Islamabad Health Equity Model launched

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Islamabad Health Equity Model launched

The concept of ‘Equity in Health’ is not only new but the model to implement health equity which raises level of poor, decrease gap between rich and vulnerable is absolutely creative. It is the first of its type in the national history. Even in the regional context this model is unique and gives boost to develop an environment for ‘Health for All’.

The Islamabad Health Equity Model was launched by Directorate of Health Services, Capital Development Authority in the presence of Munir Ahmed Chaudhry-CDA’s Member Administration, Dr. Hasan Orooj-DHS Director General, Ejaz Rahim-Former Cabinet & Health Secretary and Dr. Ghulam Nabi Kazi from World Health Organisation. A large number of professionals from national and international institutions including civil society members were also present on the occasion.

The model is a tool based on indigenously derived evidence gathered as part of a baseline equity assessment of the socio-demographic and health indicators of Islamabad. The assessment, which is the first-ever study of its kind, has identified existing gaps in the health status of people falling in different income quintiles in Islamabad. It provides foundation for implementation of interventions which will enable the residents of Islamabad to enjoy equitable access to health services, regardless of the vast disparities characterizing the city’s haves and have-nots.

Sharing his views on the occasion, Dr. Hasan Orooj-DHS Director General informed that the study had a sample size of 770, with one respondent being chosen and interviewed from selected households. Of the total respondents, 84 per cent were males and 16 per cent were females. According to area of residence, 29 per cent of the respondents were from I-10, 22% from Dhoke Abbasi, 14.5% from G-10, 13% from G-8, 11% from F-8, and 10.6% from Rawal Town.

Sharing the social and demographic findings of the study, he said that sectors F-8, I-10 and G-8 have higher educational status as compared to Dhoke Abbasi and Hansa Colony, showing a strong association of income with educational attainment. The age of marriage is 19 years in the lowest income quintile and 26 years in the highest income group. A majority of the respondents (76.4%) are residing in self-owned accommodation while 15.7% are living in hired and only 8% in government houses. The vast disparity in quality of life of the residents of Islamabad is evident from the fact that a majority of the respondents from the lowest income group have one or two rooms in their houses, but a larger household size, implying a lifestyle marred by overcrowding. Those in the highest income group, on the contrary, have more than five rooms to themselves.

With reference to economic factors, the study informs that a 94.2% of the respondents are employed while 5.8% are jobless. The income level reported by the respondents ranged from Rs4,000 to Rs500,000 per month. The study, therefore, created five income quintiles of 20% each to compare the various indicators for an assessment of equity issues. The study also throws light on the association of income levels with area of residence.

Regarding the use of transport, 55.4% respondents have self-owned vehicles, 41.5% use public transport, and only 2.6% use government transport for commuting. The mode of transport is different in different income groups as well. For instance, 85% of the lowest income quintile group report use of public transport, which makes it necessary for Islamabad to have an efficient public transport system. Referring to behavioural factors, he said the study reports equity in smoking. There is not a significant difference in the level of smoking regarding income levels, age of initiation, and number of cigarettes smoked per day. It is almost similar in all income quintiles.

Some of the worrying findings of the study are that one-fifth of the respondents are having less than 6 to 8 hours of sleep; that only 6% respondents in Hansa Colony and 5% in Dhoke Abbasi consume fruits on a daily basis. On the other hand, 40% respondents in I-10, 22% in F-8 and 18% in G-8 have a daily pattern of fruit consumption. About 69% respondents report restricted salt and sugar intake. Within households practicing such restriction, the highest percentage is from I-10 and the lowest from Hansa Colony and Rawal Town; 53% respondents in the lowest income quintile report restricted intake of sugar and salt as against 82% in the highest income quintile. On a positive note, 99% respondents report handwashing before meals and over 97% report hand washing after using the toilet.

Dr. Hasan Orooj speaking on health factors said that half of the respondents do not have any kind of disease. With in the remaining half, the most common disease is hypertension (29.9%), followed by diabetes (14.5%), haemorrhoids (13.5%), and arthritis (8.2%). Asthma, arthritis and haemorrhoids are more common in I-10, Dhoke Abbas and Hansa Colony while non-communicable diseases are more prevalent in F-8 and G-8. This shows that people in the lower income quintile are not aware of the silent killers and are not being screened for hypertension and heart disease. Secondly, over 97% of the respondents go to a general practitioner when unwell. In 88% of the cases, distance of GP from home is less than 5 kilometres. Thirdly, young age pregnancy stands at 45% in the lowest income group, as against only 10% in the highest income group. Fourthly, 86.2% respondents report the use of government health facilities in case of illness. Interestingly, the overall use of government health facilities is only 58% in the lowest income and 100% in the highest income quintiles, which means that the affluent are making the best of these facilities.

The study informs that the filtration plants of CDA are the most common source (40.6%) of drinking water, followed by bore water (31.3%), boiled water (14.3%) and mineral water (8.8%). He attributed it to public trust in the CDA’s filtration plants and advised CDA to revisit its filtration plant strategy with a focus on rural areas. The study also highlights the need for a proper waste disposal system in low income areas.

Ejaz Rahim recommended to present the study to the CDA Board for appropriate policy making in order to take practical steps for the benefit of the citizens of Islamabad can be taken. He urged DHS to work out a package of basic interventions required to ensure health equity and pay heeds to manpower requirements, resource availability, strengthening of existing structures and streamlining of processes under an able leadership.

Munir Chaudhry termed to Islamabad as a fast growing city that stood firm in various health emergencies and natural disasters without any additional resources being allocated. He conceded that conditions in the city’s urban slums are conducive for the spread of communicable diseases.

Dr. Shahzad, Technical Team Member of the study shared methodology of data collection exercise. In the end, Dr. Ghulam Nabi Kazi regretted the fact that Pakistan is yet to have a health policy. He said that living conditions in urban slums are often worse than those in the rural areas.

2017-04-26T12:35:09+00:00