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Pakistan's health system has a critical role to play in global health security, however, it faces numerous structural and systemic challenges while contributing to international health efforts. Understanding the dynamics of health system is essential for developing effective strategies to prevent, detect, and respond to health emergencies, ensuring regional stability, and the overall global health security This paper documents the strengths and weaknesses of Pakistan's health systems, the impact of the COVID-19 pandemic, challenges such as funding constraints and fragmented healthcare delivery, threats including antimicrobial resistance, and the importance of international collaboration. Anti-microbial particularly multi-drug resistance, food safety in emergencies, surge capacity of the frontline workforce, patient safety at the health care facilities to curtail healthcare associated infections, and strengthening the points of entry are still the areas that need special attention. To optimise the system's performance, governance and accountability mechanisms are necessary to be put in place under the auspices of national public health agency. Pakistan has the potential to transform its health system by addressing these critical areas and improve its preparedness and readiness for any future health emergency of this scale.
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The attainment of the noble objective of Universal Health Coverage (UHC)- 'leaving no one behind' necessitates sufficient financial resources, an ample supply of skilled healthcare professionals, and the availability of essential services as part of a basic package This paper presents an analysis of the health system, health seeking behaviours and health service utilization en route to UHC in Pakistan. We have used the UHC 14 tracer indicators of service coverage to see where Pakistan stands, what are the gaps and what needs to be done. Pakistan clearly is lagging behind its neighboring countries. The country's health system ought to work on health seeking behaviours and broader determinants of health. The pursuit of UHC demands a shared responsibility and collective action, with stakeholders from different sectors uniting their efforts and expertise. Together, they can establish robust systems, design comprehensive policies, allocate adequate resources, and implement interventions that transcend disciplinary boundaries.
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Depression among married women of reproductive age is on the rise in Pakistan, owing to post-COVID-19 phase, super-inflation, increasing poverty, deteriorating law and order situation and perpetuating the uncertain political situation in the country. This study aimed to investigate the factors associated with depression among married women of reproductive age in Pakistan, using a mixed methods approach. The quantitative phase utilized the Urdu version of the Patient Health Questionnaire-9 (PHQ-9) to assess depression among 340 married women. Twelve women with higher scores on the PHQ-9 were selected for in-depth interviews in the qualitative phase. The quantitative analysis revealed a higher prevalence of depression among women with poor socioeconomic status, lower educational levels, larger family sizes, and recent deaths in the family. In the qualitative phase, the main themes identified were the impact of social conditions, such as societal expectations and gender roles, the influence of medical conditions on mental health, financial difficulties, the stress associated with caring for a larger number of children, and the emotional burden of recent deaths in the family. This study highlights the importance of addressing depression among married women of reproductive age in Pakistan. It is crucial to focus on early diagnosis and prompt treatment to mitigate the adverse effects of depression on the affected individuals and their families. Targeted interventions should consider the social determinants of depression, including improving socioeconomic conditions through safety nets, providing mental health support at the primary health care level, and addressing the specific health issues and needs of women in the reproductive age group. A multi-pronged approach and health system's thinking can reduce the burden of depression among women, ultimately enhancing their overall well-being, productivity and quality of life.
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COVID-19 , Saúde Global , Acessibilidade aos Serviços de Saúde , Humanos , COVID-19/epidemiologia , Saúde Global/estatística & dados numéricos , Feminino , Criança , Pandemias , Serviços de Saúde Materno-Infantil/organização & administração , Gravidez , Serviços de Saúde da Criança/organização & administração , Serviços de Saúde Materna/estatística & dados numéricos , Serviços de Saúde Materna/organização & administraçãoRESUMO
BACKGROUND: Effective skills and training for physicians are essential for communicating difficult or distressing information, also known as breaking bad news (BBN). This study aimed to assess both the capacity and the practices of clinicians in Pakistan regarding BBN. METHODS: A cross-sectional study was conducted involving 151 clinicians. Quantitative component used a structured questionnaire, while qualitative data were obtained through in-depth interviews with 13 medical educationists. The responses were analyzed using descriptive statistics and thematic analysis. RESULTS: While most clinicians acknowledged their responsibility of delivering difficult news, only a small percentage had received formal training in BBN. Areas for improvement include time and interruption management, rapport building, and understanding the patients' point of view. Prognosis and treatment options were not consistently discussed. Limited importance is given to BBN in medical education. DISCUSSION: Training in BBN will lead to improved patient and attendants' satisfaction, and empathetic support during difficult times.
