Pakistan | Programme areas | Primary and secondary health care

Primary and secondary health care

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A photo of a woman being trained at a first-level care facility in Karachi, SindhTraining of primary health care workers at a first-level care facility in Karachi, SindhPakistan has a relatively large primary health care infrastructure. This includes 5000 basic health units, 600 rural health centres, 7500 other first-level care facilities and over 100 000 lady health workers providing services across Pakistan.

These primary health care services are supported by a network of 989 secondary care hospitals, at tehsil and district levels, for referrals.

Lady health workers programme

The national programme for family planning and primary health care, commonly referred to as the lady health workers programme was launched in 1994 to increase access to basic preventive health care services, particularly in rural areas.

The main objectives of the programme are to reduce poverty and improve national health indicators through the provision of essential primary health care services. The programme contributes directly to Millenium Development Goals 1, 4, 5 and 6 and indirectly to Goals 3 and 7.

Lady health workers deliver a range of services related to maternal and child health including promoting childhood immunization, growth monitoring, family planning and health promotion. They treat minor ailments and injuries and are trained to identify and refer more serious cases.

Family planning responsibilities include motivating women to practice contraception, providing contraception and condoms, and referring consenting clients for intrauterine device provision and/or sterilization. Recently, the implementation of Expanded Progamme on Immunization services and a direct role in immunization is being planned.

Lady health workers are involved in supporting the implementation of many public health programmes including those on tuberculosis treatment, malaria control, immunization, polio eradication, health education, maternal, newborn and child health and family planning.

WHO supports the Pakistani health authorities in training lady health workers, updating their curriculum and other related human resource capacity building. WHO also provides technical support in updating the knowledge and skills of supervisors through regular refresher courses and assists the health authorities in developing monitoring and supervisory checklists and creating a feasible health management information system for the programme.

Integrated primary health care

At present, different health programmes target different health conditions in Pakistan. Each programme has an independent organizational structure at the federal, provincial, district and first-level care facility levels. Having integrated primary health care services will help to improve the health status of the people of Pakistan.

In response to this situation, WHO commissioned the development of an essential health services package in 2008–2009. Essential health services are those necessary for provision of the minimal health services expected by the population from a certain level of health care. An essential health package consists of a list of public health and clinical services that will be provided at the primary and/or secondary health care level.

Primary health care