Health and the SDGs 2021: Pakistan

Health and the SDGs Pakistan Selected determinants of health Population living in urban areas (%) (2021) 37.0 Annual GDP growth (%) ( 2021) 6.5 Population growth rate (%) (2020) 2.0 Children aged < 5 years with pneumonia symptoms taken to a health care provider (%) ( 2018) 71.0 Universal health coverage UHC service coverage index (2021) 45.0 Primary health care facilities per 10 000 population (2021) 0.6 Hospital beds per 10 000 population (2021) 10.1 Demand for family planning satisfied with modern methods (%) ( 2021) 52.0 Antenatal care visits (4+ visits) (2018) 51.4 Measles immunization coverage among 1-year olds (%) (2021) 81.0 Tuberculosis treatment coverage rate (2021) 55.0 DTP3-containing vaccine/pentavalent coverage among 1-year olds (%) (2021) 83.0 Out-of-pocket expenditure as percentage of current health expenditure (2017) 56.0 Domestic general government health expenditure as % of general government expenditure (2021) 5.0 Neonatal, infant and under-5 mortality rates per 1000 live births Distribution of causes of death among children aged < 5 years (%) Pneumonia (ALRI), 14.4% Prematurity, 22.8% Birth asphyxia/trauma, 14.5%Sepsis & other infec�ons, 9.3% Congenital anomalies, 5.5% Diarrhoea, 8.2% Malaria, 0.0% Measles, 1.4% HIV/AIDS, 0.1% Meningi�s/encephali�s, 2.9% Injuries, 6.6% Others, 14.2% Top 10 causes of death for both sexes and all ages (2019) 0 20 40 60 80 100 120 Tuberculosis Cirrhosis of the liver Kidney diseases Diabetes mellitus Lower respiratory infections Chronic obstructive pulmonary disease Diarrhoeal diseases Stroke Neonatal conditions Ischaemic heart disease Deaths per 100 000 population Communicable, maternal, perinatal and nutritional conditions Noncommunicable diseases 0 50 100 150 200 250 300 2000 2005 2010 2015 2020 Ra te p er 1 00 0 liv e bi rt hs Neonatal mortality Infant mortality Under-5 mortalitySource: UN-IGME 2021 W H O -E M /H ST /2 60 /E Net primary school enrolment ratio per 100 school-age children (2020) Total ratio 64.0 Male ratio 68.0 Female ratio 60.0 Literacy rate (15–24 years) (2019) (%) Total 72.0 Male 79.0 Female 65.0 Population below the international poverty line (2017) (%) 37.0 Proportion of employed population below the international poverty line 15+ (%) (ILO modelled estimate, 2019) Male 3.3 Female 4.0 Children under 5 (%) who are (2018) stunted 37.6 wasted 7.1 overweight 2.5 Population with primary reliance on clean fuels and technologies at the household level (%) 49.3 (WHO Global Health Observatory, 2020) Proportion of population using safely managed drinking water services (%) (World Health Statistics, 2020) 36.0 Proportion of population using safely managed sanitation services (%) (World Health Statistics, year) … Unemployment rate (15+ years) (%) (ILO estimate, 2021) Total 6.3 Male 5.5 Female 9.2 Concentrations of fine particulate matter (PM2.5) (μg/m3) (WHO Global Health Observatory, 2019) Total 50.1 Urban 51.6 Estimates of rate of homicides (per 100 000 population) (WHO Global Health Observatory, 2019) 6.0 Selected health-related SDG indicators Indicator Male Female Total Life expectancy at birth in years (2019) 64.6 66.7 65.6 Healthy life expectancy (HALE) at birth (years) (2019) 56.9 56.8 56.9 Healthy life expectancy (HALE) at 60 (years) (2019) 12.6 12.5 12.6 Maternal mortality ratio (deaths per 100 000 live births) (UN-MMEIG 2020 estimate) — — 154.0 Neonatal mortality rate (deaths per 1000 live births) (UN-IGME 2021 estimate) … … 39.4 Infant mortality rate (deaths per 1000 live births) (UN-IGME 2021 estimate) 57.4 47.8 52.7 Under-5 mortality rate (deaths per 1000 live births) (UN-IGME 2021 estimate) 67.5 58.8 63.3 Tobacco use among persons 15+ years (%) (2019) 34.3 7.8 21.0 Overweight (18+ years) (%) ( 2016) … … 41.3 Obesity (18+ years) (%) (2016) … … 14.9 Raised blood pressure