How does the healthcare system work in Pakistan?

What is the quality of healthcare in Pakistan?

• Living in Pakistan does have some challenges when it comes to healthcare. There are good facilities in the big cities, but in serious situations evacuation is sometimes necessary.
• Pakistan has a mixed healthcare system of public and private healthcare and there is a lot of cooperation between these sectors.
• Since the government abandoned public healthcare, private healthcare has taken on a more important role. Unfortunately, the majority of Pakistanis do not have access to healthcare due to the high costs.
• Access to adequate healthcare really depends on where you live. The best facilities are in big cities such as Lahore, Karachi and Islamabad.
• There is no reliable system for emergency medical services. The fastest way to get to a healthcare facility is to take your own transport or a taxi.
• Pharmacies are easy to find in urban areas and are usually well stocked.

How does the public healthcare system work in Pakistan?

• There is a universal public healthcare system. Free healthcare is available, but it is very limited and subject to extreme shortages of facilities, staff and equipment. The biggest source of this problem is the consistent underfunding of the sector by the government.
• The continuous turnover of the government due to political unrest also plays a major role in the absence of good health care policy.
• Public care is still lagging far behind modern health care, hygiene leaves much to be desired and waiting times are long. Foreigners in Pakistan therefore usually do not use public care, nor do the wealthier locals.

How does the private healthcare system work in Pakistan?

• Private care is a lot better, in the larger cities. Hospitals are well equipped, medication is generally available and the doctors are well trained.
• Unfortunately, private care is a lot more expensive, which means that most Pakistanis do not have access to private care.
• Some of the best hospitals are the Aga Khan University Hospital, the Seventh Day Adventist Hospital in Karachi and the Shifa Medical Center and Pakistan Institute of Medical Sciences in Islamabad.

How is the general practitioner arranged in Pakistan?

• There is no general practitioner system in Pakistan. Usually people go directly to a public or private clinic or hospital.

How is the dentist arranged in Pakistan?

• There are major extremes in the field of oral care in Pakistan. Local dentists earn little and many are unemployed. Locals cannot afford dental care and there are illegal street dentists who help these people in self-established street clinics.
• For wealthy Pakistanis and other people who can afford it, there are good, foreign-trained dentists available in the big cities. The clinics are ultramodern and offer good dental care and are also very expensive.

How is pregnancy care arranged in Pakistan?

• The child and maternal mortality rates in Pakistan are among the highest in the world. This is due to malnutrition, poor hygiene and limited access to medical care.
• Teenage pregnancies are still a problem, especially in conservative communities where girls marry at a young age.
• Pregnancy is seen as a blessing, and the family (especially in-laws) often plays a major role in the care and decisions surrounding the birth. Mothers-in-law often have a lot of influence on how a woman goes through her pregnancy and delivery, which can sometimes be a pressure.
• As is perhaps obvious, medical care in Pakistan is very unequal. In the big cities there are facilities for pregnant women and newborns, but outside of that it will be difficult.
• In rural areas, care is much less accessible. Women often have to travel long distances to get medical help. In some areas, deliveries are still done at home by traditional birth attendants (dais). They can have valuable knowledge, but do not always have the medical expertise to deal with complications.
• Antenatal care is not a given for many women, especially in conservative communities. Many women only visit a doctor when complications arise.
• In the bigger cities, ultrasounds and blood tests are regularly offered in private hospitals and clinics.
• Iron and folic acid supplements are often recommended because of the high risk of anaemia in pregnant women.
• For childbirth, local women often choose public hospitals because of the cost, even though the conditions are often not good. In private hospitals, care is better and expensive.
• C-sections are becoming increasingly common, especially in private clinics, where they are sometimes performed unnecessarily for financial reasons.
• Mothers are often given a special diet after giving birth, with lots of nuts and herbs to help the body recover.
• Abortion is strictly regulated in Pakistan and in most cases illegal.

How safe or unsafe is a trip or stay in Pakistan?

What should you pay attention to in terms of safety in Pakistan?

• Pakistan is located in a seismically active region and has experienced severe earthquakes in the past. It is important to be aware of local emergency procedures and be prepared for possible earthquakes.
• During the monsoon season (July to September), heavy rains and flooding can occur, especially in Punjab and Sindh. Travelers should monitor weather forecasts and take precautions.
• Balochistan and Khyber Pakhtunkhwa, including the former FATA areas, are considered unsafe due to terrorist activity and armed conflict. The border areas with Afghanistan and Iran are also prone to tensions and are not recommended for non-essential travel.
• Kashmir, a disputed territory between India and Pakistan, is frequently subject to military tensions. Travel around the Line of Control (LoC: a military control line) in Jammu and Kashmir province is not recommended. 

What should you look out for in terms of diseases in Pakistan?

• Diseases such as dengue and malaria are common in Pakistan, especially in the summer and rainy months. Protect yourself by wearing protective clothing and using spray.
• Tuberculosis is common, especially in busy urban areas.
• Tap water is not safe to drink, always drink bottled water or use a good water filter.
• Air pollution can also be a major problem, especially for people with respiratory problems. The most extreme air pollution occurs in Lahore and Karachi, especially in the winter months.

What should you pay attention to when it comes to traffic in Pakistan?

• Expect chaotic traffic in Pakistan. It is as if traffic rules do not exist and everyone takes their stress out in traffic. Also, don't be surprised if you have to overtake a slow donkey cart on the highway.
• Traffic lights and stop signs are just street decorations for some people.
• Distances between major cities are large. Highways are good, but local roads can be quite bumpy.
• For long distances, domestic flights are the fastest and safest way.
• Public transport is cheap, but not always reliable. Rickshaws and Careem/Uber are good options in cities.

What work and travel insurance policies are suitable for short and long stays in Pakistan?

• Is the trip to Pakistan and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you take out for Pakistan if you are going to live there for a while?

• Although it is generally not mandatory to take out international health insurance for a visa for Pakistan, it is strongly recommended. The health care system is substandard, or (very) expensive and there are many health risks in the country. 
• Make sure your insurance covers medical evacuation as well as coverage in neighboring countries. Read more about insurances for abroad on Expatinsurances.org.