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PAKISTAN HEALTH AND POPULATION WELFARE FACILITIES ATLAS

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PAKISTAN HEALTH AND POPULATION WELFARE FACILITIES ATLAS

Geographic Information System For Health Sector
CENTRE FOR RESEARCH ON POVERTY REDUCTION AND INCOME DISTRIBUTION
PLANNING COMMISSION ISLAMABAD, PAKISTAN
IN COLLABORATION WITH UNICEF PAKISTAN
2002
PAKISTAN
HEALTH AND POPULATION WELFARE FACILITIES
ATLAS
Dr. MUSHTAQ A. KHAN
DIRECTOR
Govt Monogram UNICEF
Monogram
GLOSSARY
P
atient: Used for person seeking curative care.
Clint: Used for person seeking preventive care.
H
ealth Institution: Any institution where health care is provided. Health institutions can be further divided into first level health care facilities and in referral level
care facilities.
F
irst Level Care Facilities (FLCFs): Health institutions where first contact between the patient and the professional health care providers take place. They include:
RHCs, BHUs, Dispensaries, MCH Centers and OPDs of Hospitals.
P
reventive Care Services: This part of health services is based on fulfillment of community public health services to prevent the spread of communicable as well as
non-communicable diseases.
Curative Care Services: It deals with indoor and outdoor specific disease related treatment. It includes total no. of new cases.
P
opulation Projections: Estimates of the future size and characteristics of a population, based on the pattern of past trends and the predicted future pattern o
f
births, deaths, migration and land availability.
H
ousehold: A household means a group of persons living together who have collective arrangement for eating. A person living alone was also considered to
constitute a household. The distinguishing characteristic of a household is its common cooking arrangement (Population Census 1998).
Urban Areas: All localities, which were either metropolitan corporation, municipal corporation, municipal committee, town committee or cantonment at the time
of the census, were treated as urban (Population Census 1998).
Geographic Information System: GIS is a computer system for capturing, managing, integrating, manipulating, analysing and displaying data, which is spatially
referenced to the Earth.
atabase: A logical collection of interrelated information managed and stored as a unit, usually on some form of mass-storage system such as magnetic tape o
r
disk.
Map Query: The process of selecting information from a GIS by asking spatial or logical questions of the geographic data.
Spatial Analysis: The process of modeling, examining, and interpreting model results. Spatial analysis is useful for evaluating suitability and capability, fo
r
estimating and predicting, and for interpreting and understanding.
TEAM MEMBERS
DR. MUSHTAQ A. KHAN
Director CRPRID
Mr. TAYYAB IKRAM SHAH
Ms. JANAT–UL–MAWA
Ms. UZMA RABAB
GIS Team Members
Mr. OSMAN–UL–HAQ
IT Specialist
DISCLAIMER
The maps and/or tables included in this Atlas were developed using different existing data sources. Neither the CRPRID nor the team members make any guarantees or accept
liability for the accuracy of the spatial datasets and/or attribute data presented here.
Centre for Research on Poverty Reduction and Income Distribution (CRPRID)
P
lanning Commission, Ministry of Planning and Development, Govt. of Pakistan.
R
oom # 125 –140, 1ST Floor, ‘P’ Block, Pak Secretariat, Islamabad 44000
Tel: 9217111
e – mail: info@crprid.org
URL: www.crprid.org
PREFACE
The Social Sectors of Pakistan although have developed a reasonable good information system but there remains the need to depict it to a Geographical Information
System, which provides information of location of facilities to help the decision makers to know over served, adequately served and underserved areas. The Centre for
Research on Poverty Reduction and Income Distribution (CRPRID), located in the Planning Commission has taken the initiative to develop the Education and School
Atlas as well as the Health and Population Welfare Facilities Atlas of Pakistan. The overall goal of these two products is to help and equip the Government, Decision
Makers and Planners to make informed decisions in Social Sector through integrated economic and educational/health planning. The series of Atlas developed for social
sectors i.e. Education, Health and Family Planning Facilities will be a diagnostic tool to be used by the planners for incipient planning, for arising general interest and
knowledge in common public, or to present the overall situation about social sector infrastructure to decision makers. The accomplishment of above said task will iterate
through the necessary steps of information collection, location demarcation, indexation and a presentation.
We feel immense pleasure to present the Social Sector Atlas, which is first of its kind not only within the country but also in the region. The Geographic Information
System (GIS) has been used as a tool to show the information in the form of maps, tables and graphs. The information at National, Provincial, District and Tehsil levels
is primarily based on Management Information System of Education and Health Sectors. However, the other data sources have also been used to perform multi-layer
analysis. The availability of atlas in hard and sort form will be helpful in further analysis and updation in future.
The document may have some deficiencies, which could not have been addressed at the time of its preparation but because of lack of information of complete
coverage of census and mapping (especially in private sector). However, these deficiencies, and improvement of the document would be possible through revision and
subseuent update.
To that end we welcome feedback, suggestions, comments, and offer of ideas and assistance to bring out the next edition.
December, 2002 Dr. SHAHID AMJAD CHAUDHRY
Deputy Chairman,
Planning Commission
MESSAGE
I
t gives me a great pleasure, to congratulate Dr. Mushtaq A. Khan and his team, who has done an excellent wor
k
in developing a Geographical Information System (GIS) in Social Sector. The series of Atlas in Education
Sector, Health and Population Sector, is a diagnostic tool for the decision makers and the service providers to
identify the areas, which need facilities and social services.
The gigantic task is a great contribution to rationalize the distribution of facilities and services in accordance
with the need. These Atlas would provide information about the availability of the facilities and will help in
p
lanning to a pragmatic planning to cater to the needs of underserved and for inadequately served areas.
The GIS is the most modern technology available for reaching the decision to give a comprehensive coverage to
the population. In the past, one of the factors, which has always been talked about is wrong planning in site
s
election of various facilities. This has been major reason fo
r
low utilization of existing facilities. The ATLA
S
would help in overcoming this problem in the future. The National Commission on Human Development has been
created to shoulder the responsibilities with the Public and Private Sectors to eradicate Poverty, universalize
P
rimary Education, provide Basic Health Services and Safe Motherhood at the door step of the community. The
GIS will definitely help the Commission’s activities in fulfilling its objectives. The useful work done by the Centre
f
or Research on Poverty Reduction and Income Distribution (CRPRID), which is a Centre of Excellence, locate
d
in the Planning Commission is highly appreciable and is a great contribution in the Social Sector.
--------- Dr. NASIM ASHRAF
Chairman
National Commission for Human Development
FOREWORD
Poverty has a number of manifestations, including lack of income and productive resources sufficient to ensure sustainable livelihoods; hunger and malnutrition; ill
health; limited or lack of access to education and other basic services; increased morbidity and mortality from illness; homelessness and inadequate housing; unsafe
environment and social exclusion. All these areas need systematic and in depth analysis.
The Centre for Research on Poverty Reduction and Income Distribution (CRPRID), established in January 2002 is a Center of Excellence, located in Planning
Commission, for applied research on poverty and income distribution issues. Recognizing the link between Social Sector (especially education, health and population
welfare) and poverty, efforts were made to develop Social Sector Atlas, which is GIS based and is first of its kind within the country. By presenting the data on maps,
the atlas provides a graphical image of the distribution of health status in different regions of the country. The maps at various administrative levels prepared facilitate
better quality and timely information for decision-making in the education and health sector. The format of the atlas makes the information easy to understand and
readily accessible to abroad group of users, including decision-makers, planners, providers, researchers, and others. This data is vital for policy development and local
area (district level) planning, and for monitoring and evaluating Social Sector services. It is also of major importance for improvements in resource allocation at the
macro level, and between areas, services and population groups. The maps and tabulations presented in this atlas represent a major compilation of information for this
purpose.
The success and full benefits of this activity, or more precisely the tool would rest on its adaptation of the logic behind the process i.e. update it for repeat series of
cycles so as to delineate a set of priority problems. The regular updating and interaction with the community to develop a visual blue print of the planned target areas is
an achievable objective.
December, 2002 Dr. MUTTAWAKIL KAZI
Secretary,
Planning and Development Division
Government of Pakistan.
TABLE OF CONTENTS
Acknowledgment
Introduction
Technical Notes
THEMATIC MAPS/TABLES/CHARTS
PROVINCIAL LEVEL
Geographic (Spatial) Distribution of Urban Localities
Number of Health Care Facilities by Controlling Authority
District wise Summary of FLCFs
Summary of Population Welfare Programme Outlets
Percentage Contribution of FLCFs
Geographic (spatial) Location of Hospitals
List of Hospitals by Controlling Authority
NATIONAL LEVEL
Terrain Map
Administrative Boundaries (International, Provincial, District, Tehsil)
List of Tehsils
Population Size of Pakistan (in millions)
Thematic Map Showing Population Density of Pakistan
Utilization of Public Health Care Facilities of Pakistan
District wise Utilization of Health Institutions
District wise Ranking on the Basis of NHMIS Reporting Compliance
NHMIS Reporting Compliance by District
District wise Distribution of Lady Health Workers in Pakistan
District wise Current Allocation of Lady Health Workers in Pakistan
Public Sector Medical Colleges of Pakistan
Geographic Location of Medical Colleges of Pakistan
List of PMRC Research Centres
Growth in Health Sector in Pakistan
Financial Outlays of Five Year Plans
Health Facilities
Health Sector Manpower
Number of Health Care Facilities in Pakistan by Controlling Authority
Province Wise Distribution of FLCFs
Province Wise Doctors and Specialists in Pakistan
Trends in TFR and CPR
DISTRICT LEVEL
Geographic (Spatial) Location of Health and Population Welfare Facilities
District Profile, List of Health and Population Welfare Facilities and their ID
Annexure
Health and Population Welfare Service Delivery Systems and Staffing Pattern
Glossary
ACKNOWLEDGMENT
I wish to express my deepest appreciation to Dr. Shahid Amjad Chaudhry, Deputy Chairman, Planning Commission for his keen interest and support in preparing
the Atlas and other activities of the Centre for the Research on Poverty Reduction and Income Distribution.
