
Sindh health minister's criticism of K-P's Sehat Card rings hollow amid province's own healthcare failures
The Sehat Card Plus programme in K-P covers all citizens, regardless of income, ensuring free treatment in both public and private hospitals. Even if it focuses on hospitalisation, it still guarantees free life-saving treatments. What comparable system has Sindh implemented?
The Sindh health minister's argument is weak because it attacks an existing, functional health insurance system without offering a better alternative.
If Sindh truly had a superior healthcare model, its people wouldn't be forced to rely on expensive private hospitals. Instead of dismissing K-P's initiative, Sindh should work on expanding its own services, improving hospital conditions, and ensuring OPD access to medicines and specialists.
While Sindh has initiated programs targeting chronic diseases, including diabetes, challenges persist in service delivery. Data indicates that only 57.3% of women in Sindh made the recommended four or more antenatal care visits, and just 53.7% received their initial antenatal care during the first trimester, highlighting gaps in preventive and continuous care services.
Public hospitals are overcrowded, underfunded, and lack proper facilities. If Sindh had a fully functioning system for OPD and chronic disease management, why do thousands of Sindh residents seek treatment in private hospitals?
Sindh has approximately 41,082 beds across 7,651 health facilities, equating to one bed per 1,200 individuals. This ratio is less than half of the World Health Organization's recommended standard, underscoring significant overcrowding in public hospitals.
The Sindh public health system's utilisation rate stands at 22%, notably lower than the national average of 29%. This discrepancy suggests a lack of public confidence in government healthcare facilities, prompting patients to turn to private options.
A study revealed that 82.5% of healthcare encounters in Sindh occurred in the private sector, with 85% of these being outpatient visits. This trend indicates that a significant portion of the population incurs out-of-pocket expenses for private healthcare services, likely due to deficiencies in public healthcare infrastructure.
Patients in Sindh suffering from blood-borne diseases like thalassemia, as well as those battling cancer, face significant challenges in accessing essential outpatient services and life-saving treatments.
The Sindh Health Department has ceased the provision of free cancer medications in public hospitals. This abrupt halt has left thousands of patients without access to essential drugs, forcing them to purchase expensive medications out-of-pocket or forego treatment altogether.
Despite the enactment of the Sindh Prevention and Control of Thalassemia Ordinance in 2013, which mandates diagnostic facilities and blood transfusion services for thalassemia patients, implementation has been inconsistent. Many patients still struggle to access essential services, indicating gaps between policy and practice.
Despite the high prevalence of thalassemia, public awareness campaigns and preventive measures, such as carrier screening and genetic counseling, remain insufficient. This gap contributes to the ongoing transmission of the disorder and places additional strain on healthcare resources.
Instead of attacking K-P's Sehat Card programme, the Sindh health minister should confront her own government's failing healthcare system. While K-P provides free hospitalisation and critical care, Sindh's public hospitals remain overcrowded, underfunded, and unreliable.
Before criticising a functional insurance model, she should ask why millions in Sindh are forced to seek private treatment. Rather than engaging in political point-scoring, Sindh must learn from K-P, fix its broken system, and truly serve its people.
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Business Recorder
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Express Tribune
06-08-2025
- Express Tribune
Autistic children lack support in K-P
Listen to article In Pakistan, the predominant definition of a healthy child is a cute chubby kid with squeezable cheeks. As a result of this superficial criterion for well-being, children born with autism, who experience trouble reaching various neuro-developmental milestones, are often left neglected not only by caregivers but also by healthcare providers. Although lack of awareness on autism persists across the whole country, in Khyber-Pakhtunkhwa (K-P), the issue is significantly more alarming since till date the government has failed to establish a single public autism centre during their 14 years of holding office. Across the province, including Peshawar, there is no government-run facility to diagnose or treat children living with autism, leaving families to rely on expensive private centres or seek online consultations from other cities and abroad. The World Health Organization (WHO) defines autism as a diverse group of conditions marked by some degree of difficulty with social interaction and communication. Among children, the most common symptoms include difficulty in speech, avoiding eye contact, repetitive movements, social isolation and fixed preferences and routines. According to the Autism Society of Pakistan, nearly 400,000 children in Pakistan suffer from autism, with around 150,000 belonging to K-P and the nearby tribal areas. Alarmingly, K-P's health and social welfare departments do not even maintain official data on these children, highlighting a complete absence of state-level awareness or planning. As a result, parents are forced to approach facilities like PIMS in Islamabad, the Aga Khan Hospital in Karachi, or even attend costly online sessions with foreign experts. One such parent was Sidra Khan, whose four-year-old son was diagnosed with autism. It took her three months to even find a doctor for consultation. After an online session with a US-based doctor via PIMS, she discovered that no government centres for autism existed in K-P. At a private centre in Peshawar's University Town, she was charged Rs100,000 per month for therapy, forcing her to sell family property to continue her son's treatment. Similarly, Kamran, another parent from inner Peshawar, revealed that his nine-year-old son's autism was diagnosed three years ago. Due to the absence of experts in Peshawar, he is now planning to relocate to Islamabad or Karachi. Similarly, Nafeesa, a mother of two autistic children from K-P, was compelled to move to Islamabad to enroll her children into a special needs school, after spending nearly Rs200,000 to Rs300,000 on their unsuccessful treatment in Peshawar. According to a survey conducted by the Express Tribune, Peshawar has just one semi-public autism centre, which started as a project in 2021 and became operational in 2023 under the Social Welfare Department. This centre, located in Hayatabad, registers only 70 children, operates with just 14 staff members, and has a waiting list of over 200 children due to space and staffing shortages. There are roughly 15 private autism centres and five schools in Peshawar, charging between Rs60,000 to Rs100,000 per month, with only one offering free therapy to underprivileged families. Approximately 700 children receive therapy in these private facilities. Clinical psychologist, Masooma Khan explained that psychological, speech, occupational, and behavioral therapies, along with parental involvement, were essential for improving the lives of autistic children. Likewise, Dr Farrukh Tariq, a speech therapist associated with the Paraplegic Centre in Peshawar, stressed the need for early intervention, noting that most children were diagnosed at ages seven or eight, when developmental improvements become much harder. 'Government intervention is necessary for improving autism services in public hospitals, increased awareness, and affordable therapies. Lack of treatment pushes many autistic children into lifelong psychological struggles, while poor families remain helpless due to unaffordable therapy costs,' said Dr Tariq.