Mussarat Khan Dreshak

Amjad Hussain aged 4, a student of government school, is diagnosed as stunted child by a team of doctors at a foundation assisted school near Wang, a town, 30 KM away from Rajanpur city in the province of Punjab.

The team of doctors was visiting the school for children medical check-up, and a number of children & their parents were advised to take care of their diet as they are stunted - their height is short compared to their age.

As many as 33percent children of Punjab province are classified as stunted children as reported by Multi- Indicator Cluster Survey (MICS) Punjab, 2014 and situation in the southern districts is even worse. Dera Ghazi Khan Division's 47percent children, under the age of 5, are stunted and nearly 44 children are classified as under-weight. The said alarming situation will require additional curative support in the later years as the state has to incur additional resources for their treatment as stunted children are more prone to diseases.

There are two types of programme to uplift public health status of masses; curative care programme and preventive programme. Curative care programme is such in which health care is imparted to victim segment of public. It is post method after effect of disease. This type of method takes a lot of economy to cope up disease hazardous effects. Curative care differs from preventive care, which aims at preventing the appearance of diseases through pharmaceuticals and immunization, exercise, proper eating habits and other life style issues, and from palliative care, which concentrates on reducing the severity of symptoms, such as pain. It is considered more expensive and needs major budget if focus lies upon this type of programme.

On the other side is preventive method, it is proactive technique in which measures are taken before occurrence of any ailment. Preventive care is the care that is imparted to prevent masses from illnesses or diseases. It includes counseling, therapy and treatment aiming to protect masses from impending health problems. Providing these services at no cost is based on the idea that getting preventive care, such as screenings and immunizations. In this regard, primary prevention refers to efforts to eliminate health or functional problems at their source-that is, preventing their occurrence-or to procedures (such as immunizations, improving nutritional status, and increasing physical fitness and emotional well-being) that reduce the incidence of disease. It takes less cost as compared to curative method.

Pakistan spends only 090percent of its GDP on Health care services and Punjab the most populated province of the country, also spend only 1.6 of its GDP. Although, the allocation & spending are on the rise during the last 5 years of the government but Public Health services needs to be prioritized viz-a-Viz financing in order to optimize available resources.

Globally, developed countries have shift their major health concern from curative method to preventive approach. The focus on prevention measures is so important as it is a key source of cost savings in health care. According to OCED Health statistics, in 2015, nearly all OECD countries allocated between 2 and 4percent of all final consumption expenditure on health care services and goods to preventive care. for example, France spent 1.9percent of Health expenditure on preventive healthcare schemes such as; information, education and counselling programmes, immunization, early disease detection programmes, Health condition monitoring programmes, EPI Epidemiological surveillance and cBsease control programmes and preparing for disaster and risk and disease control programmes. It shows, prevention programmes are rapidly becoming the corner stones of public health programmes.

According to School Education Department, Government of the Punjab released statistics, there are 52,443 schools, in which, 12 million enrolled students, out of this, nearly 3 million children are under the age of 5, thus providing a great opportunity for immunization coverage.

There are 1700 School Health & Nutrition Supervisor waged in Punjab under Primary & Secondary Health Care Department. If Punjab Govt. prioritize its focus from general masses toward these accessible multitudes; school children. Then, in contemporary time, it will be more beneficial & productive by launching School Health and Screening Programme. This programme should be initiated by capacity building of teachers and School Health Nutrition Supervisor. Primary school Teachers particularly teaching early grades should not only be sensitized but formally trained on screening basic Hygiene practices, supported by more rigorous screening & documentation by Health & Nutrition Supervisors. Health & Nutrition Supervisors will have to divulge awareness session in schools regarding pre-prevention of diseases in schools. For this programme, there should proper systemized set up be introduced; malnourished children should be referred medical support for proactive treatment measures.

By launching this smart screening programme, we can save numbers of young ambassador from harmful effects of heinous diseases and it will protect from expensive curative treatment which may need to imparted after hitting of disease. If we want to improve public health status, then Govt. should prioritize its focus from curative health measures toward preventive health care programme.

Health is considered a key indicator if a country wants to improve it status toward human development. If we review the historical stance of developed countries regarding higher level of HDI (Human Development Index), the key factor of their development lies on uplifting health status of their masses. According to United Nation Development Programme (UNDP) report, Pakistan status on HDI value for 2015 is 0.550- which put the country in the medium human development category-positioning it at 147 out of 188 countries and territories. Meanwhile, if we analyze HDI ranking of 3rd largest Asian economy, India, it status lies on 131 out of 188 countries.

The route cause for such declining position of Pakistan in Human Development Index could be less utilization on basic prerequisites i-e health, education, gender equality, food security, youth employment, etc. In an important sense, a nation's standing in the world is gauged by how its people's basic needs are being met. Much like education, health sector was not on the government's priority in Pakistan until recently, which spends merely 0.9pc of its GDP on healthcare. Developed countries have improved their Human Development Index (HDI) by launching major intervention in promoting GDP, life expectancy and educational status of the masses. If we analyze Life expectancy indicator it can be best raised by improving public health status of masses.