My warmest gratitude is also extended to Ch. Mueen Afzal, Secretary General Finance and Dr. Mutawakkil Kazi, Secretary Planning & Development Division for
encouragement, support and insight throughout the preparation of this document. I am grateful to Dr. Nasim Ashraf, Chairman and Dr. Mussaddaq Malik, Chief
Executive Officer, National Commission on Human Development for their useful ides.
My special thanks to Mr. Tariq Hussain, Advisor CRPRID, for his immense and valuable contribution in overall work of the Centre.
I am thankful to UNICEF and special thanks to Ms.Carroll C. Long Country Representative for the constant support in alleviation of poverty through investment in
human capital formation for Women and Children. In preparation of the Atlas her invaluable assistance is highly acknowledged. I would like to acknowledge with
thanks the contribution, guidance and support provided by Dr. Abdul Alim, Ms. Sarah M. Ahmad, Mr. Shafat Sharif, and Mr. Muhammad Mahmood, PM&E
Section of UNICEF.
I also acknowledge with thanks Mr.Onder Yucer, Resident Representative for his support and keen interest in strengthening the CRPRID and in preparation of the
Atlas. I am thankful to Dr.Ch. Inyatullah, Chief SL Unit, UNDP for valuable support.
I am thankful to JICA and Mr. Ishi, Ms.K.Tanaka, Mr. Sohail Ahmad and Mr. David Randall, UNOPs for timely help in the procurement of color printer and other
assistance.
I am extremely grateful to Dr. S. M. Mursalin, Coordinator, National Health Management Information System, Ministry of Health, Dr. Shafiq-ud-din, Chief, Health
Section and Mr. Ammanullah Khan, Chief, Population Welfare Section, Planning and Development Division for providing related data and information needed for
this Atlas.
I am also thankful to the Bio-Statistics Section, Ministry of Health, Monitoring and Statistics Wing, Directorate of Survey Statistics and Data Processing, Islamabad
and Education Departments of Federal Government and Provincial Governments for the provision of supporting datasets for the Atlas. I would like to appreciate the
encouragement and support of Planning Commission, Federal Bureau of Statistics and Population Census Organization throughout this activity.
I am highly indebted to GIS Specialists team led by Mr. Tayyab Ikram Shah, and consists of Ms. Janat-ul-Mawa and Ms. Uzma Rabab for the excellent work they
have done.
My colleagues in the CRPRID, Dr. M. Aslam Khan, Chief Poverty Section deserves appreciation for the assistance in preparation of this document.
December, 2002 Dr. MUSHTAQ A. KHAN
Director, CRPRID
MEMBER
NATIONAL COMMISSION FOR HUMAN DEVELOPMENT
ACRONYMS
BHU: Basic Health Unit
C.H: Civil Hospital
DCR: District Census Report
DCW: Digital Chart of the World
FLCF: First Level Care Facilities
FWCs: Family Welfare Centres
GIS: Geographic Information System
HMIS: Health Management Information System
LHWs: Lady Health Workers
MCH: Mother & Child Health Centres
MSU: Mobile Services Unit
NHW: National Health Workers
NIH: National Institute of Health
RHCs: Rural Health Centres
RHS: Reproductive Health Services Unit
UNICEF: United Nations Children's Fund
VBFPWs: Village Based Family Planning Workers
WHO: World Health Organization
INTRODUCTION
Pakistan, in the past five decades has achieved impressive economic growth of
6% in GDP, on average, and substantial progress in the agriculture sector,
through a green revolution, which has exceeded the population growth rate.
However, social indicators in general, and health and demographic indicators in
particular have lagged behind the average of not only the countries of
comparable economic level but also most of the lower income countries.
Pakistan started with a very weak base in the health sector in 1947. At the time
of independence, the country inherited insufficient medical facilities (one
medical college, 78 doctors, wide spread tuber-culosis, unsanitary
environmental conditions and a high prevalence of malnutrition, contagious and
communicable diseases).
Progress in the expansion of health facilities and health manpower remained
very sluggish for many years, because of the low priority given to the health
sector; which led to an extremely inadequate and inequitable distribution of
health facilities in both urban and rural areas.
In the first 25 to 30 years after independence, hospitals, medical colleges, and
curative health care development received priority in the health sector. This
resulted in the establishment of 830 hospitals with 86,921 beds, 90,000 doctors
and 7,000 PHC units by 1998. The Primary Health Care and Preventive Services
remained neglected and under-funded. This began to change in the 70’s when
basic rural health program received a greater focus and was substantially
expanded after the famous Alma-Ata Declaration in 1978. Currently, almost all
of urban population and 70% of rural population within 5 Km radius have a
health outlet.
However, there are still inter and intra geographical imbalances in the
distribution of health facilities in rural and urban settings, availability of health
personnel and curative vs preventive measures.
Pakistan has made some monumental gains and land mark achievements in
health sector. Small pox was eradicated in 1975 and Guinea worm in 1991.
Diseases like Plague, Pellagra or Scurvy are now only confined to the textbooks;
we will be polio free country by the end of this year. Cretinism, mental and
physical dwarfism and the pendulous goiter have diminished due to Salt
Iodization Program and along with other manifestations will be eradicated in
coming years. Three pronged approach to combat Iron deficiency anemia i.e.
Supplementation through Iron Tablets by LHW, Food diversification through
public awareness and fortification of wheat flour with iron and vitamin is on the
anvil, Vitamin A deficiency blindness and morbidity is dealt effectively with
supplementation and fortification of edible oil/fact.
Pakistan has some successes in the population control program i.e.
Contraceptive Prevalence Rate (CPR), Total Fertility Rate (TFR) and Growth
Rate (GR) have improved in the past years and this momentum will be
continued till we achieve ultimate goals.
In Pakistan the economic situation is primarily responsible for one of the most
important systemic issues faced by the health care sector. Pakistanis as a whole
spend an equivalent of $17 per head per year on health care. Almost 77 percent
of this money ($13) is out-of-pocket private expenditure. Except India, the share
of private expenditure in the total health expenditure is higher in Pakistan than
in most other developing countries. The private sector, thus, is playing an
increasing role in the provision of health care services in Pakistan. However,
this growing importance of the private sector and its implications for the health
care system as a whole so far received little attention from policy makers. It is
imperative that through appropriate reform, the public-private partnership be
strengthened in order to make the health sector more integrated and effective.
Another systemic anomaly is the under-utilization of publicly funded health
facilities by the population at large. Beds in Rural Health Centres, Basic Health
Units or Taluka Hospitals also remain largely underutilized. This under-
utilization of the government health care system also raises questions about its
quality and efficiency. Government health centers often lack appropriate staff,
equipment, medicines and other facilities. Scarcity of women health
professionals, particularly in rural areas, has been identified as a persistent
problem. It is apparent that Pakistan's public health care system needs
improvement. Improving the quality of its services through appropriate resource
allocation - human, financial and technical - must be taken up as an important
and urgent issue.
The public health care system also suffers from some structural problems. While
health is a provincial subject and the provinces provide most health care
services, the National Program on Family Planning and Primary Health Care is
administered by the federal Ministry of Health. The National Program provides
basic primary health care services to the women and children in the villages
through locally hired Lady Health Workers (LHWs). While LHWs are part of
the federally administered National Program, the Basic Health Units (BHUs)
and Rural Health Centres (RHCs) - other pillars of the primary health care
system - are managed by the provincial Departments of Health. The overall
responsibility of managing the health care system at the district level lies with
the District Health Officer (DHO) who is part of the provincial bureaucracy.
DHO has no control over the National Program or jurisdiction over the LHWs.
This structural ambiguity needs to be addressed through appropriate health
sector reform.
Apart from the reasons mentioned earlier, one of the critical issues is the
location of health facilities. Due to circumstances known to all planners, the
distribution and location of health and population welfare facilities has been
done on less than ideal basis. This has resulted in some facilities located at
peripheries of catchment populations, creating problems of overlap and under
serving their full potential. Location of health facility assumes even more
importance in case of pregnant women. Studies have shown that number of
hours taken to reach a facility with emergency obstetric facilities plays a critical
role in deciding the fate of delivery and the subsequent health of the child and
the mother.
In order to bring fundamental changes in Health Care Delivery System in
Pakistan National Health Management Information System (NHMIS) has been
established since 1993. Presently the new information system is operational in
more than about 90% of approximately 10,000 first level care outlets managed
by the government. It provides an essential and a minimum set of information
with focus on Priority Health Problems and service delivery needs. It generates
the data from FLCFs through monthly reports and each facility has to submit 12
monthly reports in a year. Particularly for diseases included in HMIS
surveillance, the new system through its comprehensive and integrated structure
is a promising tool for timely and informed decision-making process.
The first edition of Health and Population Welfare Facilities Atlas came in 2000.
It was a joint product of the Health and Nutrition Section, Planning
Commission, Ministry of Planning and Development and UNICEF. The atlas
included the maps showing distribution of health facilities at district level and
other health sector and population related information. The work done was
manually, but served as a basis for the present work.
The current activity of Health and Population Welfare Facilities Atlas has been
completed in the Centre for Research on Poverty Reduction and Income
Distribution (CRPRID), Planning Commission in collaboration with UNICEF.
A health sector Geographic Information System (GIS) has been developed. The
use of maps has been helpful to show the geographic location of the health
facilities (including Hospitals, Rural Health Centres, Basic Health Units,
Dispensaries, Mother and Child Health Centres and others) and Population
Welfare Centres (including Reproductive Health Services and Family Welfare
Centres). These locations have been marked by using the school mapping data,
village locations and city maps from Internet, and other layers in GIS format.
The sources of spatial data included District Census Reports, Health and
Population Welfare Facilities Atlas (first edition), Digital Chart of the World
(DCW) and others.
