THIS is apropos of Shumaila Usman’s letter ‘Reform in health sector’ (Aug 15) and Mehtab S. Karim’s article (Aug 4). I would like to highlight possible solutions to the problem that is healthcare discrepancies that they rightly highlighted.

As a doctor in a developing country like Pakistan which is overwhelmed with poverty, political instability and natural disasters, you cannot neglect the striking statistics of a maternal mortality ratio of 260 per 100,000 live births and under-five mortality rate of 94 deaths per 1,000 live births.

Further, the considerably low doctor-to-patient ratio of almost one doctor to 1,250 patients in the country makes it only worse. These statistics also reflect that comprehensive changes required to be made in the current health policy.

Despite South Asia’s rapidly growing economies, budget allocations on health and education sectors remain alarmingly low. In Pakistan, the expenditure on health as percentage of the GDP is as low as 2.6 (World Bank 2010), which indicates low interest of the policymakers in this department.

The conventional understanding is the health status of a nation is determined by its wealth. In my opinion, income is not the most critical factor in explaining global health outcomes and that improving the health standards in the poorest of countries does not have huge financial requisites.

The challenge is to ensure that a cheap basic package of health interventions is available to all. The political will to bring about a tangible change is all that is required.

In a country like Pakistan where around 60 per cent of the population make less than $2 a day, micro health insurance is the perfect health reform that offers some form of social security and inclusivity to the vast majority of the people who cannot afford to pay for ‘private’ healthcare.

Also, this is bound to shift patients load from the poorly managed public health facilities to the private sector which has much more capacity.

Naya Jeevan, a social enterprise providing micro-health insurance, is connected to over 120 private hospitals nationwide, where its beneficiaries can avail themselves of cashless health services worth up to Rs150,000.

Dr SHIFA S. HABIB Karachi