LAHORE: The government spent less than one per cent of gross domestic product on the health sector during the outgoing fiscal year against the world average of 9.9pc of GDP.

Expenditures on health sector during 2016-17 remained as little as 0.46pc of the GDP, reveals the Economic Survey of Pakistan released by Finance Minister Ishaq Dar on Thursday.

“During current fiscal year (July-March) 2016-17, the [health sector] expenditures remain at Rs145.97 billion showing an increase of 9 per cent over the same period of last year.”

The ratio is in line with the last 10 years pattern as it never reached the one per cent of GDP mark. Rather from 0.54pc of the GDP in 2006-07 it gradually dropped down to 0.23pc in 2010-11 and then recovered to the maximum of 0.72pc in 2014-15.

The survey admits that health spending is slow but “persistently rising” though much below the bench mark set by the World Health Organisation (WHO) for low-income countries.

“The country is spending 0.5 to 0.8pc of its GDP on health over the last 10 years. These percentages are less than the WHO bench mark of at least 6pc of GDP required to provide basic and life saving services.”

Quoting the World Bank’s latest report, it says “[C]urrently Pakistan’s per capita health spending is $36.2 which is below than the WHO’s low income countries bench mark of $86.”

Pakistan Medical Association, the parent body of medical community in the country, laments that Pakistan is spending even less than war-torn neighbouring country Afghanistan.

“Afghanistan is annually spending $167 per capita, India $267 and Iran as high as $1.82,” PMA President Dr Ashraf Nizami says.

“Of the less than 1pc, 80pc goes to [staff] salaries and administrative cost and just 20pc is left for the poor masses. Corruption eats up a major chunk of it, leaving a terribly negligible amount for the patients.”

The survey claims that the number of doctors, dentists, nurses and LHVs has increased and availability of one doctor, dentist, nurse and one hospital bed versus population has also improved.

“Today, the doctor to population ratio stands at 1: 997, dentist 1: 10,658 and hospital bed 1:1,584. While national health infrastructure comprises 1,201 hospitals, BHUs 5,518, RHCs 683, dispensaries 5,802, maternity & child health centres 731 and TB centres 347, and the total availability of beds in these health facilities is estimated at 123,394.”

It points out high population growth, uneven distribution of health professionals, deficient workforce, insufficient funding and limited access to quality health care services as some of key issues the health care delivery suffers from despite an elaborate and extensive health infrastructure.

PMA general secretary Dr Izhar Chaudhry says the public sector health facilities are gravely understaffed, while the government portrays that doctors are not working diligently or efficiently. “The world standards demand that there should be four nurses and eight paramedics with one doctor but the situation is contrary to it here as we’re working with up to 40pc less support staff.”

The survey put addition of 4,500 new doctors, 450 dentists, 3500 nurses, 4,550 paramedics and 475 traditional birth attendants as achievements of the health sector during the year.

But Dr Chaudhry says that most of these doctors are graduates from China, Russia and Central Asian States, while the quality staff produced by local state-run medical colleges have and are leaving for greener pastures abroad.

Published in Dawn, May 26th, 2017