The weight of the global pandemic is functionally crippling an already struggling health care system in Pakistan. Hospitals established in cities are overburdened, but nothing compares to the deficiencies in resources in rural hospitals. Some of these hospitals are ghost units with no shows of health practitioners and a severe shortage of female medical staff. Despite the country’s females outperforming their male counterparts in medical college admissions, few continue to practice after marriage. These social realities widen the health administration gap when many female patients prefer to consult a female practitioner for socio-religious reasons, particularly in rural areas that are often more conservative.
During the pandemic, urban hospitals saw a considerable influx of Covid-19 patients from within cities and remote rural areas. To better manage resources, these hospitals closed outpatient departments, thus worsening non-Covid-19 health outcomes. Private healthcare—which only the rich can afford but still is an essential component of Pakistani healthcare—also suffered a massive blow during the pandemic. Many healthcare workers lost their lives to Covid-19, creating a shortage in the private and public health sectors.
Nevertheless, Covid-19 offers a window of opportunity to develop telemedicine in Pakistan, potentially closing the gendered and geographic gap in public health. For instance, telemedicine can serve remote places by recruiting unutilized female doctors. With a relatively educated youth and a higher smartphone penetration, telemedicine should be a natural course to cater to an ever-growing demand for medical care.
Telemedicine was introduced after the dreadful earthquake of 2005, impacting most of Pakistan’s far-off northern areas. Despite the government launching some initiatives, including Telemedicine Forum (2001) and a Telehealth Project (2007) in a few hospitals, telemedicine is not widespread in the country.
Pakistan indeed has some successful telemedicine ventures (e.g., the Holy Family Hospital, the Agha Khan University Hospital, Sehat Kahani, and Marham), but it lacks a telemedicine policy. Therefore, as a first step, policymakers should pass legislation to help advance the use and implementation of telemedicine in health care for both rural and urban populations. Furthermore, government officials should educate the masses and spread awareness about telemedicine systems among them by using communication tools. Finally, proper usage and protection of medical records should also be made a priority while establishing these new systems.
As researchers from Pakistan, we also urge the health ministry and National Institute of Health (NIH) in Pakistan to create plans to increase the prevalence of telemedicine so that equitable healthcare becomes a reality.
Muhammad Salar Khan is a Ph.D. Public Policy candidate and graduate research assistant at Schar School of Policy & Government, George Mason University. He tweets at @salarppolicy
Anum Niazi is an MD Candidate at Windsor University School of Medicine, St. Kitts and Nevis.
Shanlina Kifayat is a medical doctor (MBBS) and currently serving as a postgraduate resident at Combined Military Hospital, Peshawar, Pakistan.