The database provided by National Health Management Information System
(NHMIS 2000) was linked with the health facility points. This linkage enabled
the categorization of health points according to their type. Finally, the
information was displayed on district level maps of Pakistan. These maps will
be helpful and may serve as a guide for developing health level plans and
provide valuable information to the policy makers and researchers.
Geographic Information System has been helpful and has served as an enabling
tool in this regard. It will help to manage large amount of the data regarding the
geographic conditions of the area, environmental profile, population and
household census data, and detailed attribute information about the health
facilities, resources and trend of diseases. The spatial analysis done by
overlaying geographic features/themes, querying the physical and socio
economic indicators, social sector information etc. will bring an improvement in
decision-making process. These decisions will be informed, timely and helpful
in cases like: determining the status of existing facilities, accessibility of health
facilities, establishment of new facilities, disparities among districts for EPI
coverage, facilities offering emergency obstetric care services, disease early
warning, and many others. However, the selection of appropriate hardware,
software, personnel and training is vital for building a successful GIS.
TAYYAB I. SHAH Dr. MUSHTAQ A. KHAN
GIS SPECIALIST DIRECTOR, CRPRID
MEMBER
NATIONAL COMMISSION FOR HUMAN DEVELOPMENT
TECHNICAL NOTES
The Health and Population Welfare Facilities Atlas includes the information collected from the following sources:
Bio-Statistics Section, Ministry of Health
National Health Management Information System
Health Section, Planning Commission
Monitoring and Statistics Wing, Ministry of Population Welfare
National Programme for Family Planning and Primary Health Care
In case of FLCFs, two types of data sources were available:
(1) Bio-Statistics Section that keeps a record of all types of health care facilities owned by Federal Government, State Public, State Special, Local
Bodies, Private (Aided) and Private (Non-Aided) for the four Provinces of Pakistan, ICT, Azad Kashmir and Northern Areas. This information is
collected and updated every year.
(2) National HMIS Cell, Federal Ministry of Health that deals with the information coming from the First Level Care Facilities only. The information is
focused on Priority Health Problems and service delivery needs. It generates data from FLHCFs through monthly reports and each facility has to
submit 12 monthly reports in a year. The staff, trained in HMIS has to send the report form to the District HMIS Cells by the end of each month.
These reports are then collected at Provincial level and finally gathered at National level. The scope of HMIS is yet to be expanded to the othe
r
areas of the health care including inpatient/hospital information system and information system for personnel, logistic and supplies. Concurrently
the community-
b
ased data from the Lady Health Workers, which is potential source of information about the community, is yet to be integrated with
the facility based HMIS.
The HMIS database had a unique identification number for each facility type and complete address book. Therefore, it was decided to use HMIS
data for the mapping of FLHCFs at the district level. The district wise summaries of health facilities were then generated and information was
aggregated at Provincial and National level.
However, the complete coverage of hospitals was made possible by combining the information from Provincial Directorates of Health, Bio Statistics
Section and National HMIS Cell.
There was no problem of data mismatch in the case of Population Welfare Programme Outlets and Lady Health Workers. The reason being that only source
of information was the relevant department.
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#332
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344 #
346
Disputed Area
Chagai
Kharan
Kech
Gilgit
Khuzdar
Dadu
Awaran
Zhob
Kalat
Thatta
Chitral
Baltistan
Panjgur
Bahawalpur
Sibi
Diamir
Ghizer
Khairpur
Lasbela
Tharparkar
Gwadar
Bolan
Jhang
Loralai
Rajanpur
Kohlu
D. Bugti
Sanghar
Leiah
Attock
R. Y. Khan
Badin
K. Saifullah
Swat
D. G. Khan
Bhakkar
Ghotki
Ghanche
Kohistan
Larkana
Chakwal
Pishin
D. I. Khan
Khushab
Sukkur
Mianwali
Okara
Kasur
Mirpur Khas
Mastung Bahawalnagar
Sargodha
Muzaffargarh
Musakhel
Vehari
Multan
K. Abdullah
Faisalabad
Jhelum
Rawalpindi
Kohat
Sheikhupura
Kurrum
Hyderabad
Gujrat
Jacobabad
Karak
S. Waziristan
Malir
Mansehra
J. Magsi
Khanewal
Barkhan
Muzaffarabad
Quetta
Khyber
Sahiwal
Sialkot
Upper Dir
N. Waziristan
Lodhran
Kotli
Nawabshah
Tank
L. Marwat
Nasirabad
N. Feroze
Haripur
Buner
T. T. Singh
Pakpattan
Shikarpur
Ziarat
Lahore
Narowal
Bajaur
Mohmand
Bagh
Mardan
Hangu
M. Bahauddin
Bhimber
OrakzaiNowshera
Shangla
Abbottabad
Islamabad Sudhnoti
Umerkot
Jafferabad
PeshawarSwabi
Batagram
Lower Dir
Malakand
Charsadda
Karachi
Gujranwala
Hafizabad
Mirpur
Poonch
Map of Pakistan Showing Province, District , and Tehsil Boundaries
(Note: Adminis trativ e Boundar ies Ac cording to 1998 -Cens us )
PAKISTAN BY PROVINCE
Islamabad
Balochistan
NWFP
Punjab
Sindh
FATA
FANA
AJK
Disputed Area
District Boundary
N
<Empty Legend>
N
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
Sibi
Kohat
Skardu
Gilgit
Lahore
Multan
Quetta
Sukkur
Gwadar
Sialkot
Loralai
KhuzdarLarkana
Manshera
Peshawar
Sargodha
Hyderabad
Dalbandin
Islamabad
Rawalpindi
Gujranwala
Faisalabad
Bahawalpur
Muzaffarabad
D. I. Khan
Karachi
Pakistan
ADMN-UNIT AREA TOTAL MALE FEMALE SEX RATIO POPULATION DENSITY URBAN HOUSE HOLD SIZE POPUALTION (1981) Avg. ANNUAL GROWTH RATE
(SQ.KM) (PER SQ.KM) PROPORTION (Avg.) 1981-1998 (% AGE)
Pakistan 796096 132352279 68873686 63478593 108.5 166.3 32.5 6.8 84253644 2.69
N.W.F.P. 74521 17743645 9088936 8654709 105 238.1 16.9 8 11061328 2.82
FATA 27220 3176331 1652047 1524284 108.4 116.7 2.7 9.3 2198547 2.19
Punjab 205345 73621290 38094367 35526923 107.2 358.5 31.3 6.9 47292441 2.64
Sindh 140914 30439893 16097591 14342302 112.2 216 48.8 6 19028666 2.8
Balochistan 347190 6565885 3506506 3059379 114.6 18.9 23.9 6.7 4332376 2.47
Federal Capital Territory 906 805235 434239 370996 117 888.8 65.7 6.2 340286 5.19
AREA, POPULATION BY SEX, SEX RATIO, POPULATOIN DENSITY,
URBAN PORTION, HOUSEHOLD SIZE AND ANNUAL GROWTH RATE
Source: Population Census 1998 and National Institute of Population Studies, Islamabad
1947 1951 1961 1972 1981 1998 2001 2004 2010 2021
32.5 33.7
42.9
65.3
84.3
132.4
142.5
151.1
170.5
198.2
0
20
40
60
80
100
120
140
160
180
200
POPULATION (in millions)
POPULATION OF PAKISTAN
(million)
(Projected)
YEAR
Health Facilities Doctors Surgeons Nurses
1947 1108 78 14 186
1951 1300 548 157 539
1961 2040 4304 317 2800
1971 3714 11782 539 4480
1981 6617 23188 1163 10570
1991 10924 62504 2472 19973
2001 - 02 12000 92000 3921 28900
Total 37703 194404 8583 67448
Source: Planning Commission
Report from 14/08/1947 to 13/02/2002
CATEGORIES
GROWTH IN HEALTH SECTOR IN PAKISTAN
GRAPHICAL REPRESENTATION
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
100000
1947 1951 1961 1971 1981 1991 2001 - 02
TIME PERIOD
Health Facilities Doctors Surgeons Nurses
DOCTORS SPECIALISTS
PROVINCE MBBS B.D.S MEDICAL DENTAL
MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL
Punjab 26781 12623 39404 1208 703 1911 5874 1368 7242 118 35 153
Sindh 26250 15144 41394 856 672 1528 3175 927 4102 42 9 51
NWFP 7333 2533 9866 512 209 721 1557 292 1849 36 6 42
Balochistan 2221 903 3124 113 25 138 425 50 475 13 1 14
AJK 1197 473 1670 113 35 148 224 43 267 9 0 9
Foreign 1724 414 2138 214 60 274 50 13 63 3 0 3
TOTAL 65506 32090 97596 3016 1704 4720 11305 2693 13998 221 51 272
Source: Planning Commission
Report 14/08/1947 to 13/02/2002
PROVINCE WISE DOCTORS AND SPECIALISTS IN PAKISTAN
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Punjab
Sindh
NWFP
Balochistan
AJK
Foreign
DOCTORS BY GENDER
MALE FEMALE MALE FEMALE
MBBS BDS
PLAN
Hospital MCH RHC BHU Beds Population/Bed Population/Doctor Population/Dentist Population/Nurse Population/Paramedics
Upto 1978 536 748 200 554 42469 1804 not available not available not available not available
5th Plan 1983 626 794 302 1982 52161 1708 not available not available not available not available
6th Plan 1988 710 998 417 3454 64471 1610 not available not available not available not available
7th Plan 1993 799 849 485 4663 80047 1509 1919 50341 5968 not available
8th Plan 1998 830 864 542 5147 86921 1610 1466 34210 5239 1711
2000 876 870 542 5171 93907 1495 1529 33629 3732 1130
2001 * 907 879 542 5230 97945 1490 1516 31579 3639 not available
Source: Planning Commission
* Economic Survey 2001 - 2002
TYPE OF FACILITY
HEALTH FACILITIES
0
1000
2000
3000
4000
5000
6000
Upto 1978 5th Plan 6th Plan 7th Plan 8th Plan 2000 2001 *
Time Period
GRAPHICAL REPRESENTATION OF HEALTH FACILITIES
Hospital MCH RHC BHU
(Rs. Million)
PLAN
General Preventive Programme Non- Development Programme
