KARACHI - Public health remains a neglected science in Pakistan with the major focus on curative rather than preventive healthcare resulting in deep cuts in the healthcare budget as well as pockets of private patients, experts observed at the ‘CHS Research Day 2013’ held at Aga Khan University on Friday.

This year’s theme ‘Generating Actions from Knowledge’ was geared to make policy makers understand that public health is a multidisciplinary approach and must be treated as a significant piece of the whole system rather than approached in isolation.

“There needs to be a direct link between research evidence and informed policy making,” said Dr Imtiaz Jehan, Associate Professor, Department of Community Health Sciences, AKU.

Over 100 abstracts were submitted based on four main research themes: health systems and public healthcare development, women’s health and empowerment, environmental and occupational health, and chronic disease and nutrition.

The keynote speaker, Dr Abdul Ghaffar, Executive director, Alliance for Health Systems and Policy Research urged for a combined effort by policy makers and researchers in academia to identify research priorities and information gaps that need to be addressed through research. On the one hand, ownership of research by policy makers and practitioners is needed and on the other researchers need to be sensitised to gauge the success of their research by the degree to which their findings are used to inform policy and practice.

“We want policy makers to review the present healthcare system and make the required changes based on systems research rather than clinical research, which centres on biomedical and biotechnical domains,” Dr Jehan added. In successfully achieving such a balance the cost of healthcare can be significantly decreased while offering a high yield of healthcare services.

Meanwhile, Dr Fauziah Rabbani, Chair, CHS, AKU commented that one of a country’s most important resources is its population, and a healthy population directly impacts the country’s economic and social determinants. “However, access to healthcare [in Pakistan] is dismal with no coherent or concise healthcare policy,” she said.

Recognising the need for a more basic system to integrate the population the Urban Health Programme was initiated in 1985 at AKU as a community campus partnership model to develop primary healthcare prototypes. In a recent study UHP has tested integrated models of health and development in 17 different urban squatter settlements. It was awarded the MacJannet prize by Telloires Network in 2009 for its impact.

Dr Agha Xaher Gul, a researcher at the UHP, explained the sensitive transition from a ‘dependency syndrome’ on healthcare systems to people becoming aware that they are responsible for their health. “Every day we have more and more people migrating to cities but this mass urbanisation has not come without its share of problems,” he said.

According to Dr Gul cities are becoming inundated with people without education, proper skill set and infrastructure. “What many migrants do bring is an unhygienic lifestyle and a rural mindset with regards to healthcare, especially for women and children.” 

Seconding his assertions Dr Rabbani told the audience that the rapid and disorganised rise in urban population does not bode well for already weak healthcare systems. “For example in a city as heavily populated as Karachi 45 per cent of the people are living in squatter settlements,” she stressed. “By 2020 the percentage is expected to rise to 55 if not 60 per cent.” Presently stunted growth or ‘stunting’ in Pakistan is at 18 per cent, in Sindh it is at 25 per cent. These figures should have already sounded alarms as the World Health Organisation declares an emergency at 15 per cent.

“The whole system is interdependent, be it dealing with malnutrition and food security, economic policy or other areas. As a result of ignoring this we are now looking at a whole generation who will grow up with impaired cognition (due to stunting),” Dr Gul said.