Sociology 100

Course paper
Submitted by : Farhat Gill 19-10592
Submitted to : Sara Rizvi Jafree

Title:
(Social health issues in public sector hospitals in Pakistan)

Research Question:
What are social health issues due to inadequate public sector hospitals of Pakistan ?

Introduction :
The purpose of conducting this search is to aware people about the social health issues nation
is facing right now in Pakistan. Hospitals are the pillars of society , they form the basic
infrastructure of a society. The adequate hospital with the proper equipment’s for nation
should the prior concern of government. Today’s world due tremendously increasing
population hospitals are playing a very important role as many and many people are falling
prey for disease.These health issues are mostly related to the inadequate hospitals of Pakistan.
The hospitals in which there are machines but there is no one to operate them and they won’t
hire people for that. And sometimes there are machine but there due to poor maintenance
there are not in working conditions. In such big buildings of public sector hospitals they don’t
even have proper staff or the staff is not enough for such a large number of patients. They
don’t have enough beds for patients even in emergency departments patients have to suffer
for their turn due to lack of beds and emergency services. They are unable to provide them
first aid. The unsterilized equipment’s used in these hospitals cause a lot more to a patient
from which a patient has to suffer to great extent. The contagious infections caused by these
infections unbearable. People are suffer more inside the hospital then outside. There is no
proper care for them, no proper check on them. The budget allocated to the hospitals are only
2.5 percent where there is no check and balance on it, and that is major cause of inadequacy,
when they don’t use that money for development and maintenance of hospitals. No proper
policies and mismanagement. This study will discuss all such social problems and
consequences of these problem in Pakistan.

Sociological theories:

Conflict theory:
The conflict approach emphasizes inequality in the quality of health and of health-care
delivery (Weitz, 2013).

This is the biggest issue that Pakistani public sector hospitals are facing right now. We have
buildings but we don’t have enough resources to run them and that’s why we are unable to
provide our nation with best health care facilities. People from disadvantaged social
backgrounds are more likely to become ill, and once they do become ill, inadequate health
care makes it more difficult for them to become well. As we will see, the evidence of
disparities in health and health care is vast and dramatic.

Functional theory:
As conceived by Talcott Parsons (1951), the functionalist perspective emphasizes that good
health and effective medical care are essential for a society’s ability to function.

Good health and effective medical care are essential for the smooth functioning of society.
Patients must perform the “sick role” in order to be perceived as legitimately ill and to be
exempt from their normal obligations. The physician-patient relationship is hierarchical: The
physician provides instructions, and the patient needs to follow them.

Literature review:
In Pakistan hospitals are badly influenced by corruption. There is no check and balance on
funds, no one is in charge to check where hospital managements are spending money.
Research study conducted by Tryan Vain(2008) focuses on the corruption in Public sector
hospitals, the policies are not beneficial for hospitals. The hospitals need better and advance
policies for reduction of corruption. It also focus on how pressures, competition and
rationalization influence corruption in public sector hospitals. It also examined the link
between corruption and financial managements. How the behavior of government clients
affects the patients. As there is no proper check on them. And how a single doctor handle a
large rush of patients at time influence patients. This causes a lot ignorance to some patients
that leads towards a serious consequences.

Marueen Lewis (2007) in her article also focus on corruption as a part of public sector
hospitals. She researched that there is no proper management for such things, as it should be
the most prior government concern. Otherwise it can never overcome where our government
show no interest in it. Corruption is the main challenge in public sector hospitals now a days.
And the consequences can lead to a loss of someone’s life. She examined that how horror
could be that consequences of mismanagement in public sector hospital.

Babar T. Shaikh Juanita Hatcher (2004) reviewed that how the negligence of health care
policy makers causing social health issues in Pakistan. This study was conducted in
developing countries especially in Pakistan. That focus on health care policy makers
understanding. They reviewed that our policy maker don’t even know what a healthy
environment is and how important it is for our country and for patients and staff as well.

They appraised that our policy are not strong enough to provide us with best health care
facilities. The hospitals needs an efforts and collaboration to get stable for providing what a
citizen deserve.