among persons 18+ years (%) ( 2017) … … 46.2 Raised blood glucose among persons 18+ years (%) ( 2017) … … 26.3 Raised cholesterol among persons 18+ years (%) (year) … … … Mortality between exact ages 30 and 70 from cardiovascular disease, cancer, diabetes or chronic respiratory disease (%) ( 2019) 31.8 26.8 29.4 Cancer incidence per 100 000 ( 2020) 107.0 113.7 110.4 Key health indicators Universal health coverage (UHC) means provision of quality services to everybody without discrimination of any kind and without exposing people to financial hardship. UHC is one of the targets of SDG 3, and attaining UHC will also contribute directly or indirectly to achieving the other SDGs. Achieving UHC means ensuring healthy lives and promoting well-being for all at all ages with explicit affirmative action for vulnerable populations including refugees and migrants. Thus, disaggregated data will be necessary to assess and address inequities in health. UHC requires intersectoral action. All countries can and must advance towards UHC by 2030, if not earlier. Source: Progress on the health-related Sustainable Development Goals and targets in the Eastern Mediterranean Region, 2020. Cairo: WHO Regional Office for the Eastern Mediterranean; 2022. Availability of data for each SDG 3 indicator: no data, one and at least two data points, 2014–2019 3. 1. 1 M at er na l m or ta lity ra tio 3. 1. 2 Sk ille d bir th a tte nd an ce 3. 2. 1 Un de r-5 m or ta lity ra te p er 1 00 0 liv e bir th s 3. 2. 2 Ne on at al m or ta lity ra te p er 1 00 0 liv e bir th s 3. 3. 1 Nu m be r o f n ew H IV in fe cti on s 3. 3. 2 TB in cid en ce 3. 3. 3 M ala ria in cid en ce (p er 1 00 0 po pu lat ion a t r isk ) 3. 3. 4 He pa titi s B vi ru s p re va len ce a m on g ch ild re n un de r 5 ye ar s 3. 3. 5 Nu m be r o f p eo ple re qu irin g int er ve nt ion s a ga ins t le ish m an ias is 3.4 .1 Pr ob ab ility of dy ing be tw ee n a ge 30 an d e xa ct ag e 7 0 f rom C VD , c an ce r, d iab ete s, CR D 3. 4. 2 Su ici de m or ta lity ra te (d ea th s p er 1 00 0 00 p op ula tio n) 3. 5. 2 Al co ho l c on su m pt ion p er ca pit a (a ge d 15 ye ar s a nd o lde r) 3. 6. 1 D ea th ra te fr om ro ad tr af fic in ju rie s pe r 1 00 0 00 3. 7. 1 D em an d fo r f am ily p la nn in g sa tis fie d w ith m od er n m et ho ds 3. 7. 2 A do le sc en t f er til ity (1 5− 19 y ea rs ) r at e (p er 1 00 0 gi rls ) 3. 8. 1 UH C se rv ice co ve ra ge in de x 3. 8. 2 La rg e ex pe nd itu re s o n he alt h as a sh ar e of to ta l h ou se ho ld ex pe nd itu re (> 10 % ) 3. 9. 1 M or ta lit y ra te a ttr ib ut ed to h ou se ho ld a nd a m bi en t a ir po llu tio n 3. 9. 2 M or ta lit y ra te a ttr ib ut ed to u ns af e w at er , u ns af e sa ni ta tio n an d la ck o f h yg ie ne 3. 9. 3 M or ta lit y ra te a ttr ib ut ed to u ni nt en tio na l p oi so ni ng s 3. a. 1 To ba cc o us e (a ge d 15 ye ar s a nd o lde r) (% ) 3. b. 1 Va cc ine co ve ra ge (D TP 3) 3. b. 1 Va cc ine co ve ra ge (M CV 2) 3. b. 1 Va cc ine co ve ra ge (P CV 3) 3. b. 2 To ta l n et O DA to m ed ica l r es ea rc h 3. b. 3 Av ail ab ilit y o f s ele cte d es se nt ial m ed ici ne s ( pu bli c h ea lth fa cil itie s) (% ) 3. c.1 P hy sic ian s p er 1 0 00 0 po pu lat ion 3. c.1 N ur sin g an d m idw ife ry p er 1 0 00 0 po pu lat ion 3. c.1 P ha rm ac ist s p er 1 0 00 0 po pu lat ion 3. c.1 D en tis ts pe r 1 0 00 0 po pu lat ion 3. d. 1 IH R an nu al re po rti ng 3. d. 2 Pe rc en ta ge o f b loo ds tre am in fe cti on s d ue to E SB L- E. co li 3. d. 2 Pe rc en ta ge o f b loo ds tre am in fe cti on s d ue to M RS A Yemen United Arab Emirates Tunisia Syrian Arab Republic Sudan Somalia Saudi Arabia Qatar Pakistan Oman Occupied Palestinian territory Morocco Libya Lebanon Kuwait Jordan Iraq Iran, Islamic Republic of Egypt Djibouti Bahrain Afghanistan No d at a On e da ta p oin