Upto 1978 0.069 5.405
5th Plan 1983 0.774 25
6th Plan 1988 6.57 40
7th Plan 1993 8.466 8.9
8th Plan 1998 8.9 70
2000 (only preventive or PHC) 18.337
2001 * (only preventive or PHC) 18.717
Source: Planning Commission
* Economic Survey 2001 - 2002
32.5
5.944
6.688
0.007
1.25
3.798
6.305
9
No more calculated
No more calculated
0.076
4.584
10.368
14.77
TYPE OF FACILITY
FINANCIAL OUTLAYS OF FIVE YEAR PLANS
Development Programme Rural Health Programme
0
10
20
30
40
50
60
70
Rs. in Million
Upto 1978 5th Plan 6th Plan 7th Plan 8th Plan 2000 2001 *
Time Period
GRAPHICAL REPRESENTATION OF FINANCIAL OUTLAYS
Development Programme Rural Health Programme
General Preventive Programme Non- Development Programme
PLAN
Doctors Dentists Mid Wives Nurses LHVs/FMTS TBAs LHWs
Upto 1978 8041 781 3106 3892 341
5th Plan 1983 20865 1222 6031 7348 1144 15000
6th Plan 1988 42862 1772 12866 14015 2697 30000
7th Plan 1993 63003 2402 18641 20245 3920 48000
8th Plan 1998 90000 3000 21304 24810 4250 57744 43000
2000 91823 4175 22528 37623 5619 No more formal train
i
43000
2001 * 96248 4600 23714 40114 5845 No more formal train
i
69000
Source: Planning Commission
* Economic Survey 2001 - 2002
HEALTH PERSONNEL
HEALTH SECTOR MANPOWER
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
100000
Upto 1978 5th Plan 6th Plan 7th Plan 8th Plan 2000 2001 *
TIME PERIOD
GRAPHICAL REPRESENTATION OF HEALTH SECTOR MANPOWER
Doctors Dentists Mid Wives Nurses LHVs/FMTS
HEALTH DEPARTMENT AND POPULATION WELFARE DEPARTMENT’S SERVICE DELIVERY FACILITIES AND STAFFING PATTERN
FACILITY No. of
Units POPULATION SERVED FUNCTION STAFFING PATTERN
Dispensary 4,625 Outpatient curative services only
Medical Officer, Dispenser, TBA and
Other staff
Basic Health Unit
(BHU) 5,152 10,000
Provides basic services including MCH and FP
No labor rooms
Usually no beds
Medical Officer, LHV or Female Health
Technician, Dispenser, Trained TBA
Maternal and Child Health
Centre
(MCH)
859
Objective is to safeguard health of mothers and children
Midwifery services
Euqiped to handle routine deliveries but not obstetric emergencies
One or two beds
1 LHV and 1 TBA, LHV is incharge.
She provides PHC services, midwifery
services, some support to TBAs and
community based workers
Rural Health Centre
(RHC) 530 50,000 to 100, 000
Referral Centre for BHUs
Inpatient services
10 to 12 beds
Most have no ambulance
Can handle obstetric emergencies
Total Staff is 20- 30, MOs (2 males,
1female), 1 Nurse (post rarely filled),
LHVs, Dispensers, Nursing Assistants,
Dental Technician, and Vaccinator
Family Welfare Centre
(FWC) 1,296 5,000 to 7,000
The FWC is the Primary Service Outlet for National Population
Program.
Provides mother/child health services, family planning services,
and treatment of minor ailments
A female paramedic and support staff
consisting of 2 Family Welfare Workers (1
male and 1 female) and Family Welfare
Assistants
Mobile Service Unit
(MSU) 130
MSUs have been established at tehsil level to cover distant areas
where no family planning or health services exist
Provides full range of family planning services including clinical
contraception.
Supervise and provide on the job training to staff in FWC
A staff of 3 consisting of a female
physician or paramedic, a driver and an
ayah (lady attendant)
Reproductive Health
Service Centre – Type A
(RHSC-A)
79 One in each district hospital, and
in selected tehsil hospitals
Hospital-based unit with an independent operating room for
sterilization (mostly female).
Provides a range of preventive Ob./Gyn. care, childcare, and
infertility treatment.
10- member staff headed by a female
physician.
Reproductive Health
Service Centre – Type B
(RHSC-B)
119 Hospital based unit that is authorized to perform sterilizations
(primarily female). Managed by hospital’s Obs./Gyn. Staff.
Health outlets of Health and
Education Departments,
Municipal Corporations and
target group institutions
6, 221
Health outlets are involved in providing contraceptive services. Outlets
with a female physician or paramedic have been targeted for special
training in FP
Social Marketing Outlets
67,000
Private retail outlets are involved in the government’s Social Marketing of
Contraceptives Project by selling “Sathi” condoms, mostly to urban
consumers.
Source: National HMIS Cell, Ministry of Health
Pakistan Human Condition Report 2002
DISTRICT TOTAL NC TOTAL REPORTS UTILIZATION * DISTRICT TOTAL NC TOTAL REPORTS UTILIZATION *
Abbotabad 266209 1007 11 Kotli 572886 741 31
Attock 421267 697 24 Lahore 558862 683 33
Awaran 22483 58 16 Lakki Marwat 336551 552 24
Badin 519809 742 28 Larakana 556102 614 36
Bagh 654341 564 46 Layyah 575035 691 33
Bahawalnagar 1138201 1469 31 Lesbella 125863 274 18
Bahawalpur 890868 1173 30 Lodhran 396190 674 24
Bajaur Agency 232045 352 26 Loralai 226644 607 15
Bannu 162024 583 11 Lower Dir 266450 449 24
Barkhan 21231 2 425 M. Baha-Ud-Din 478430 739 26
Battagram 59074 203 12 Malakand Agency 595609 456 52
Bhakkar 438183 530 33 Malir 46003 57 32
Bolan 9728 19 20 Mansehra 124789 264 19
Buner 200876 388 21 Mardan 565389 792 29
Chagai 142928 342 17 Mastung 73845 111 27
Chakwal 743300 932 32 Mianwali 397741 523 30
Charsada 583465 691 34 Mihmand Agency 47307 184 10
Chilas 189860 138 55 Mirpur 760656 935 33
Chitral 93014 225 17 Mirpur Khas 575534 565 41
D.G.Khan 521348 656 32 Multan 748370 1001 30
D.I.Khan 343209 960 14 Musa Khel 40807 124 13
Dadu 827822 782 42 Muzaffarabad 958056 1032 37
Dera Bughti 149881 416 14 Muzaffargarh 1136544 1140 40
Faisalabad 1661538 2328 29 Narowal 573258 824 28
Ganche 100376 253 16 Naseerabad 197363 274 29
Ghizer 162002 188 34 Nausharo Feroze 562858 671 34
Ghotaki 94392 178 21 Nawabshah 446274 520 34
Gilgit 285699 335 34 Nowshera 330960 554 24
Gowadur 249133 391 25 Okara 474574 1189 16
Gujranwala 674939 1247 22 Orakzai Agency 155 1 6
Gujrat 1120378 1202 37 Pakpattan 410814 567 29
Hafizabad 346297 462 30 Panjgur 149242 281 21
Haripur 176146 610 12 Peshawar 468213 1078 17
Hyderabad 998703 888 45 Pishin 215890 323 27
I.C.T 106671 99 43 Poonch 793897 679 47
Jacobabad 239530 365 26 Quetta 279802 437 26
Jafferabad 309557 568 22 Rahimyar Khan 1542599 1564 39
Jhal Magsi 89773 258 14 Rajanpur 392938 488 32
Jhang 1101159 1463 30 Rawalpindi 997980 1295 31
Jhelum 565482 719 31 Sahiwal 787552 1061 30
Kalat 175355 527 13 Sanghar 551641 580 38
Karachi Central 25148 32 31 Sargodha 1080919 1691 26
Karachi East 726998 411 71 Sheikhupura 1148443 1777 26
Karachi South 202029 60 135 Shikarpur 494103 624 32
Karachi West 125383 149 34 Sialkot 714947 1265 23
Karak 135929 323 17 Sibi 224822 444 20
Kasur 681158 1126 24 Skardu 301272 437 28
Keich 353123 814 17 Sukkur 909072 642 57
Khairpur 704838 1083 26 Swabi 531738 679 31
Khanewal 904276 1141 32 Swat 991843 1208 33
Kharan 77470 136 23 Tank 196713 286 28
Khusab 355623 561 25 Tharparkar 243007 315 31
Khuzdar 226128 571 16 Thatta 449275 696 26
Khyber Agency 128913 310 17 Toba Tek Singh 921933 917 40
Killa abdullah 6990 13 22 Upper Dir 91178 137 27
Killa Saifullah 68671 227 12 Vehari 799775 1177 27
Kohat 357774 793 18 Zhob 124106 460 11
Kohlo 14417 8 72 Ziarat 50072 109 18
* : No. of Patients per Day
Source: National HMIS Cell, Ministry of Health
DISTRICT WISE UTILIZATION OF HEALTH INSTITUTIONS
BHUs, RHCs, Dispensaries, MCH Centers, & Hospitals (HMIS Data 1998-2000)
PROVINCE BHU DISP AUX FAP HOSP LC MCH RHC SHC TBC UHC TOTAL
Balochistan 444 676 35 74 14 82 61 29 6 1421
NWFP 822 363 89 7 65 81 33 3 1463
Punjab 2485 998 224 1 394 303 591 45 5041
Sindh 789 309 1 2 90 1 57 119 8 1 17 1394
ICT 13 6 3 1 3 1 27
AJK 181 105 185 14 4 7 29 525
FANA 17 100 147 24 1 1 290
FATA 132 117 33 14 7 4 1 308
TOTA
L
4883 2674 36 334 551 28 620 604 665 56 18 10506
RHS-A MSU VBFPWS FWC-U FWC-SEMI U FWC-R FWC-T TOTAL
5 7 15 21 9 60 90 117
13 18 32 45 12 205 262 325
49 68 104 322 100 512 934 1155
25 31 26 143 35 137 315 397
3 1 17 21
95 125 177 531 156 914 1618 2015
Source: NHMIS database, Mininstry of Health
TOTAL
NWFP
Punjab
Sindh
ICT
PROVINCE WISE SUMMARY OF FLCFs IN PAKISTAN
SUMMARY OF POPULATION WELFARE PROGRAMME OULETS IN PAKISTAN
PROVINCE
Balochistan
46.6
25.5
0.3
3.2 5.3
0.3
5.9
5.8 6.4
0.5 0.2
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
50.0
PERCENTAGE (%)
BHU DISP AUX FAP HOSP LC MCH RHC SHC TBC UHC
FLCFs TYPE
PERCENTAGE CONTRIBUTION OF FLCFs
INDICES Upto 1978 5th Plan 1983
6th Plan
1988
7th Plan
1993
8th Plan
1998 1999 2000 2002
Infant Mortality Rate
Per 1000 Live Births 120 110 100 95 90 89.8 85 85
Crude Death Rate
Per 1000 Live Births 14 12 10 9.1 8.7 8.5 8.3 7.8
Maternal Mortality Rate
Per 100,000 Live Births 600-800 600-700 500-600 400-500 300-400 350-400 350-400
Life Expentency
Male (Years) 54 55 57 61 62 62.5 63 63.5
Female (Years) 53 54 56 60 62 62 63 63.2
Low Birth Weight Babies (%) 35 32 30 27 25 25
Child Mortality Rate 140 137 133 128 120 111 103 100
Malnourished Children under
5 Years (%) 49 49 47 45 42 40 39 35
Iron Deficiency Anemia 1978 1990 1995 2000
75 70 65 65
48 45 42 42
where:
Child Mortality: Number of Deaths of children under five years of age per 1,000 live births.