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Comunicação , Relações Médico-Paciente , Revelação da Verdade , Humanos , Paquistão , Estudos Transversais , Masculino , Feminino , Inquéritos e Questionários , Adulto , Médicos/psicologia , Pesquisa Qualitativa , Competência Clínica , Entrevistas como Assunto , Pessoa de Meia-Idade , Atitude do Pessoal de SaúdeRESUMO
Burnout and emotional exhaustion are becoming common among health workers in the busy teaching hospitals due to increased workload and the dearth of human resource. This study aimed to determine the causes of burnout among doctors and across gender differences. This was a descriptive cross-sectional study conducted in the Fauji Foundation Hospital, Rawalpindi, Pakistan, from 1st July to 30th September 2022. Two hundred and forty-five randomly recruited doctors who filled out self-administered questionnaires were included in the study. Independent samples t-test was used for comparison of the mean emotional burnout score. Female doctors felt more emotionally drained, more fatigued, and more worn out from work than male doctors (p < 0.05). Overall emotional exhaustion was also higher in female doctors (p < 0.05). This situation was more serious during the COVID-19 pandemic. Gender-sensitive environments, workplace policies, and necessary interventions will save physicians' burnout and brain drain. Emotional burnout is greater in female doctors as compared to their male counterparts. This evidence not only calls for prevention and treatment but also certain service-related reforms to facilitate female physicians to balance out their work and family lives more effectively. Key Words: Physicians, Emotional exhaustion, Burnout, Gender difference, Pakistan.
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Esgotamento Profissional , Médicos , Centros de Atenção Terciária , Humanos , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Feminino , Masculino , Estudos Transversais , Paquistão/epidemiologia , Adulto , Médicos/psicologia , Fatores Sexuais , Inquéritos e Questionários , COVID-19/psicologia , COVID-19/epidemiologia , Carga de Trabalho/psicologia , SARS-CoV-2 , Pessoa de Meia-Idade , Satisfação no Emprego , Local de Trabalho/psicologia , Médicas/psicologia , Médicas/estatística & dados numéricosRESUMO
Objectives: Amidst inconsistent prescribing patterns and potentially harmful medication errors in the field of medical practice, this study endeavored to explore the prescription practices of physicians in Rawalpindi metropolitan city in Pakistan. Methods: A mixed method study was conducted based on the analysis of 1232 prescriptions gathered from 16 pharmacies, along with in-depth interviews with 13 practicing physicians. The prescriptions were assessed for legibility, polypharmacy, patient details, history, diagnosis, and other relevant information. Data were analyzed using descriptive statistics, and the prevalence of various aspects of prescription accuracy was calculated. Thematic analysis was conducted on the qualitative data. Results: Almost half of the prescriptions were from the private general practitioners, and the rest were from hospital-based doctors and consultants. Only a small percentage of prescriptions were fully legible, and many had incomplete or missing patient information, medical history, and diagnosis. Polypharmacy was also found to be prevalent, with significant differences in prescription accuracy across different medical specialties. The absence of continuing medical education, influence of pharmaceutical industry, and overcrowded practice settings drive the doctors to prescription practices. On the user side, perception of polypharmacy, patient-physician communication, and availability and cost of medicines emerged as major themes. Conclusion: There is an obvious need to improve prescription accuracy regarding patient safety on the whole. Increased investment in health-care infrastructure, greater access to continuing medical education, and a commitment to promote evidence-based medicine could make a difference. Prescription practices must be safe, effective, and aligned with the latest advances in medical science.
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OBJECTIVE: In 2022, Pakistan witnessed unprecedented flooding, submerging one-third of the country under-water, ruining millions of houses, taking lives, afflicted injuries, and displacing scores of people. Our study documents not only the public health problems that have arisen due to this natural calamity but also the state of health systems' response. METHODS: We conducted a qualitative study asking key questions around prevalent health problems, health-care seeking, government's response, resource mobilization, and roadmap for the future. We purposively selected 16 key frontline health workers for in-depth interviews. RESULTS: Waterborne and infectious diseases were rampant posing huge public health challenges. Disaster mitigation efforts and relief operations were delayed and not at scale to cover the entire affected population. Moreover, a weak economy, poverty, and insufficient livelihoods compounded the tribulations of floods. Issues of leadership and governance at state level resulted in disorganized efforts and response. CONCLUSIONS: Pakistan is famous for its philanthropy; however, lack of transparency and accountability, the actual benefits seldom reach the beneficiaries. Such climatic disasters necessitate a more holistic approach and a greater responsiveness of the health system. In addition to health services, the state must respond to financial, social, and infrastructural needs of the people suffering from the calamity.
