KARACHI, Oct 5: Sindh is lagging behind the rest of the country in health indicators, revealed an analysis carried out by the health department for the newly launched Sindh Health Sector Strategy (2012-2020).

The health department had carried out an evidence-based situational analysis from September to November 2011 for the eight-year health plan announced on Thursday. The report presents an overview of the current health situation and also points out the weak areas in the operational health system.

According to the evidence-based report, detection of tuberculosis has reached 59 per cent in Sindh, while it was 70 per cent in the rest of the country. The prevalence of Hepatitis B and C remained a major concern while around 52 per cent of the total HIV cases have been reported from Sindh, particularly the urban areas.

In children’s health, Sindh has the highest rate of undernourished children, 40 per cent. The report adds that 62 per cent mothers in the province are also undernourished and 73 per cent children anaemic, while food insecurity is as high as 72 per cent.

Giving an overview of the health conditions across the province, the report stats that only 27 per cent childbirths take place in proper health facilities, 70 per cent children below the age of one year are immunised for measles, 11 per cent couples of child-bearing age practice contraception, while 22 per cent people in Sindh use public sector health facilities as compared to 29 per cent in the rest of the country.

The report also highlights an alarming trend in illnesses in urban areas. According to it, non-communicable diseases in Sindh are endemic to economically productive adults and account for 56 per cent of the total number of patients.

The number of patients in urban areas is higher in Sindh as compared to other provinces since the urban areas are more heavily populated here than the rest of the country. The most prevalent condition is said to be the ischemic heart disease, followed by mental health disorders and trauma, while chronic obstructive lung diseases and various forms of cancers make up the remaining percentage. The analysis also reveals that non-communicable diseases mostly affect the urban poor and also have an earlier age of onset.

“Karachi has one of the highest global rates of particulate air pollution and breast cancer,” says the report. “Despite high prevalence levels most of the patients are unaware of the onset of diseases which were also inappropriately controlled.”

The report also sheds light on some specific problems which need to be addressed. It called for special focus on nutrition, polio and prevalence of non-communicable diseases and strengthening of district health networks. “Provision of maternal and child health services, contraception, vaccination and communicable disease control is patchy because of poorly functional basic and emergency services,” it reads.

In the report, the lady health workers programme (LHWP) is referred to as a flagship programme of the Sindh health department for community intervention, while observing that it covers between 20 and 43 per cent areas in certain districts. However, the LHWs neither have proper technical knowledge nor are they properly supervised.

The analysis also refers to human resource deployment in the province and stated that the deployment, retention and capacity of staff was sub-optimal in rural areas, especially when it comes to female staff.

The report also calls the provision of basic medicines in public sector health facilities ‘poor’. This is also endorsed by various stakeholders who also called for concerted action on maternal, newborn and child health programme, nutrition and non-communicable diseases, among other fields.

According to Kiran Nauman, the additional secretary of the health department and chief of the Health Reforms Support Unit established by it, introduction of family health cards for free consultation services and drugs, and subsidised charges for diagnostic support for the lower-income groups has also been planned under the newly evolved health strategy.

Moreover, primary and secondary control of non-communicable diseases and lifestyle support in urban townships would also be streamlined, she added.