Curative Healthcare

Zaidi, S., Bigdeli, M., Aleem, N., &Rashidian, A. (2013). Access to essential medicines in Pakistan: policy and health systems research concerns. PLoS One, 8(5), e63515.
This paper adds to the global evidence on access to essential medicines by sharing findings from Pakistan. It applies to both a health systems perspective and a local priority setting exercise. The paper sets out to identify policy concerns in access to medicines through desk review and key informant interviews; and present consultatively prioritized policy and research concerns. The results are intended to improve the use of evidence in medicines policies and forging integrated responses to related challenges within the heath systems. A synthesis of evidence found major gaps in essential medicine access in Pakistan related to weak regulation of quality assurance, poor affordability, and irrational use. These are driven both by weaknesses in pharmaceutical regulation with little attention to quality and cost efficiency in drug registration and a lack of creative and transparent pricing, as well as by health systems weaknesses involving unregulated provider prescriptions and weak supply management. Thus the Pakistan experience shows that policy concerns related to essential medicine access in Pakistan need integrated responses across various components of the health systems, are poorly addressed by existing evidence, and require an expanded health systems research agenda.
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0063515

Siddiqi et al. (2002).Prescription practices of public and private health care providers in Attock District of Pakistan.The International journal of health planning and management, 17(1), 23-40.
This study carried out in Attock assesses the magnitude of the problem of drug use and misuse in the formal allopathic health sector in Pakistan, in order to compare differences in prescribing practices of providers working in the public and private health facilities. It uses WHO recommended drug use indicators to highlight the current status of prescription practices of health care providers in Pakistan. It highlights that there are deficiencies in prescription practices among all health care providers; however, the problem is more serious among the more qualified private practitioners. Not only are private practitioners prescribing the highest number of drugs per prescription anywhere, their prescription practices for common health problems are highly inappropriate. The study suggests measures that could improve prescription practices. These include regulatory measures that relate to the issuance of licenses to practice, criteria for promotion and quality assurance of pharmaceuticals prescribed. However, regulation alone is ineffective unless it is supported by a well-established institutional mechanism, which ensures effective implementation and strengthens the role of various agencies. In this context the role of the Pakistan Medical Association (PMA) is emphasized.
http://onlinelibrary.wiley.com/doi/10.1002/hpm.650/abstract.