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Desastres , Inundações , Humanos , Saúde Pública , Paquistão , Acessibilidade aos Serviços de SaúdeRESUMO
In April 2021, following the Federal government's decision, an intervention was designed to execute COVID-19 home-based care training program for the LHWs in all provinces to avoid overcrowding in large hospitals so that critically ill patients can get due attention and treatment. The training curriculum was developed in local languages following guidance from NIH and WHO. Basic health units were used as the venue for training and the doctors delivered the sessions as master trainers. Around 46,000 LHWs completed the training all over Pakistan and started visiting their catchment households to identify and counsel any COVID-19 patients and families on home-based care. Their post-training impressions showed that 97% were satisfied with the content, rigour, quality of training, and that they received the most updated information on COVID-19 from reliable sources. Training of these LHWs enhanced their skills for dealing with COVID-19 patients and helped ease the pressure on a stressed and over-burdened hospitals. This intervention exemplifies task shifting to LHWs, hence addressing the issue of insufficient health workforce in the hospitals and extending public healthcare to rural communities. Key Words: COVID-19, Home-based care, Health system, Lady health workers, Pakistan.
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COVID-19 , Mão de Obra em Saúde , Humanos , Paquistão , COVID-19/epidemiologia , Pessoal de SaúdeRESUMO
BACKGROUND: There is a strong and wide consensus that Pakistan must pursue universal health coverage (UHC) attainment as the driving force for achieving sustainable development goals by 2030. Nevertheless, several institutional and socioeconomic challenges may hinder the progress toward UHC. MAIN BODY: It is important that the health system of Pakistan must be transformed to strengthen all three dimensions of UHC i.e. maximizing the population covered, increasing the range of services offered, and reducing the cost-sharing. To make UHC dream a reality in Pakistan, there are some pre-requisites to meet upfront: a) budgetary allocation for health as percentage of GDP must be increased; b) health system's readiness especially in the public sector ought to improve in terms of human resource and availability of essential services; c) safety nets for health must continue regardless of the change in the political regimes; d) decrease the reliance on donors' funding; and e) accountability to be ensured across the board for service providers, managers, administrators and policymakers in the health system. CONCLUSION: COVID-19 pandemic has revealed some major gaps in the health system's capacity to deliver equitable healthcare, which is a cornerstone to achieving the UHC agenda. The priority-setting process will need to be aligned with the SDGs to ensure that the agenda for action towards 2030 is comprehensively addressed and successfully accomplished preferably before, but hopefully not beyond the targeted dates.
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COVID-19 , Cobertura Universal do Seguro de Saúde , Humanos , Paquistão , Pandemias/prevenção & controle , COVID-19/epidemiologia , COVID-19/prevenção & controle , Atenção à SaúdeRESUMO
Background: Pakistan's health system over the past three decades has experienced social, economic, geopolitical instability, and notwithstanding man-made and natural catastrophes. Since 2001, the health system in Pakistan has undergone three phases of organizational and management reforms and does not have a unified national health policy since then. The aim of this research was to assess the factors behind the decision-making by policy planners in the health system of Pakistan. Methods: An exploratory qualitative study based on grounded theory was designed where in-depth interviews conducted with 20 representatives of the political constituencies, civil bureaucracy, health planners and managers, research and educational institutions, NGOs providing technical support in the health sector, development partners and media. Results: There leading reason cited was the dearth of leadership in health sector, which is compounded by a range of factors such as "institutional monopoly", "contextual deterrents", "power for turf"; "inadequate knowledge", and "design faults". Such factors were perceived to have a serious effect on the competencies, roles and responsibilities, use of knowledge for decision making. The behavioral aspects of decision makers include the "mindset," and "conflicting interests". Conclusions: The multitude of factors and complexities within the health sector of Pakistan continue to widen the vacuum in the leadership echelons. Hence, there is a high probability of taking wrong decisions not based on evidence, and resulting in a grossly under-performing health system.
