Pakistan stands at the brink of a healthcare crisis. The warning signs are flashing – overwhelmed hospitals, absent care in rural areas and a crippling shortage of frontline responders during emergencies. The crisis is real but the solution isn’t more doctors or shiny new hospitals. It’s something faster, cheaper and entirely achievable.
The WHO projects a global shortfall of 10 million health workers by 2030, with the sharpest gaps in low- and middle-income countries like Pakistan. But while the rest of the world prepares for this future, Pakistan clings to a flailing model: more doctors, more hospitals, more years of slow, expensive building and training.
The doctor bottleneck is killing us. Training a single doctor takes nearly a decade and Rs10 million to Rs15 million, depending on whether it’s public or private. That’s a huge investment for a workforce that often leaves the country and rarely serves in the rural areas where they are needed the most.
By contrast, nurses and paramedics can be trained in 1-4 years, at less than 20 per cent of the cost and deployed immediately in critical areas – emergency care, maternal and child health, vaccinations and disease prevention. They are the backbone that the system is missing.
Consider the math: Pakistan has one doctor per 970 people – just above the WHO’s minimum standard of 1:1000. But the real crisis is in nursing: only 0.5 nurses and midwives per 1,000 people, far below the recommended three. In rural districts, the ratio collapses further. This is a matter of life and death.
Pakistan’s maternal mortality rate stands at 155 deaths per 100,000 live births – five times higher than in developed countries. One in every 22 infants dies before their first birthday, many from preventable causes. A trained midwife or nurse could have saved those lives.
In emergencies, the gap becomes deadly. During floods, dengue outbreaks or road accidents that kill 28,000 people annually, doctors are rarely the first on the scene. It’s paramedics, nurses and EMTs who stabilise, manage trauma and save lives. Yet, Pakistan has fewer than 1,000 certified EMTs for 240 million people. Survey data is clear: practical, hands-on skills make the difference in care quality. These can be taught quickly, at scale, through paramedic training. And for young women in particular, this training offers dignified jobs and upward mobility.
The impact goes beyond Pakistan’s borders. Countries like Saudi Arabia, the UAE and Germany are facing an ageing population and a shortage of social care or elderly care workers. This deficit has prompted them to open recruitment pathways for healthcare workers. With the right certifications, Pakistani nurses and paramedics can meet this global demand.
This is a triple-win. Better healthcare access across Pakistan, fast and affordable workforce development for the youth, and economic resilience through local and international employment.
Let’s be clear – doctors are essential. But over 80 per cent of Pakistan’s health workforce funding goes into producing doctors. This imbalance is unsustainable and fails to meet the urgent needs of our population.
If Pakistan is serious about Universal Health Coverage (UHC) under Vision 2025, the fastest, most cost-effective move is simple: equip every Basic Health Unit (BHU), ambulance, school clinic and rural hospital with trained nurses and paramedics.
We must reimagine healthcare not through grand, expensive hospitals that serve the few, but by empowering the frontline workers who serve the many. The solution path is clear as a Cordoba Care Institute Skills Survey shows that 71 per cent of hospital supervisors want more training in basic/advanced life support and patient history-taking, 57 per cent call for better knowledge of hygiene and infection control and 42 per cent stress the need for knowledge of post-operative care and patient hygiene.
But clinical skills alone are not enough. Quality healthcare also requires soft skills: 75 per cent of hospital managers cited lack of communication, time management and teamwork as key weaknesses, and 28 per cent pointed to poor professionalism and attention to detail. Among graduates: 66 per cent said internships significantly improved their skills, 70 per cent credited the quality of instructors and 56 per cent found skills labs essential to their training.
These upgrades don’t demand massive budgets or long waits. The payoff is quick. Within a year, 62.9 per cent of training graduates were earning Rs42,000 per month.
This is the real frontline of Pakistan’s healthcare battle. It’s not fought only in operating rooms, but in flooded villages, school clinics, roadside emergencies and maternity wards in remote towns.
If we continue to rely on large hospitals or doctors to save the system, we will miss the opportunity to save lives.
We don’t need to build more monuments to medicine. We need a people-powered, skills-first revolution in healthcare which saves lives, empowers youth and brings healthcare to where it's needed most.
The writer is a venture builder, a private equity investor and investment banker. He tweets/posts @AhmadJalal_1
