Elsevier

Health Policy

Volume 88, Issues 2–3, December 2008, Pages 269-281
Health Policy

Pakistan's health policy: Appropriateness and relevance to women's health needs

https://doi.org/10.1016/j.healthpol.2008.03.011Get rights and content

Abstract

The interface between national health policy and women's health needs is complex in developing countries like Pakistan. This paper aims to assess if Pakistan's national health policy 2001 is relevant and appropriate to women's health needs.

Through review of existing data on women, a profile of women's health needs was developed which was transformed into framework of analysis. This framework indicates that Pakistani women's health needs are determined by gender disparities in health and health-related sectors.

Comparison of national health policy with women's health needs framework reveals that although policy focuses on women's health through prioritization of gender equity, it is however addressed as an isolated theme without acknowledging the vital role gender inequalities in health and health-related sectors play in defining women's health needs. Moreover, gender equity is translated as provision of reproductive health services to married mothers, ignoring various critical overarching issues of women's life such as sexual abuse, violence, induced abortion, etc. Health systems strengthening strategies are though suggested but these fails to recognize main obstacles of utilization of healthcare services by women including non-availability of female healthcare providers and gender-based obstacles to healthcare utilization such as illiteracy, lack of empowerment to make decisions related to health, etc.

In order to be relevant and appropriate to women's health needs the policy should: (1) use gender equity in health and health-related sectors as an approach to develop a healthy policy (2) expand the focus from reproductive health to life cycle approach to address all issues around women's life (3) strengthen health systems through creation of gender equity among all cadres of health providers (4) tailoring health interventions to counter gender-based obstacles to utilization of healthcare services and (5) dissemination interventions for behavior change.

Section snippets

Pakistan's health policy 2001

The interface between national health policy and women health needs is complex in developing countries like Pakistan. Policy formulation itself faces a number of challenges including: influence of macroeconomic policies [1], inadequate health spending [2], [3], paucity of empirical work [4], and lack of government capacity and will to utilize available data. Being signatory to Structural Adjustment Program of International Monitoring Fund, Pakistan's government decided to adopt Health Sector

Approach and methodology

Identification of health needs in itself is challenging and becomes even more daunting in developing countries like Pakistan owing to scarcity of data. Information available on women in health and health-related sectors was reviewed in existing documents (Appendix B) to identify poor indicators and develop a profile of women's health needs. This profile was then transformed into a framework of analysis (Appendix C) using the descriptive framework of analysis suggested by Janovsky [22] and

Results

Results are presented in two sections: (Section 3.1) the first section describes the profile of women's health needs gathered through reviewing the data in existing documents and (Section 3.2) the second section states the findings of the assessment of the national health policy on the framework of analysis based on the profile of women's health needs.

Lessons learnt

Despite being pragmatic and focused the national health policy 2001 has a conventional approach to health, failing to acknowledge the impact of gender inequalities in health-related sectors on women's health needs with regard to health status, health seeking behavior and healthcare utilization. Although women's health is being focused through prioritization of gender equity as one of the key areas, it is only presented as an isolated theme rather than being an ingredient in all policy areas and

The way forward

In order to use gender equity as an approach to improve women's health, the policy needs to admit the multi-sectoral nature of health and the health ministry should work closely with other ministries to eliminate gender inequalities with the vision that achievement in social development indicators will bring about simultaneous gains in health outcomes and vice versa [53]. Moreover, the policy has to expand its focus from reproductive health to life cycle approach as most critical morbidities

Policy implications

Being part of the government's Poverty Alleviation Plan, the health policy has to realize and reflect that poverty could not be alleviated only through restoration of economic growth, but health status of the population has a role to play in economic development. To improve national health indicators, access to not only basic health services but to related disciplines such education, security, and employment opportunities, having influence on health is essential for which gender equity is

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