government and especially health department has a great opportunity to look and revise its human resource policies, so that with the digitalization of health systems in near future, which is in pipeline by the Ministry of national health, the health sector here can be revitalized according to the policy lines at national level. The young chief minister of this region can have advisory level working group which can formulate a comprehensive health framework for human resource which should have a mandate to redesign and address all the issues related to shortage, trainings/skills, posting, promotions and salary structure.
As with the technological involvement in health sector, there is realization at national level and provincial level, the importance of human resource information system (HRIS) and health management information system (HMIS) and the utmost need of the time to collect data for analysis and for better health management decisions. So, this is another avenue to be emphasized on by exploring opportunity of health digitalization better outcomes can be achieved in public sector health system.
The common man of Gilgit Baltistan who is facing health issues has a lot of burden on his pocket for seeking better health expertise. So, giving better technological health options through better trained/ skilled human resource can ease the burden in far furlong areas of the region through tele- medicine/health approaches at local health facilities. This will decrease the burden of disease in long term and would facilitate a pro poor approach for better health seeking choices.
It is now a known fact in health sector that without the use of better technologically and skilled human resource, it is very hard to achieve the vision of universal health coverage. So, Gilgit Baltistan health sector should not be alien to this new global phenomenon and it is the right time for the new government to hit the iron when it’s hot. This is very much the right time for health sector reforms for Gilgit Baltistan, whether we talk about human resource for health or health digitalization.
By upgrading health services and taking technical inputs through public private partnership approaches in our limited resources, the current and future needs of the health system in this region can be rejuvenated for greater interest of the region.
By: Dr.Hafizullah, A Health Systems Specialist/Public Health Opinion maker, working at
Department of Health GB