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Tuberculosis (TB) is on the rise in Pakistan and there could be multiple reasons including poverty, difficulty in access to TB treatment services, non-compliance with treatment, social stigma etc. According to the TB program managers, limited treatment and testing sites for tuberculosis and lack of trained human resources play a major role in compromising TB management. A major lacuna in the TB control program is the absence of active contact tracing strategy. This is essential for a disease where positive cases are known to be able to infect a further 10â15 individuals in a year. Tackling tuberculosis in Pakistan has been beleaguered by funding challenges and other systems' bottlenecks such as lack of skilled human resources and insufficient supply of medicines, despite the fact that disease burden is one of the highest in the world. Although it is a notifiable disease, active case finding, contact tracing and reporting is notoriously low throughout the country. Access to diagnostics and treatment facilities has been limited and stigma attached to the disease remains deeply entrenched among the communities. Researchers have shown that enhanced and active approaches to contact investigation effectively identifies additional patients with TB among household contacts at a relatively modest cost. USAID's Integrated Health Systems Strengthening and Service Delivery Activity extended support to the Health Departments of Sindh and Khyber Pakhtunkhwa provinces. In collaboration with the two provincial TB programs, community based active contact tracing was conducted on 17,696 individuals, based on the index cases. Among the contacts traced, 243 cases were diagnosed as drug sensitive or drug resistant TB. Awareness sessions were conducted to sensitize people on the various aspects of disease and importance of getting tested. The project also supported establishing three satellite Programmatic Management of Drug Resistant Tuberculosis (PMDT) sites for drug resistant TB treatment, enhancing the programs' diagnostic and testing capacity.
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Tuberculose Resistente a Múltiplos Medicamentos , Tuberculose , Busca de Comunicante , Humanos , Paquistão/epidemiologia , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologiaRESUMO
BACKGROUND: Pakistan faces a considerable burden of disease with regard to inherited blood disorder, i.e., Thalassemia Major. Its economic implications are least studied before, particularly when it comes to ascertaining a household's out of pocket expense on treating the disease. This study was carried out to understand the current estimate of Out-of-pocket expenditure (OOP) expense and its implications on the household and livelihood, while seeking treatment for a child suffering from thalassemia. Methods: It was a descriptive cross-sectional study of 3 months' duration. Patients were selected from Fauji Foundation Hospital (FFH) and Pakistan Institute of Medical Sciences (PIMS), through. The descriptive quantitative analysis and inferential analysis was carried through purposive sampling. RESULTS: Treatment expense of entitled patients from FFH hospital (a public hospital which offers entitlement to the families of retired army personnel) was compared with that of non-entitled patients coming to PIMS (a public sector general hospital). Total expense incurred on treatment by the end of the month was PKR. 5000-10,000 (USD31-62) in FFH, while at PIMS, the total expense incurred on treatment by the end of the month was around PKR 80,000 (USD500). Around 37% families having an average monthly income of PkRs25000 (USD150) only, sold their livelihoods, 31% compromised on their children's education expenses and 23% percent curtailed the health expenses of the other children. CONCLUSIONS: The out-of-pocket expenditure on treating TM is quite high and compels the families to borrow money and sell or mortgage their property, which puts a great deal monetary pressure given their socio-economic status. A practical solution would be to cover these families under the health safety net supported by the government.
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Gastos em Saúde , Talassemia beta , Criança , Estudos Transversais , Características da Família , Humanos , Renda , Talassemia beta/terapiaRESUMO
At the outset of year 2020, COVID-19 emerged as a new public health threat and the world resorted to a diverse range of combating plots including lock down downs, social distancing, advocating precautions like wearing masks, using sanitizers etc. Pakistan followed the same pathway despite the fact that the virus resulted in less severe morbidity and mortality as compared to the rest of the world. Nevertheless, the fear and panic it created due owing to virulence and subsequent outcomes of corona illness was of alarming magnitude. Pakistan went for smarter, conservative and prudent plans and kept the balance between saving lives and livelihoods. Health system showed its inherent weaknesses and it was soon realized that a multi-sectoral response would be needed to address the catastrophe. A large majority is inclined to call it a 'new normal' and is persuading to go on with life; for sure, by adopting a health system thinking.