More specifically this is the probability of dyingbetween birth and exactly five years of age.
Crude Birth Rate: Annual number of births per 1000 population.
Crude Death Rate: Annual Number of Deaths per 1000 population.
Life Expectancy at Birth: Number of years a newborn infant would expect to live if prevailing patterns of mortality
at the time of its birth were to stay the same throughout its life.
Infant Mortality Rate: Number of deaths of infants under one year of age per 1,000 live births.
More specificallythis is the probability of dying between birth and exactly one year of age.
Low Birth Weight Less that 2,500 grammes.
Malnutrition: Moderate and serve - percent of children below minus two standard deviations from medians
weightfor age of reference population. Severe percent of percent of children below minus three
standard deviations from median weight for age of reference population
Source: Human Condition Report 2002, CRPRID and Atlas of South Asian Children and Women, UNICEF
School Going Children (%)
HEALTH INDICATORS
Women Child Bearing Age
15-45 Years (%)
Category/Controlling Authorit
y
U/R T.B.Clinic SHC/FAP
No. Bed No. Bed No. Bed No. Bed No. Bed No. No. Bed No. Bed
FEDERAL GOVERNMEN
T
U 10 3830 71 16 1 0 7 198 0 0 0 0 0 89 4044
R 001000 0 0375 0131817 93
U+R 10 3830 72 16 1 0 7 198 3 75 0 13 18 106 4137
I. STATE PUBLIC
U 317 46417 156 38 200 154 250 10 131 2272 0 50 90 1096 48981
R 112 4129 1377 376 79 20 133 2 407 6520 636 4444 5340 7150 16387
U+R 429 50546 1533 414 279 174 383 12 538 8792 636 4494 5430 8246 65368
II. STATE SPECIAL (TOTAL i_viii
)
U 127 6591 405 242 7 0 47 20 0 0 84 0 0 670 6853
R 10 202 49 12 0 0 0 0 0 0 0 0 0 59 214
U+R 137 6793 454 254 7 0 47 20 0 0 84 0 0 729 7067
(i) Jail Departmen
t
U 42 1470 45 78 4 0 0 0 0 0 0 0 0 91 1548
R 001000 0 000 0001 0
U+R 42 1470 46 78 4 0 0 0 0 0 0 0 0 92 1548
(ii) Police Departmen
t
U 27 626 10 3 0 0 1 0 0 0 0 0 0 38 629
R 8 152 6 12 0 0 0 0 0 0 0 0 0 14 164
U+R 35 778 16 15 0 0 1 0 0 0 0 0 0 52 793
(iii) WAPD
A
U 11 506 28 0 0 0 0 0 0 0 0 0 0 39 506
R 002000 0 000 0002 0
U+R 11 506 30 0 0 0 0 0 0 0 0 0 0 41 506
(iv) Pakistan Railways
U 15 1440 52 143 0 0 36 0 0 0 0 0 0 103 1583
R 002000 0 000 0002 0
U+R 15 1440 54 143 0 0 36 0 0 0 0 0 0 105 1583
(v) Auquaf Departmen
t
U 19619000 0 000 00020 96
R 001000 0 000 0001 0
U+R 19620000 0 000 00021 96
(vi) Social Security Departmen
t
U 17 1642 172 0 0 0 1 16 0 0 84 0 0 274 1658
R 004000 0 000 0004 0
U+R 17 1642 176 0 0 0 1 16 0 0 84 0 0 278 1658
(vii) Forest Departmen
t
R 004000 0 000 0004 0
(viii) Other Departments
U 14 811 79 18 3 0 9 4 0 0 0 0 0 105 833
R 25029000 0 000 00031 50
U+R 16 861 108 18 3 0 9 4 0 0 0 0 0 136 883
III. LOCAL BODIES
U 18 1470 274 61 5 0 180 10 0 0 0 0 0 477 1541
R 11 140 1466 1571 0 0 73 0 0 0 0 0 0 1550 1711
U+R 29 1610 1740 1632 5 0 253 10 0 0 0 0 0 2027 3252
IV. PRIVATE (Aided
)
U 19 3168 11 16 0 0 0 0 0 0 0 0 0 40 3184
R 2 82 14 4 0 0 0 0 0 0 0 0 0 34 102
U+R 21 3250 25 20 0 0 0 0 0 0 0 0 0 74 3286
IV. PRIVATE (Non-Aided
)
U 276 14053 748 500 28 0 141 8 0 0 0 0 0 1193 14561
R 5 263 53 11 1 0 20 0 0 0 0 0 0 79 274
U+R 281 14316 801 511 29 0 161 8 0 0 0 0 0 1272 14835
A
ZAD KASHMI
R
U 79826011014 000 35646988
R 7 300 99 0 56 0 153 0 29 324 180 176 214 700 838
NORTHERN AREAS U 54820000 0 000 0005482
R 2028510505039 020 110160297285
SUB TOTAL U 12 1464 6 0 11 0 14 0 0 0 3 5 6 51 1470
R 27 585 204 0 61 0 192 0 31 324 290 192 214 997 1123
U+R 39 2049 210 0 72 0 206 0 31 324 293 197 220 1048 2593
SUB TOTAL U 779 76993 1671 873 241 154 649 246 131 2272 90 55 96 3616 80634
R 167 5401 3164 1974 103 20 436 18 441 6919 926 4649 5572 9886 19904
GRAND TOTA
L
U+R 946 82394 4835 2847 344 174 1085 264 572 9191 1016 4704 5668 13502 100,538
Source: Bio Statistics Section, Ministry of Health
NUMBER OF HEALTH CARE FACILITIES IN PAKISTAN
BY CONTROLLING AUTHORITY AS ON 01-01-2001
Hospital Dispensary M.C.H. Centre R.H.C. B.H.U. Total
PROVINCE ID DISTRICT LHWs PROVINCE ID DISTRICT LHWs PROVINCE ID DISTRICT LHWs
PUNJAB
1 BAHAWALNAGAR DISTRICT 1032 9 KHAIRPUR DISTRICT 1340 11 NASIRABAD DISTRICT 468
2 BAHAWALPUR DISTRICT 1212 10 NAUSHARO FEROZE DISTRICT 1332 12 CHAGAI DISTRICT 157
3 RAHIM YAR KHAN DISTRICT 1046 11 NAWABSHAH DISTRICT 613 13 PISHIN DISTRICT 127
4 D.G.KHAN DISTRICT 1098 12 SUKKUR DISTRICT 1044 14 QUETTA DISTRICT 592
5 LEIAH DISTRICT 595 13 GHOTKI DISTRICT 341 15 KILLA ABDULLAH DISTRICT 70
6 MUZAFFARGARH DISTRICT 985 14 MIRPUR KHAS DISTRICT 1261 16 DERA BUGTI DISTRICT 40
7 RAJANPUR DISTRICT 437 15 SANGHAR DISTRICT 740 17 KOHLU DISTRICT 60
8 FAISALABAD DISTRICT 1694 16 THARPARKAR (MITHI) DISTRICT 254 18 SIBI DISTRICT 138
9 JHANG DISTRICT 899 18008 19 ZIARAT DISTRICT 104
10 TOBA TEK SINGH DISTRICT 896 20 KILLA SAIFULLAH DISTRICT 89
11 GUJRANWALA DISTRICT 1538 NWFP 21 LORALAI DISTRICT 431
12 GUJRAT DISTRICT 926 1 BANNU DISTRICT 420 22 ZHOB DISTRICT 111
13 NAROWAL DISTRICT 958 2 D.I.KHAN DISTRICT 810 4305
14 SIALKOT DISTRICT 1762 3 LAKKI MARWAT DISTRICT 295
15 HAFIZABAD DISTRICT 677 4 TANK DISTRICT 163
A
J
K
16 MANDI BAHAUDDIN DISTRICT 956 5 ABBOTTABAD DISTRICT 599 1 BAGH DISTRICT 360
17 KASUR DISTRICT 1042 6 HARIPUR DISTRICT 498 2 BHIMBER DISTRICT 283
18 LAHORE DISTRICT 1791 7 MANSEHRA DISTRICT 581 3 KOTLI DISTRICT 405
19 OKARA DISTRICT 1301 8 BATTAGRAM DISTRICT 84 4 MIRPUR DISTRICT 212
20 SHEIKHUPURA DISTRICT 854 9 KARAK DISTRICT 430 5 MUZAFFARABAD DISTRICT 540
21 KHANEWAL DISTRICT 1306 10 KOHAT DISTRICT 578 6 POONCH DISTRICT 258
22 LODHRAN DISTRICT 668 11 BUNER DISTRICT 143 7 SUDHNUTI DISTRICT 192
23 MULTAN DISTRICT 1663 12 CHITRAL DISTRICT 384 2250
24 PAKPATTAN DISTRICT 631 13 LOWER DIR DISTRICT 403
25 SAHIWAL DISTRICT 1158 14 MALAKAND DISTRICT 371 FAN
A
26 VEHARI DISTRICT 1142 15 SWAT DISTRICT 1149 1 SKARDU DISTRICT 310
27 ATTOCK DISTRICT 855 16 UPPER DIR DISTRICT 150 2 CHILAS DISTRICT 232
28 CHAKWAL DISTRICT 680 17 MARDAN DISTRICT 729 3 GANCHE DISTRICT 155
29 JHELUM DISTRICT 1000 18 SWABI DISTRICT 854 4 GHIZER DISTRICT 201
30 RAWALPINDI DISTRICT 1788 19 CHARSADDA DISTRICT 597 5 GILGIT DISTRICT 370
31 BHAKKAR DISTRICT 910 20 NOWSHERA DISTRICT 418 1268
32 KHUSHAB DISTRICT 788 21 PESHAWAR DISTRICT 607
33 MIANWALI DISTRICT 804 10263 FAT
A
34 SARGODHA DISTRICT 1392 1 BAJAUR AGENCY 71
36484 BALOCHISTAN 2 KHYBER AGENCY 63
1 KALAT DISTRICT 86 3 KURRAM AGENCY 122
SINDH 2 KHARAN DISTRICT 154 4 MOHMMAND AGENCY 123
1 BADIN DISTRICT 675 3 KHUZDAR DISTRICT 298 5 NORTH WAZIRASTAN AGENCY 50
2 DADU DISTRICT 1305 4 LASBELA DISTRICT 150 6 ORAKZAI AGENCY 66
3 HYDERABAD DISTRICT 2150 5 MASTUNG DISTRICT 140 7 SOUTH WAZIRISTAN AGENCY 50
4 THATTA DISTRICT 435 6 AWARAN DISTRICT 65 545