Gillies Dassault and Maria Cristina Franceschini (2006) research study focuses on not
enough health care facilities. How patients have to suffer due to lack of health care
facilities. The study basically focus on geographically distributed health care problem
especially in rural areas and areas underdevelopment are more influenced by lack of facilities.
They don’t even have proper awareness about the hospital systems, to whom they should
contact. They are not even aware that having a good health care facilities in public sector
hospitals are there right. It also examine that we need qualified staff in developing areas. And
how this effecting hospitals and how crucial it is making the process of achieving good health
care facilities.

P.khan, Z. bhutta, Munim and A.Bhutta (2009) conducted a resreach about how maternal
health and survival is affected. They researched that each year in Pakistan 500000 women
got pregnant and out that 70000 faced medical complication during treatment and delivery.
That means that 15% of pregnant women are unable to achieve the best health care at this
vulnerable time. The lack of facilities and equipment’s caused a lot of complications with
their treatment. And an estimated 30000 women die from pregnancy related problems, and
this all are caused by poor facilities and not skilled workers. This research study focus that
how women are affected by these social issues in public sector hospitals. It also tells that the
total MMR is 256 out of 100000 births annually. How awfully these problem are affecting
our birth rate as well.

Kumar A1, Lalani S, Afridi AA, Khuwaja AK (2010) researched about the growing hepatitis
in developing countries like in Pakistan. The research was conducted in Tando Muhammad
Khan city in province of Sindh. That how awfully people are affected by hepatitis due to un
awareness and lack of good facilities at health care centers. People don’t even know the word
vaccination because government is not concerned about providing the best health care
facilities to their citizens they don’t think that it should be the part of their life. How
important it is for a person to be treated in a clean proper environment. They reviewed the
data of 5989 laborites reports basically a data from two laboratories for hepatitis B and C.

Out of which one fourth of the reports are positive for which adults more that 18 are affected
by hepatitis B and C. The results in older age are higher 56.6% and in younger 43.3%. The
main causes for this is again unhealthy environment and unhealthy care facilities.

Asad Ali Khan Afridi, Ameet Kumar, and Raza Sayani research study focus on needle stick
infections caused by poor care . This study focus on that not only patients are the victim of
these social problem but also the health care staff. The main reason behind this agenda is that
they are not properly trained for their work. They don’t know the proper way of using
equipment and disposing them of properly. How important is the use of sterilized equipment
is for health care they are not even aware of that. This unawareness caused a lot of blood
borne infections like HIV, HEPATITS A and B.

Data was collected on 2008 through structured questionnaire interview from 497 of HCWs
(doctors and nurses) in which 64 % of were once exposed to needle stick infection. And 73%
were exposed more than two times. Due to poor training.

Syed Nabeel Zafar and K. A. Kelly McQueen (2011) appraised that the major health issue in
public sector hospitals are lack of surgical and emergency health care, hospitals are unable
to provide emergency health care facilities to their patients, which lead to a major health
issues or even death of a patient. If the patient is not providing with a treatment on time that
treatment is useless afterwards, when there is no use of that treatments. Patients die because
of lack of availability of facilities like lack of beds, lack of equipment, lack of machinery
needed. In such a populated countries hospitals are not providing that much outcome.

Especially in surgical treatment lack of equipment and machinery can cause awful
significances. These inadequacies leads a person to death. Especially infections caused by
unsterilized equipment used during surgeries.

Omar A Khan and Adnan A Hyder (2011) appraised that even in this era Pakistan is facing a
high risk of HIV due to no proper treatment and used of unsterilized equipment. How a high
rate of people are infected by this Diseases even after such great advancements in medical
field. Because in our hospital patients are not provided with these advance facilities or if
hospitals have these facilities they are out of the range of a poor or a mediocre person

Governments is not even concern about this high risk. There is no policy for this. And the
citizens are suffering on high percentage day by day.

Social causes of health issues:

 Corruption:
The main agenda is corruption. They budget owed to hospitals are already only 2.5 %
from which only 0.2 % to 0.5% is used for the welfare of hospitals and the rest of that
where it is used no one has a idea and no one even bother to ask. Overcome on
corruption can solve a lot health issues. The total budget owed to hospitals if totally
used for the welfare of hospitals can help a lot in overcoming the health issues caused
by inadequate hospitals.

