A brief overview of the demographics, epidemiology, nutrition status, general healthcare and oral healthcare system of Pakistan

1. HEALTHCARE IN
PAKISTAN
Sanaa Aslam
Msc. DPH Student
Kings’ College London
Nov2012

2. COUNTRY PROFILE
U.S. CENSUS BEAUREU . International database [online] . Available.
http://www.census.gov/population/international/data/idb/region.php?N=%20Results%20&T=13&A=separate&RT=0&Y=2012&R=-1&C=PK
[Accessed].

3. COUNTRY PROFILE
WHO 2007. Health Systems Profile-Pakistan. World Health Organisation-Regional Office for the
Eastern Mediterranean (WHO/EMRO).

4. ORAL HEALTH
• Mean DMFT score- National
Age (yrs) Decayed Missing Filled ( F ) DMFT
(D) (M)
12 1.01 0.18 0.04 1.23
15 1.44 0.36 0.14 1.94
35-44 4.64 2.93 0.45 8.02
65+ 4.44 12.85 0.44 17.73
• 50% of children 12-15 years are caries free, 97% of all carious
lesions remain untreated
BILLIE,K., ASLAM, M. Oral Health in Pakistan: A situation analysis [online].
Available: http://www.fdiworldental.org [Accessed].

5. ORAL HEALTH
• Poor periodontal condition
• Percentage of individuals with CPITN score-National
Age Healthy Bleeding Calculus Periodontal Periodontal Excluded
(yrs) (score0) (score1) (score2) Pocket 4- Pocket> 6mm
5mm (score4)
(score3)
12 28.10% 33.70% 20.90% 0.60% 0.10% 16.60%
15 26.50% 27.60% 28.70% 1.60% 1.10% 14.50%
35-44 16.80% 22.50% 33.90% 10.20% 6.70% 9.90%
65+ 6.20% 6.30% 31.40% 17.90% 17% 20.40%
BILLIE,K., ASLAM, M. Oral Health in Pakistan: A situation analysis
[online]. Available: http://www.fdiworldental.org [Accessed].

6. ORAL HEALTH
• Prosthesis requirements
Age 65+, 65% require a prosthesis
Age35-44,30% require a prosthesis
• Enamel fluorosis
69% of examined population had no fluorosis
• Oral Cancer
Tobacco use, men 34% and women 12%
Oral cancer 5 year prevalance: men 17133, women 19556

7. HEALTHCARE SYSTEM:
ORGANISATION
TERTIARY
FACILITIES
SECONDARY CARE:
Tertiary health quarters,
District health quarters
PRIMARY CARE:
first level healthcare facilities e.g. basic
health units, rural health units, dispensaries

8. HEALTHCARE SYSTEM: DELIVERY

9. RESOURCES & FINANCING
• 1978, primary health care was integrated in the entire
system
• 972 hospitals, 4842 dispensaries, 5374 basic health
units, 909 maternity and child health care centers
• 149,201 doctors, 10,958 dentists, 73,244 nurses
• Population and health facilities ratio: 1,206 persons per
doctor, 16,426 persons per dentist and 1,665 persons
per hospital bed
• Two principle modes of financing
– Out of pocket fee based
– General taxation

10. ORAL HEALTHCARE SYSTEM
• Public and private
• Public oral healthcare system is integrated in
the general health care system
• Financing and fee structure:
Public: govt. taxation and fee per item
Private: out of pocket, private insurance
arrangements, fee per item and/or fee per hour

11. DENTAL CARE PROFESSIONALS
Number of dental surgeons in Pakistan
PROVINCE MALE FEMALE TOTAL
PUNJAB/FEDERA 1167 806 1973
L AREA
SINDH 902 837 1739
KPK 548 256 804
BALOCHISTAN 109 31 140
AZAD KASHMIR 105 43 148
FOREIGN 237 67 304
NATIONALS
TOTAL 3068 2040 5108
• 15-20 Dental hygienists in two institutes
• 800 Lab. Technicians
• 40,000 + un-qualified dental practitioners (quacks)
• 0 Dental nurses and therapists

12. FUNCTIONS & TARGET
POPULATIONS
• Preventive programs
• Community outreach programs
• Restorative services
• Surgical services
• Public oral healthcare system:
basic and cost effective interventions, for everyone
• Private oral healthcare system:
high quality delivery of cost effective interventions for
everyone