5 KARACHI CENTRAL 3243 7 GAWADAR DISTRICT 60
6 JACOBABAD DISTRICT 636 8 PANJGUR DISTRICT 390 ISLAMABAD
7 LARAKANA DISTRICT 1856 9 KECH DISTRICT 406 1 ISLAMABAD DISTRICT 325
8 SHIKARPUR DISTRICT 783 10 KACHI DISTRICT 169
73448
Source: National Programme for Family Planning and Primary Health Care (Year 2002 -2003)
PROVINCIAL TOTAL
TOTAL LHWS AT NATIONAL LEVEL
DISTRICT WISE CURRENT ALLOCATION OF LADY HEALTH WORKERS (LHWs) IN PAKISTAN
TOTAL
PROVINCIAL TOTAL
PROVINCIAL TOTAL
PROVINCIAL TOTAL
TOTAL
TOTAL
PROVINCE ID COLLEGE NAME CITY
BALOCHISTAN
1 Bolan Medical College Quetta
ISLAMABAD
2 College of Medical Lab. Technology, NIH Islamabad
3 College of Medical Technology for Paramedics, PIMS Islamabad
4 College of Nursing, PIMS Islamabad
5 Quaid-e-Azam Postgraduate Medical College, PIMS Islamabad
NWFP
6 Ayub Medical College Abbottabad
7 Postgraduate College of Nursing Peshawar
8 Khyber College of Dentistry Peshawar
9 Khyber Medical College Peshawar
PUNJAB
10 Quaid-e-Azam Medical College Bahawalpur
11 Punjab Medical College Faisalabad
12 Allama Iqbal Medical College Lahore
13 College of Veterinary Sciences Lahore
14 de' Montmorency College of Dentistry Lahore
15 Fatima Jinnah Medical College Lahore
16 Institute of Blood Transfusion Services Lahore
17 Institute of Pubilic Health Lahore
18 King Edward Medical College Lahore
19 Postgraduate Medical Institute Lahore
20 School of Physiotherapy, Mayo Hospital Lahore
21 Shaikh Zayed Postgraduate Medical Institute Lahore
22 Nishter Medical College Multan
23 Armed Forces Postgraduate Medical Institute Rawalpindi
24 Army Medical College Rawalpindi
25 Rawalpindi Medical College Rawalpindi
SINDH
26 Liaquat Medical College Jamshoro
27 Basic Medical Sciences Institute, JPMC Karachi
28 Dow Medical College Karachi
29 Karachi Medical & Dental College Karachi
30 National Institute of Cardiovascular Diseases Karachi
31 National Institute of Child Health Karachi
32 Ojha Institute of Chest Diseases Karachi
33 School of Physiotherapy, JPMC Karachi
34 Sind Institute of Urology & Transplantation Karachi
35 Sind Medical College Karachi
36 Chandka Medical College Larkana
37 Peoples Medical College for Girls Nawab Shah
PUBLIC SECTOR MEDICAL COLLEGES OF PAKISTAN
S.No Districts Total
Institutes
Expected
Reports
Reports
Received
%
Reports
Received
Remarks S.No Districts Total
Institutes
Expected
Reports
Reports
Received
%
Reports
Received
Remarks S.No Districts Total
Institutes
Expected
Reports
Reports
Received
%
Reports
Received
Remarks
PUNJAB BALOCHISTA
N
1 Attock 79 948 190 20 Very Poor 41 Karachi East 42 504 310 62 Average 81 Awaran 6 72 12 17 Very Poor
2 Bahawalnagar 162 1944 1355 70 Good 42 Karachi South 10 120 80 67 Good 82 Barkhan 2 24 24 100 Very Good
3 Bahawalpur 106 1272 1268 100 Very Good 43 Karachi West 23 276 144 52 Average 83 Chagai 47 564 65 12 Very Poor
4 Bhakkar 52 624 624 100 Very Good 44 Khairpur 110 1320 1219 92 Very Good 86 Dera Bugh
t
54 648 190 29 Average
5 Chakwal 89 1068 795 74 Good 45 Larakana 82 984 842 86 Very Good 87 Gowadur 37 444 340 77 Good
6 D.G.Khan 74 888 587 66 Good 47 Mirpur Khas 78 936 513 55 Average 88 Jafferabad 72 864 672 78 Good
7 Faisalabad 200 2400 2098 87 Very Good 48 Nausharo Feroze 860 824 96 Very Good 89 Jhal Magsi 34 408 151 37 Average
8 Gujranwala 116 1392 1202 86 Very Good 49 Nawabshah 54 648 391 60 Average 90 Kalat 60 720 450 63 Average
9 Gujrat 105 1260 1216 97 Very Good 50 Sanghar 74 888 888 100 Very Good 91 Keich 74 888 768 86 Very Good
10 Hafizabad 44 528 350 66 Good 51 Shikarpur 60 720 662 92 Very Good 92 Kharan 51 612 78 13 Very Poor
11 Jhang 126 1512 1035 68 Good 52 Sukkur 73 876 389 44 Average 93 Khuzdar 72 864 441 51 Average
12 Jhelum 72 864 640 74 Good 53 Tharparkar 51 612 612 100 Very Good 94 Killa Abdull 5 60 3 5 Very Poor
13 Kasur 101 1212 985 81 Very Good 54 Thatta 72 864 585 68 Good 95 Killa Saifull 31 372 301 81 Very Good
14 Khanewal 96 1152 530 46 Average 55 Umer Kot 789 527 67 Good 96 Kohlo 2 24 24 100 Very Good
15 Khusab 58 696 467 67 Good 97 Lesbella 55 660 488 74 Good
16 Lahore 69 828 828 100 Very Good NWFP 98 Loralai 82 984 573 58 Average
17 Layyah 66 792 292 37 Average 56 Abbotabad 102 1224 1021 83 Very Good 99 Mastung 27 324 154 48 Average
18 Lodhran 63 756 585 77 Good 57 Bajaur Agency 31 372 245 66 Good 100 Naseeraba 28 336 258 77 Good
19 M. Baha-Ud-Din 65 780 759 97 Very Good 58 Bannu 75 900 329 37 Average 101 Panjgur 32 384 276 72 Good
20 Mianwali 80 960 706 74 Good 59 Battagram 75 900 311 35 Average 102 Pishin 87 1044 76 7 Very Poor
21 Multan 102 1224 1037 85 Very Good 60 Buner 33 396 165 42 Average 103 Quetta 55 660 279 42 Average
22 Muzaffargarh 110 1320 720 55 Average 61 Charsada 60 720 344 48 Average 104 Sibi 45 540 394 73 Good
23 Narowal 71 852 775 91 Very Good 62 Chitral 61 732 169 23 Average 105 Zhob 52 624 449 72 Good
24 Okara 106 1272 1254 99 Very Good 63 D.I.Khan 86 1032 507 49 Average 106 Ziarat 17 204 204 100 Very Good
25 Pakpattan 61 732 335 46 Average 64 Haripur 62 744 547 74 Good
A
J
K
26 Rahimyar Khan 159 1908 1332 70 Good 65 Karak 38 456 147 32 Average 107 Bagh 77 924 636 69 Good
27 Rajanpur 46 552 293 53 Average 66 Khyber Agency 28 336 199 59 Average 108 Kotli 201 2412 986 41 Average
28 Rawalpindi 125 1500 1227 82 Very Good 67 Kohat 77 924 231 25 Average 109 Mirpur 170 2040 1021 50 Average
29 Sahiwal 93 1116 898 80 Good 68 Kohistan 600 455 76 Good 110 Muzaffara
b
143 1716 1414 82 Very Good
30 Sargodha 149 1788 1608 90 Very Good 69 Lakki Marwat 96 1152 193 17 Very Poor 111 Poonch 97 1164 919 79 Good
31 Sheikhupura 184 2208 1719 78 Good 70 Lower Dir 78 936 647 69 Good NAs
32 Sialkot 118 1416 1193 84 Very Good 71 Malakand Ag. 41 492 473 96 Very Good 112 Chilas 36 432 31 7 Very Poor
33 Toba Tek Singh 81 972 695 72 Good 72 Mansehra 103 1236 387 31 Average 113 Ganche 50 600 135 23 Average
34 Vehari 111 1332 957 72 Good 73 Mardan 74 888 448 50 Average 114 Ghizer 50 600 140 23 Average
SINDH 74 Mihmand Ag. 29 348 179 51 Average 115 Gilgit 70 840 203 24 Average
35 Badin 70 840 633 75 Good 75 Nowshera 52 624 4 1 Very Poor 116 Skardu 792 171 22 Average
36 Dadu 74 888 632 71 Good 76 Orakzai Agency . 568 318 56 Average
37 Ghotaki 37 444 283 64 Average 77 Peshawar 105 1260 1017 81 Very Good Ranking Criteria
38 Hyderabad 97 1164 1046 90 Very Good 78 Swabi 57 684 229 33 Average Very Poor: 1 - 20
39 Jacobabad 46 552 452 82 Very Good 79 Swat 107 1284 1136 88 Very Good Average: 21 - 65
40 Karachi Central 3 36 34 94 Very Good 80 Tank 26 312 70 22 Average Good: 66 - 80
Very Good
:
81 and above
NATIONAL HEALTH MANAGEMENT INFORMATION SYSTEM
REPORTING COMPLIANCE BY DISTRICT (Year 2001 - 2002)