 Poor Management :
No proper check on staff caused a lot of social health issues. Doctors and nurses are
frustrated as they don’t know how to manage such a large number of hospitals
especially in emergency departments. One doctor is in charge our thousands of
patients. Nurses have to do a medicine of a large number of patients at a same time.
There are many patients but lack of staff.

 Lack of machinery and other facilities:

 Lack of beds or machinery needed for best treatment are also in the main causes of
social health problems. Advance machinery is not available in public sector hospitals.
Beds are not available for single patients. Two or three patients share the same bed.
Equipment is not available for a specific surgery. Due which usage of same
equipment came into being. Lack of post or pre surgery care cause a lot of health
issues.

 Untrained staff:
Untrained staff is so unhealthy for environment. And we have untrained staff
available in a bulk in our hospitals especially midwifes or not trained, untrained award
boys. Sometimes not even trained doctors and nurses are also in our hospital that
don’t know how to use and dispose equipment once used. How to give pre and post
care treatment to a patients.

 Poor policy makers:

Our policy maker are not that much socially aware about the policies of good health
care system. The don’t even have that much understanding of making policy. Poor
policies lead a lot of health issues in hospitals. No complaint department is available
as this is most important part of policy.

Conclusion:
Government should have a proper management system
there should be a proper check on staff plus any informal activity going in hospital this to
related corruption.

The proper budget used for welfare of hospitals. Help a lot for providing the best health care
facilities.

Certified policy makers with great understanding of what are the needs of best health care
systems.

Give proper training of health environment to each and every member of staff.

Aware our staff that how important is healthy environment for providing best health care
facilities.

Overcomes the lack of facilities through using the buildings in proper manner.

Hire trained and certified staff for operating machinery.

Proper and strict policies are needed for better corruption free environment.

Proper complaint department is a necessary part of every system same as it is needed in

health care system as well.
Train the staff how to use and dispose the equipment especially needles as they cause lot of
dangerous infections.

If our government maintains these little check this would help our health care department a
lot to get develop and provide nation with best facilities.

APA References:
1. Afridi AA, Kumar Ameet , Sayani Raza(2013). Needle Stick Injuries – Risk and
Preventive Factors: A Study among Health Care Workers in Tertiary Care Hospitals
in Pakistan.
2. Kumar A, Lalani S, Affridi AA, Khuwaja AK (2010). Screening of hepatitis B and C
among people visiting general practice clinics in a rural district of Sindh, Pakistan.
3. Babar T. Shaikh Juanita Hatcher (2004). Health seeking behavior and health service
utilization in Pakistan: challenging the policy makers
4. Khan Y P, Bhutta S, Munim S, Bhutta Z (2009). Maternal Health and Survival in
Pakistan: Issues and Options.
5. Babar T. Shaikh,David Haran &Juanita Hatcher (2008). Women's Social Position and
Health-Seeking Behaviors: Is the Health Care System Accessible and Responsive in
Pakistan?
6. Taryn Vian (2008). Review of corruption in the health sector: theory, methods and
interventions
7. Lewis, Maureen, (January 2006). Governance and Corruption in Public Health Care
Systems .

8. Dussault G, Franceschini M C(2006).Not enough there, too many here: understanding

geographical imbalances in the distribution of the health workforce .

9. Shaikh B, David H, Hatcher J (2008). Where Do They

Go, Whom Do They Consult, and Why? Health-Seeking Behaviors in the Northern
Areas of Pakistan.
10. Syed N Z, K. A. Kelly McQueen (2011).Surgery, Public Health, and Pakistan.
11. Knight E H , Self A, Kennedy S H (2013).Why Are Women Dying When they Reach
Hospital on Time ? A Systematic Review of the ‘Third Delay.’
12. Babar T. Shaikh,David Haran &Juanita Hatcher(2005).Complementary and
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Medicine in Pakistan: Prospects and Limitations

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ECONOMIC UNFAIRNESS IN HEALTH SYSTEM OF PAKISTAN: A HOPE
WITH THE RECENT REFORMS
15. Jafree, S. R., Zakar, R., Fischer, F., & Zakar, M. Z. (2015). Ethical violations in the
clinical setting: the hidden curriculum learning experience of Pakistani nurses. BMC medical
ethics, 16(1), 1.