ISLAMABAD, June 4: The public health sector in Pakistan suffers from considerable inadequacies with only one doctor available for 1,310 patients, one dentist for 25,297 people and one nurse for 4,636, according to the Economic Survey 2005-06 released here on Sunday.

Although the ratio between available health facilities and the population has recorded a slight improvement over last year and the number of doctors has increased with the annual addition of around 5,000 medical graduates from private and public sector medical colleges, it is still far below the recommended ratio of one doctor for 1,000 patients.

However, in terms of dentists and nurses, the ratio has recorded a decline compared to the last year when there was one dentist for 25,107 and one nurse for 3,175 people.

The total number of doctors registered with the Pakistan Medical and Dental Council till 2005-6 is 118,160 (18,029 specialists), the number of registered dentists 6,761 (387 specialists) and that of registered nurses 33,427.

There are many bonafide doctors, dentists and nurses who are not registered with the PM&DC but are practising in public-sector medical facilities and private clinics.

In human welfare indicators, Pakistan is still lagging behind compared to other Asian countries, like China, Thailand, Indonesia, India, Sri Lanka and Bangladesh. Poverty, malnutrition, unequal distribution of health facilities and inadequate allocation for the health sector are to be blamed for these deficiencies.

Drug addiction is a growing problem among the youth, with approximately five million addicts of whom 50 per cent are addicted to heroin. The growing number of addicts using syringes poses a great challenge when one considers hidden cases of HIV/Aids and Hepatitis-C.

The use of narcotics also contributes to crime and adds to the cost of already over-burdened healthcare system and the financially strapped social welfare system.

Pakistan is in the middle of an epidemiological transition where almost 40 per cent of the total burden of disease is accounted for by infectious/communicable diseases. These include diarrhoea, acute respiratory infections, malaria, tuberculosis, hepatitis B and C and childhood diseases. Another 12 per cent is due to reproductive health problems. Nutritional deficiencies, particularly iron deficiency anaemia, Vitamin A deficiency and Iodine deficiency disorder, account for a further six per cent of the total.

Non-communicable diseases caused by sedentary lifestyles, environmental pollution, unhealthy dietary habits, smoking, cardiovascular disease, cerebra, vascular accidents diabetes and cancers account for almost 10 per cent of the burden of diseases.

With the increase in life expectancy, disease disability of old age, especially eye problem, paralysis and bone diseases, are also on rise.

In 2005-06, the economic survey said, the total expenditure on health was estimated at Rs40billion of which Rs16 billion was allocated for development and Rs24 billion for current expenditure. These expenditures have shown an increase of 5.3 per cent over last year and worked out to be 0.51 per cent of the GDP.

Over the past three years, public-sector expenditures on health have increased on an average by 11.7 per cent per annum as against 10.6 per cent per annum during the previous five years.

There are 946 hospitals, 5,290 basic health units and sub-health centres, 4,554 dispensaries, 907 mother and child health centres, 552 rural health centres and 289 tuberculosis centres primarily run by provincial governments throughout the country, the report says.