Percentage Reporting Regularity of NHMIS by Province
0
10
20
30
40
50
60
70
80
Punjab Sindh NWFP Balochistan AJK NAS
Province
Percentage (%) Reporting Regularity
Location Field of Specialization Year Established
PMRC Research Centre, Khyber Medical
College, Peshawar
Maternal & Child Health, Health
Systems Research &Community Health
1973
PMRC Research Centre, King Edward
Medical College, Lahore
Tuberculosis 1973
PMRC Research Centre, Nishtar Medical
College, Multan
Communicable Diseases, Community
Health, Metabolic Diseases, Indigenous
Mdii &Ed i l
1979
PMRC Research Centre, Bolan Medical Metabolic Disorders. 1979
PMRC Research Centre Punjab Medical Nutrition 1983
PMRC Health Services Research Centre,
Hayatabad Medical Complex, Peshawar
Health Systems Research 1984
PMRC National Health Research Complex
Shaikh Postgraduate Medical Institute
Health system research, clinical
research, national health survey of
1986
PMRC Research Centre, Dow Medical
College Karachi
Health Systems Research, Community
Health
1990
PMRC Centre, National Institute of Child
Health, Karachi
Paediatrics 2002
LIST OF RESEARCH CENTRES
(According to chronological order)
Source: Pakistan Medical Research Council (PMRC), Islamabad
PMRC Research Centre, Fatima Jinnah
Medical College, Lahore
Diabetes, hypertension, coronary heart
diseases, lipid & calcium metabolism
1961
PMRC Research Centre, Jinnah
Postgraduate Medical Centre, Karachi
Gastrointestinal disorders &
hepatobiliary diseases
1968
1974
PMRC Research Centre, Liaquat Medical
College, Jamshoro
Community Health 1979
PMRC Central Research Centre, National
Institute of Health, Islamabad
Surveillance of infectious diseases
Azad Jammu & Kashmir FANA Kulachi Tehsil 160 Pind Dadan Khan Tehsil 241 Kotri Taluka 322
Bagh Tehsil 1Gultari 81 Paharpur Tehsil 161 Sohawa Tehsil 242 Mehar Taluka 323
Dhir Kot Tehsil 2Kharmang 82 Hangu Tehsil 162 Chunian Tehsil 243 Sehwan Taluka 324
Haveli Tehsil 3Rondu 83 Ghazi Tehsil 163 Kasur Tehsil 244 Thano Bula Khan Taluka 325
Barnala Tehsil 4Shigar 84 Haripur Tehsil 164 Pattoki Tehsil 245 Daharki Taluka 326
Bhimber Tehsil 5Skardu 85 Banda Daud Shah Tehsil 165 Jahanian Tehsil 246 Ghotki Taluka 327
Samahni Tehsil 6Astore 86 Karak Tehsil 166 Kabirwala Tehsil 247 Khangarh Taluka 328
Kotli Tehsil 7Chilas 87 Takhat Nasrati Tehsil 167 Khanewal Tehsil 248 Mirpur Mathelo Taluka 329
Nakial Tehsil 8Darel/tangir 88 Kohat Tehsil 168 Mian Channu Tehsil 249 Ubauro Taluka 330
Sehnsa Tehsil 9Daghori 89 Dassu Sub-division 169 Khushab Tehsil 250 Hala Taluka 331
Dudyal Tehsil 10 Khaplu 90 Palas Sub-division 170 Noorpur Tehsil 251 Hyderabad City Taluka 332
Mirpur Tehsil 11 Mashabbrum 91 Pattan Sub-division 171 Lahore Cantt Tehsil 252 Hyderabad Taluka 333
Athmuqam Tehsil 12 Gupis 92 Lakki Marwat Tehsil 172 Lahore City Tehsil 253 Latifabad Taluka 334
Hattian Tehsil 13 Ishkoman 93 Jandool Sub-division 173 Choubara Tehsil 254 Matiari Taluka 335
Muzaffarabad Tehsil 14 Punial 94 Temergara Sub-division 174 Karor Lal Esan Tehsil 255 Qasimabad Taluka 336
Abbaspur Tehsil 15 Yasin 95 Sam Rani Zai Sub-division 175 Leiah Tehsil 256 Tando Allahyar Taluka 337
Hajira Tehsil 16 Ali Abad 96 Swat Rani Zai Sub-division 176 Dunyapur Tehsil 257 Tando Muhammad Khan Taluka 338
Rawalakot Tehsil 17 Gilgit 97 Bala Kot Tehsil 177 Kahror Pacca Tehsil 258 Garhi Khairo Taluka 339
Pallandari Tehsil 18 Gojal 98 F.r Kala Dhaka 178 Lodhran Tehsil 259 Jacobabad Taluka 340
Balochistan Hunza 99 Mansehra Tehsil 179 Malakwal Tehsil 260 Kandhkot Taluka 341
Awaran Sub-division 19 Nagar 100 Oghi Tehsil 180 Mandi Bahauddin Tehsil 261 Kashmore Taluka 342
Barkhan Sub-division 20 FATA Mardan Tehsil 181 Phalia Tehsil 262 Thul Taluka 343
Bhag Sub-division 21 Bar Chamer Kand Tehsil 101 Takht Bhai Tehsil 182 Isakhel Tehsil 263 Karachi Central 344
Dhadar Sub-division 22 Barang Tehsil 102 Nowshera Tehsil 183 Mianwali Tehsil 264 Karachi East 345
Lehri Sub-division 23 Khar Bajaur Tehsil 103 Peshawar Tehsil 184 Piplan Tehsil 265 Karachi South 346
Mach Sub-division 24 Mamund Tehsil 104 Alpuri Tehsil 185 Jalalpur Pirwala Tehsil 266 Karachi West Taluka 347
Sanni Sub-division 25 Nawagai Tehsil 105 Bisham Tehsil 186 Multan City Tehsil 267 Faiz Ganj Taluka 348
Dalbandin Sub-division 26 Salarzai Tehsil 106 Chakisar Tehsil 187 Multan Saddar Tehsil 268 Gambat Taluka 349
Nushki Sub-division 27 Utman Khel Tehsil 107 Martoong Tehsil 188 Shujabad Tehsil 269 Khairpur Taluka 350
Taftan Sub-division 28 Bara Tehsil 108 Puran Tehsil 189 Alipur Tehsil 270 Kingri Taluka 351
Dera Bugti Sub-division 29 Jamrud Tehsil 109 Lahor Tehsil 190 Jatoi Tehsil 271 Kot Diji Taluka 352
Phelawagh Sub-division 30 Landi Kotal Tehsil 110 Swabi Tehsil 191 Kot Addu Tehsil 272 Mirwah Taluka 353
Sui Sub-division 31 Mulagori Tehsil 111 Matta Tehsil 192 Muzaffargarh Tehsil 273 Nara Taluka 354
Gwadar Sub-division 32 Fr Kurram 112 Swat Tehsil 193 Narowal Tehsil 274 Sobho Dero Taluka 355
Pasni Sub-division 33 Lower Kurram Tehsil 113 Tank Tehsil 194 Shakargarh Tehsil 275 Dokri Taluka 356
Jhat Pat Sub-division 34 Upper Kurram Tehsil 114 Dir Sub-division 195 Depalpur Tehsil 276 Kambar Ali Khan Taluka 357
Usta Mohammad Sub-division 35 Ambar Utman Khel Tehsil 115 Wari Sub-division 196 Okara Tehsil 277 Larkana Taluka 358
Gandawa Sub-division 36 Halim Zai Tehsil 116 Punjab Renala Khurd Tehsil 278 Miro Khan Taluka 359
Jhal Magsi Sub-division 37 Pindiali Tehsil 117 Attock Tehsil 197 Arif Wala Tehsil 279 Ratodero Taluka 360
Kalat Sub-division 38 Prang Ghar Tehsil 118 Fateh Jang Tehsil 198 Pakpattan Tehsil 280 Shahdad Kot Taluka 361
Surab Sub-division 39 Safi Tehsil 119 Hasan Abdal Tehsil 199 Khanpur Tehsil 281 Warah Taluka 362
Buleda Sub-division 40 Upper Mohammad Tehsil 120 Jand Tehsil 200 Liaquat Pur Tehsil 282 Malir Taluka 363
Dasht Sub-division 41 Yake Ghund Tehsil 121 Pindi Gheb Tehsil 201 Rahim Yar Khan Tehsil 283 Digri Taluka 364
Kech (turbat) Sub-division 42 Data Khel Tehsil 122 Bahawalnagar Tehsil 202 Sadiqabad Tehsil 284 Kot Ghulam Muhammad Taluka 365
Tump Sub-division 43 Dossali Tehsil 123 Chishtian Tehsil 203 De-excluded Area 285 Mirpur Khas Taluka 366
Kharan Sub-division 44 Gharyum Tehsil 124 Fortabbas Tehsil 204 Jampur Tehsil 286 Bhiria Taluka 367
Mashkhel Sub-division 45 Ghulam Khan Tehsil 125 Haroonabad Tehsil 205 Rajanpur Tehsil 287 Kandiaro Taluka 368
Rakhshan (besima) Sub-division 46 Mir Ali Tehsil 126 Minchinabad Tehsil 206 Rojhan Tehsil 288 Moro Taluka 369
Khuzdar Sub-division 47 Miran Shah Tehsil 127 Ahmadpur East Tehsil 207 Gujar Khan Tehsil 289 Naushahro Feroze Taluka 370
Naal Sub-division 48 Razmak Tehsil 128 Bahawalpur Tehsil 208 Kahuta Tehsil 290 Daulat Pur Taluka 371
