- Thursday | 17 Apr, 2014
- Research Reports,Project Publications
SDPI and Jica
Gender is a crucial element in health inequities as it influences the control men and women have over the determinants of their health, including their economic position and social status, access to resources and treatment in society.
Decades of active lobbying by non-governmental organizations and women’s rights advocates have had a major influence in ‘gendering’ health policies, such as the shift in focus from family planning to reproductive health paradigms and the global acknowledgement that violence against women is as much a health issues as a social issue.
The Nobel Laureate Amartya Sen, in his seminal book ‘Development as Freedom’, emphatically stressed the relationship between women's education, social status and overall child and maternal health when he made education and health as the two basic capabilities that makes life meaningful and the enjoyment of freedom possible.
Analysis of economic and socio-cultural context is an important component of health policy analysis because contextual factors significantly influence the health policy process and the overall health of population directly and indirectly. Paying attention to contextual factors helps in understanding the role of the state, society and market forces influencing health agenda building, health planning and implementation, and even more important health outcomes. Health as a sector best typifies the fallacy 53 of the trickle down theory – that despite periods of high economic growth and activity, significant changes in social indicators have not happened.
A major determinant of health seeking behaviour is the organizing of the health care system. Primary data analysis shows that majority of the people regard the tension between the public and private health care system in Pakistan does not only grid the class divide with the poor availing the public services and the well off utilizing private services, but the public health care system suffers directly from the offer of services to the affluent. Doctors often work in both sectors, and refer patients to
private care, and often neglect public sector jobs to give attention to the better paying public sector. Rural areas are poorly serviced in terms of medical personnel, because those who study medicine prefer to practice in cities as it is more lucrative. The medical education and practice system does not have in-built requirements that stipulate time-bound practice in under-serviced areas, nor are there any incentives for doctors to practice in those.
There are less than a thousand hospitals for the entire population, so facilities are over-burdened and the quality of health services suffers tremendously. In 2006, the ratio was over fifteen hundred people
to a hospital bed (see the table below). Hospital waste management falls far below any acceptable standards of public health and hygiene; incinerators are rare and reuse of syringes common.