t At le as t t wo d at a po int s No t a pp lic ab le Developed jointly by: Department of Science, Information and Dissemination Chef de Cabinet office © World Health Organization 2023 Some rights reserved. This work is available under the Creative Commons Attribution- NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons. org/licenses/by-nc-sa/3.0/igo). Health and the SDGs at a glance in Pakistan Voluntary National Review Completed in 2019: https://hlpf.un.org/countries/pakistan/ voluntary-national-review-2019 Completed in 2022: https://hlpf.un.org/countries/pakistan/ voluntary-national-review-2022 National Focal Point for 2030 Agenda Mr Ali Kemal, Chief SDGs, Federal SDGs Support Unit, Ministry of Planning, Development & Special Initiatives National Focal Point in the Ministry of Health for health-related SDGs Dr Sabeen Afzal, Deputy Director, Ministry of National Health Services, Regulation and Coordination 1. Summarize efforts at the national level in setting targets for health-related SDGs. Health-related SDG targets have been locally set at national, provincial and district levels through an extensive multi- stakeholder consultative process, and integrated in national public health policy and planning documents. A digital monitoring and reporting system, aligned with the various health management and non-health ministry information systems, has been established and a national progress report on SDG-3 and the other health-related SDGs is being developed. A mobile and web-based application on SDG-3 and the health-related SDGs was launched in 2021 and the SDG-3 Global Action Plan for Healthy Lives and Well-being for All is being implemented through an intersectoral road map. 2. How is Pakistan incorporating SDG 3 targets in health policy, strategy and planning? Locally-adapted targets, indicators and milestones for SDG-3 are incorporated in key health policy, strategy and planning documents, including the national health vision (2016–2025) and action plan (2019–2023) and different frameworks and strategies for digital health, human resources for health, noncommunicable diseases and mental health, immunization, AIDS, malaria, tuberculosis, infection prevention and control, and an essential package of health services and universal health coverage. 3. Are there any major partnerships for advancing the health-related SDGs? Key partnerships for advancing the health-related SDGs include those for the SDG-3 Global Action Plan for Healthy Lives and Well-being for All and for the World Bank and Multi-donor Trust Fund-supported National Health Support Programme 2022– 2027, as well as with USAID for supply chain, the UK Foreign, Commonwealth & Development Office for universal health coverage reforms and UNFPA, UNICEF and WHO for a range of activities. 4. Describe a success story or an opportunity for strengthening the health system for COVID-19 that supports efforts towards achieving one or more of the SDG health-related targets. Pakistan responded to the COVID-19 pandemic through a whole- of-government approach within a devolved national context. The response was an opportunity for health system strengthening and contributing towards multiple health-related SDGs targets. It involved developing and disseminating standard operating procedures for health and front-line workers, the general public, and the public and private sectors, including clinical, vaccination and travel guidelines. Recording and reporting mechanisms were established or strengthened and access to testing and treatment massively expanded. This included providing COVID-19 testing at 180 laboratories in the public and private sector, enabling around 100 000 tests per day, expanding ICU bed allocation, oxygen supply and cold chain capacity, and vaccinating around 124 million people or 80.6% of the eligible population.