Wadh Sub-division 49 Shewa Tehsil 129 Hasilpur Tehsil 209 Kotli Sattian Tehsil 291 Nawabshah Taluka 372
Chaman Sub-division 50 Spinwam Tehsil 130 Khairpur Tamewali Tehsil 210 Murree Tehsil 292 Sakrand Taluka 373
Gulistan Sub-division 51 Central Tehsil 131 Yazman Tehsil 211 Rawalpindi Tehsil 293 Jam Nawaz Ali Taluka 374
Killa Saifullah Sub-division 52 Ismail Tehsil 132 Bhakkar Tehsil 212 Taxila Tehsil 294 Khipro Taluka 375
Upper Zhob Sub-division 53 Lower Tehsil 133 Darya Khan Tehsil 213 Chichawatni Tehsil 295 Sanghar Taluka 376
Kahan Sub-division 54 Upper Tehsil 134 Kalur Kot Tehsil 214 Sahiwal Tehsil 296 Shahdadpur Taluka 377
Kohlu Sub-division 55 Birmal Tehsil 135 Mankera Tehsil 215 Bhalwal Tehsil 297 Sinjhoro Taluka 378
Mawand Sub-division 56 Ladha Tehsil 136 Chakwal Tehsil 216 Sahiwal Tehsil 298 Tando Adam Taluka 379
Bela Sub-division 57 Makin Tehsil 137 Choa Saidan Shah Tehsil 217 Sargodha Tehsil 299 Garhi Yasin Taluka 380
Dureji Sub-division 58 Sararogha Tehsil 138 Tala Gang Tehsil 218 Shahpur Tehsil 300 Khanpur Taluka 381
Hub Sub-division 59 Serwekai Tehsil 139 De-excluded Area D.g Khan 219 Sillanwali Tehsil 301 Lakhi Taluka 382
Kanraj Sub-division 60 Tiarza Tehsil 140 Dera Ghazi Khan Tehsil 220 Ferozewala Tehsil 302 Shikarpur Taluka 383
Duki Sub-division 61 Toi Khulla Tehsil 141 Taunsa Tehsil 221 Nankana Sahib Tehsil 303 Pano Aqil Taluka 384
Loralai Sub-division 62 Wana Tehsil 142 Chak Jhumra Tehsil 222 Safdarabad Tehsil 304 Rohri Taluka 385
Sinjawi Sub-division 63 T.a.adj.lakki Marwat District 143 Faisalabad City Tehsil 223 Sheikhupura Tehsil 305 Salehpat Taluka 386
Dasht Sub-division 64 Tribal Area Adj Bannu District 144 Faisalabad Sadar Tehsil 224 Daska Tehsil 306 Sukkur Taluka 387
Mastung Sub-division 65 Tribal Area Adj D.i.khan Distt 145 Jaranwala Tehsil 225 Pasrur Tehsil 307 Chachro Taluka 388
Musakhel Sub-division 66 Tribal Area Adj Kohat District 146 Summundri Tehsil 226 Sialkot Tehsil 308 Diplo Taluka 389
Chhattar Sub-division 67 Tribal Area Adj Peshawar Distt 147 Tandlian Wala Tehsil 227 Gojra Tehsil 309 Mithi Taluka 390
Dera Murad Jamali Sub-division 68 Tribal Area Adj Tank Distt 148 Gujranwala Tehsil 228 Kamalia Tehsil 310 Nagar Parkar Taluka 391
Panjgur Sub-division 69 Islamabad 149 Kamoke Tehsil 229 Toba Tek Singh Tehsil 311 Ghorabari Taluka 392
Barshore Sub-division 70 NWFP Nowshera Virkan Tehsil 230 Burewala Tehsil 312 Jati Taluka 393
Karezat Sub-division 71 Abbottabad Tehsil 150 Wazirabad Tehsil 231 Mailsi Tehsil 313 Keti Bunder Taluka 394
Pishin Sub-division 72 Bannu Tehsil 151 Gujrat Tehsil 232 Vehari Tehsil 314 Kharo Chan Taluka 395
Quetta City Sub-division 73 Allai Tehsil 152 Kharian Tehsil 233 Sind Mirpur Bathoro Taluka 396
Quetta Saddar Sub-division 74 Batagram Tehsil 153 Sarai Alamgir Tehsil 234 Badin Taluka 315 Mirpur Sakro Taluka 397
Harnai Sub-division 75 Daggar Tehsil 154 Hafizabad Tehsil 235 Golarchi Taluka 316 Shah Bunder Taluka 398
Sibi Sub-division 76 Charsadda Tehsil 155 Pindi Bhattian Tehsil 236 Matli Taluka 317 Sujawal Taluka 399
Kakar Khurasan Sub-division 77 Tangi Tehsil 156 Chiniot Tehsil 237 Tando Bago Taluka 318 Thatta Taluka 400
Sherani Sub-division 78 Chitral Sub-division 157 Jhang Tehsil 238 Dadu Taluka 319 Kunri Taluka 401
Zhob Sub-division 79 Mastuj Sub-division 158 Shorkot Tehsil 239 Johi Taluka 320 Pithoro Taluka 402
Ziarat Sub-division 80 D. I. Khan Tehsil 159 Jhelum Tehsil 240 Khairpur Nathan Shah Taluka 321 Samaro Taluka 403
Umer Kot Taluka 404
LIST OF TEHSILS OF PAKISTAN
YEAR TFR
1965 7.1
1975 6.3
1984 5.9
1991 5.4
1996 5.3
1999 5.1
TREND IN CONTRACEPTIVE PREVALENCE RATE
23.9 YEAR CPR (%)
1969 5.5
1984 9.1
1991 11.8
1994 17.8
1996 23.9
Source: FINAL REPORT REPRODUCTIVE HEALTH PROJECT ADB TA NO. 3387
TRENDS IN TOTAL FERTILITY RATE
7.1
6.3
5.9
5.4 5.3
5.1
0
1
2
3
4
5
6
7
8
1965 1975 1984 1991 1996 1999
TFR
TFR
5.5
9.1
11.8
17.8
23.9
0
5
10
15
20
25
1969 1984 1991 1994 1996
CPR (%)
CPR (%)
... These three study districts represent southern, central and northern parts of the province. All childhood TB cases registered at these hospitals during the period under review were included in the study [11]. The pediatricians from these hospitals were oriented by NTP on the newly developed national policy guidelines. ...
Article
Full-text available
The adherence to policies of National TB Control Programme (NTP) to manage a case of tuberculosis (TB) is a fundamental step to have a successful programme in any country. Childhood TB services faces an unmet challenge of case management due to difficulty with diagnosis and relatively new policies. For control of childhood TB in Pakistan, NTP developed and piloted its guidelines in 2006-2007. The objective of this study was to compare the documented case management practices of pediatricians and its impact on the outcome before and after introducing NTP policy guidelines. An audit of case management practices of a historical cohort study was done in children below 15 years who were put on anti-tuberculosis treatment at all nine public hospitals in three districts in province of Punjab. The study period was two years pre-intervention (2004-05) and two years post-intervention (2006-07) after implementation of new NTP policy guidelines for childhood TB. There were 920 childhood TB cases registered during four years, 189 in pre-intervention period and 731 in post-intervention period. The practices changed significantly in post-intervention period for use of tuberculin skin test (63% of pulmonary cases, 19% of extrapulmonary cases and 67% for site unknown), and for the use of chest x-ray (69% of pulmonary cases, 16% of extrapulmonary cases and 74% for site unknown). Diagnostic scores were recorded for only a minority of cases (18%). The proportion of correct drugs pre- and post-intervention remained same. There were unknown treatment outcomes in 38 out of 141 cases (27%) in pre-intervention and in 483 out of 551 cases (87%) post-intervention, all among the 692 cases without documented treatment supporter. The study has shown that pediatricians have started following parts of the national policy guidelines for management of childhood TB. The documented use of diagnostic tools is increased but record keeping of case management practices remained inadequate. This seems to increase case finding substantially but the treatment outcomes were poor mainly due to unknown outcomes. Development and implementation of standardized operational tools and regular monitoring system may improve the services.
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