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COVID-19 , Controle de Doenças Transmissíveis , Humanos , Paquistão , Saúde Pública , SARS-CoV-2RESUMO
BACKGROUND: Pakistan's National AIDS Control Program has registered 44,000 HIV/AIDS patients to date, but the actual number of cases have been estimated to be as high as 150,000-170,000. The health care system has a very important role to play in this equation and must be reformed to improve the health care services in Pakistan, with regards to HIV/AIDS. METHODS: It was a qualitative research employing a phenomenological approach. The principal researcher visited nine public and private health care facilities and conducted 19 key informant interviews with people working for providing preventive and curative services, in addition to the observations made on the site. RESULTS: Pakistan's health system has a limited capacity to address the HIV spread in the country, with its current resources. There is an obvious scarcity of resources at the preventive, diagnostic and curative level. However, menace can be curtailed through measures taken at the service delivery level by checking the unsafe needles practices, unclean surgical procedures and an unregulated and untrained private health workforce which are dangerous potentials routes of transmission of the virus to the general population. Healthcare establishments carry the chances of nosocomial infections including HIV/AIDS. Poverty, illiteracy and stigma associated with the disease is compounding the overall situation. CONCLUSION: Improved accessibility to service delivery with a greater focus on prevention would be imperative to address the threat of HIV/AIDS in Pakistan. A health systems approach would help in identifying gaps at both strategic and operational levels, and concurrently find and implement solutions.
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Síndrome da Imunodeficiência Adquirida , Atenção à Saúde/métodos , Infecções por HIV , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PaquistãoRESUMO
BACKGROUND: In the wake of growing c- section rates around the developing world and likewise in Pakistan, there is paucity of knowledge about the preference of Pakistani women for the mode of delivery. Therefore, this study explored the reasons behind their preference. METHODS: A cross-sectional study was conducted with a non-probability consecutive sampling technique including 232 pregnant women. RESULTS: Majority (87.5%) would prefer a vaginal delivery because it is the natural way of giving birth and its recovery is faster. Moreover, women perceive that it would be easier to provide immediate care and breastfeeding to the newborn. Fear of surgery was the main deterrent for a c-section. Nonetheless, there were 12.5% women in favour of caesarean section, among whom a majority feared birth trauma to the newborn, labour pain, or complications of vaginal delivery such as possible faecal or urinary incontinence. CONCLUSIONS: Pakistani women at large prefer a normal vaginal delivery and therefore the rising trends of c- section cannot be attributed to the demand of the expecting women. Hence, there is a need for elucidating and explicating the real and perhaps the undisclosed reasons for the rising rates of caesarean section as a mode of delivery in Pakistan.
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Cesárea/psicologia , Parto Obstétrico/psicologia , Preferência do Paciente , Adulto , Traumatismos do Nascimento/etiologia , Aleitamento Materno , Estudos Transversais , Medo , Feminino , Humanos , Recém-Nascido , Masculino , Paquistão , Gravidez , Centros de Atenção Terciária , Adulto JovemRESUMO
AIM: To gauge the level of preparedness of health system of Pakistan in the wake of Corona Virus Disease 2019 (COVID-19) pandemic. BACKGROUND: The global COVID-19 outbreak and its subsequent repercussions and implications, after being declared as a pandemic by the World Health Organization (WHO), exposed all the inherent, lingering, and acute shortcomings of the health systems in many developing countries and Pakistan was no exception. METHODS: A detailed literature review was done which included peer-reviewed articles on COVID-19 and health system, published in local and international journals, WHO and World Bank's publications, and the documents and official reports of the government. Focus was to glean and cite strategies adopted by the developing countries in response to COVID-19 and to see the applicability of those which are feasible for Pakistan. FINDINGS: Level of preparedness was minimal and the response to manage the outbreak was weak. Based on toll of the cases and number of deaths, this public health threat turned out to be a catastrophe beyond the controlling authority and capacity of the health system, and hence other sectors and agencies had to be engaged for devising a concerted and integrated response to deal with the emergency. Governance was disorderly, financing was inadequate, human resources were not trained, supplies and logistic were not stocked, information system was patchy, and research capacity was limited, and most of all the service delivery was in a biggest chaos of times. COVID-19 demanded to re-configure the health system of Pakistan. CONCLUSION: Improving the emergency preparedness of the hospitals is the foremost and an urgent need. A strong national public health system in Pakistan is needed to rapidly investigate and analyze the reports, assess the magnitude of the public health risk, share real-time information, and implement public health control measures in a concerted and systematic demeanor.
