Improving Pakistan’s healthcare from Covid-19 and beyond

In March, the World Health Organisation declared Covid-19 as a pandemic. This has challenged the world’s healthcare systems, particularly those of developing countries like Pakistan.

Early June, a team of over 25 consultants based in the UK piloted a “patient advice line” to help Covid-19 patients in Pakistan through remote consultation as well as to gather learning points for the healthcare professionals working there.

It was observed that no support platform is available to patients in Pakistan from a primary care prospective. Lack of guidelines, anxiety, conspiracy theories and false claims created more confusion among masses. Patients are learning from WhatsApp groups and social media platforms. There is a lack of understanding that the information available is not evidence-based and potentially harmful.

Patients were requesting Covid-19 tests themselves without consulting a doctor. Later, they were confused about the test results and were unable to figure out when to repeat them. It was noted that seriously ill patients were getting treated at home with oxygen without any safety checks and guidance on how much to administer.

Mental health was also neglected and the practice of polypharmacy — the concurrent use of multiple medications — was dangerously high. Also, the use of herbal treatments like ‘Sanna Makki’ was prevalent.

Given these observations from a developed healthcare system, UK clinicians feel that a multifaceted approach is needed to handle the current pandemic and long-term health management. It involves changing both patients’ and doctors’ behaviour, and the right use of medium to change the population’s health behaviour.

Doctors should be encouraged to practise evidence-based medicine only. Prescriptions should be monitored by local authorities. There should be an educational portal for all doctors, where the latest guidelines and practices should be shared to keep them up-to-date.

Polypharmacy can be dangerous and is also against good medical practice guidelines. Local pharmacies should not be allowed to dispense medication without valid prescriptions from a qualified doctor.

In terms of coronavirus, there should be health promotion services at local drug stores including hygiene, self-isolation and the use of masks. Mental health support teams and counselling services must be digitally available to both patients and clinical staff. There should be a dedicated Covid-19 support service for pregnant women with local paediatricians and gynaecologists onboard.

Pakistan must realise the importance of primary care and should invest in terms of infrastructure and workforce to revolutionise the system. The Ministry of Health must work in conjunction with the Ministry of Information and Technology to take appropriate steps towards the transformation and reforming the model of healthcare. Technology-driven healthcare models could enable patients to have wider access to doctors and nurses in the ease of their homes.

Primary care GP consultations could be delivered through online digital portals, which can also involve healthcare professionals including nurses, physiotherapists, dieticians, social workers and health visitors, resulting in a reduced burden on secondary care.

This writer is a Britain-based consultant family physician.