PESHAWAR: The World Health Organisation has complained about challenges in the fight against malaria in Pakistan, especially in Fata and Balochistan, where 80 per cent of the nationwide mosquito-borne disease’s incidence is reported.

“Malaria is totally preventable but a lack of awareness has been the main reason for its growing incidence in the country,” WHO country representative Dr Mohammad Assai Ardakani told Dawn.

Dr Ardakani also expressed concern about the 160,000 ‘undetected’ TB cases in Pakistan blaming it on a lack of public awareness and movement of Afghan refugees.

He said Pakistan ranked fifth among TB’s burdened countries in the world.

It also voices concern about 160,000 ‘undetected’ TB cases in the country

“We need to improve the TB detection rate,” he said adding that free treatment for the disease is available.

The WHO country representative said the organisation had launched family practices approach in Haripur and Swabi districts of Khyber Pakhtunkhwa to ensure the people’s access to treatment at primary health facilities to prevent major diseases.

“Under this initiative, the doctors keep record of families. That can be used in case of health problems,” he said.

Dr Ardakani said the initiative would be launched in 12 districts across Pakistan, which was the largest country among WHO Emro region and its health indicators had an impact on the whole region.

He said the measures were aimed at improving the quality of care at primary level and dealing with the high burden of diseases.

The WHO country representative said the organisation had imparted training to two doctors in family practices in Iran, where the system had been successfully implemented.

He added that the system would be replicated in all districts of the province as the health department had requested to strengthen its primary health delivery system.

“Another issue we face is the prevalence of HIV/Aids among the injecting drugs users and sex workers and social taboos associated with the disease,” he said.

He said the stigmatisation of HIV/Aids existed among health providers, which needed to be done away with.

“The WHO is extending cooperation to the government to scale up awareness among health workers about the mode of transmission about HIV/ Aids and supporting blood banks for proper screening of blood,” he said.

Dr Ardakani said the high maternal and child mortality rates were other areas of concern for the WHO and therefore, technical assistance was provided to the government to deal with it.

He said the low immunisation coverage and malnourishment among the children was being addressed to safeguard children from preventable diseases.

“We are implementing strategies in collaboration with government throughout the country to improve 14 health indicators and reduce the quantum of preventable diseases,” he said.

The WHO country representative said a two-day workshop had been organised by the organisation to impart training to doctors on family practices approach and enhance preventive and promotive healthcare for the population.

Meanwhile, health secretary Abid Majeed told Dawn that the department had approved the WHO’s recommendation regarding implementation of FP approach in Swabi and Haripur as the government was keen to strengthen primary care and give facilities to patients at their doorsteps as well as lessen burden on the secondary and tertiary care hospitals.

“We are in the process of equipping the basic health outlets at the cost of Rs3 billion so that the people could be treated there effectively,” he said.

The secretary said the government was spending massive amount on building of new facilities but patients were in the habit of visiting the secondary tertiary hospitals due to which there was a need for developing FP at the grassroots level and provide treatment to people at the local level.

He said a patient paid Rs35 for x-ray test at the public-sector hospital on which the government spent Rs156 meaning that the expansion of healthcare infrastructure was unlikely to pay off unless the government reverted to family practice under which the people got quality treatment at primary level.

“We are endeavoring to ensure universality in healthcare. All the people should have equal access to healthcare facilities,” he said.

Published in Dawn, March 4th, 2018