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COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Pandemias/prevenção & controle , Países em Desenvolvimento , Humanos , Paquistão/epidemiologia , SARS-CoV-2RESUMO
BACKGROUND: Dental students are exposed to various infections and infective sources during their training, and on this aspect, their level of knowledge is suboptimal and practices are risky. Therefore, improving their knowledge and practices would contribute significantly to infection control. OBJECTIVE: To ascertain the level of understanding of senior dental students regarding the infection control in the dental practice. METHODS: A cross-sectional study was conducted among dental students (3rd year and 4th year) of the Foundation University Dental College, Pakistan. The sample consisted of 100 third year dental students and 88 fourth year students. A self-administrated questionnaire was used for data collection which consisted of fourteen close-ended items. Frequencies of knowledge, attitudes, and practice were calculated separately by using SPSS 21.0 software. RESULTS: Almost half of the students would not use any antiseptic for sterilizing their hands, and only two-third would ask their patient to use an oral mouth rinse before starting the treatment. Many students did not the optimal temperature of the autoclave for sterilization of the instruments. Only one-third would wear the personal protective equipment during a procedure. Around one-third of the study participants reported that ineffective sterilization during clinical practice can transmit infection from one patient to another. CONCLUSION: Knowledge on infection control among the dental students is though weak, practices are not as per standards but attitudes are positive and encouraging for taking steps and complying with measures on infection control.
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Conhecimentos, Atitudes e Prática em Saúde , Controle de Infecções , Estudantes de Odontologia/estatística & dados numéricos , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Hospitais de Ensino , Humanos , Masculino , Paquistão/epidemiologiaRESUMO
BACKGROUND: Pakistan is a country with one of the highest burden of tuberculosis (TB) in the world, and therefore, it is imperative to revisit the design of behaviour change interventions in the program. This study was designed to understand and assess the knowledge, awareness, perceptions, and health-seeking behaviour of general and specifically TB-affected population and to determine the presence and level of stigma and discrimination toward TB patients. METHODS: A mixed-method study was conducted in district Haripur of the Khyber Pakhtunkhwa province, comprising a household survey, whereby 526 individuals were interviewed, and five focus group discussions with various subgroups including TB patients and health workers and authorities. Study sought an ethical approval, and data of all respondents was kept confidential. RESULTS: Quantitative results show that women were more knowledgeable on symptomatology and spread of TB, and with rising education, awareness on TB improves. The majority of our respondents had the understanding that it is a curable disease, yet some would avoid TB patients. Most of the respondents (both men and women) knew that one must go to a government facility for treatment. Only one-third would speak to doctor first, if they suspect TB-like symptoms. Television was a popular source of information on TB. Qualitative results captured people's perceptions that TB was related with poverty and was still considered a stigma in the community; hence, patients afflicted feared disclosing the disease. CONCLUSION: With contextual understanding of communities' knowledge, attitudes, health-seeking behaviour, and care-seeking patterns, it can be concluded that there is a need to increase the awareness about TB symptoms, mode of transmission, prevention, diagnosis and treatment, and destigmatization of the disease through health education.
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Comportamentos Relacionados com a Saúde , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Aceitação pelo Paciente de Cuidados de Saúde , População Rural , Tuberculose/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , Tuberculose/terapiaRESUMO
In Pakistan, the Health and Population Think Tank was launched as an initiative to conduct programmes and policy analysis, as well as give an insight into the possible future policy options on various national health issues relevant to all the provinces. This forum has also served as a platform to discuss how provincial strategies could be aligned with the National Health Vision 2016-2025, which was developed with the consensus of all provinces and development partners. Main topics chosen for the round tables included local production of vaccines; social health protection; quality of care at the time of birth; human resources for health; and the challenge of tuberculosis in Pakistan. Policy briefs produced by the think tank will maximize the absorption of knowledge and will help implement the actionable items needed to speed up the progress towards achieving Sustainable Development Goal 3 (SDG3) national targets.