Stewarding Covid-19 health systems response in Pakistan

What more can be done for a primary health care approach to future pandemics

Datos Bibliográficos

ID21880720
AutoresShehla Zaidi (0000-0001-7620-9247, Aga Khan University), Raza Zaidi (0009-0002-1201-3653, Ministry of National Health Services Regulation and Coordination), Shujaat Hussain (0000-0001-6607-2814, Aga Khan University), Malik Muhammad Safi (Ministry of National Health Services Regulation and Coordination)
Año2025
Volumen10
NúmeroSuppl 2
Páginase016149
Fecha de publicación2025-01-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaBMJ Global Health (JOURNAL)
Identificadores de la revistaISSN: 2059-7908 • E-ISSN: 2059-7908
EditorialBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2024-016149
PMID39800384
OpenAlexW4406282618
IdiomaEN
Citas recibidas2
Referencias citadas22

We apply a primary healthcare (PHC) perspective to gauge Pakistan’s health systems response to COVID-19, to identify stewardship lessons for integrating the PHC pandemic response. Analysis of Pakistan’s response against the Astana PHC framework shows that the imperative for national survival helped mobilise an agile response across a fragmented health security context. The findings show effective multisector governance in responding to the health and social aspects of the pandemic, as well as the rapid roll-out of several public health functions and emergency care. However, we found weak maintenance of essential health services and ad hoc, short-lived efforts for community engagement. Critical enablers that helped steward the response across complex power-sharing arrangements included solidarity across society, collaborative data-driven decision-making, leveraging of siloed domestic resources and private sector coordination. At the same time, a more PHC-centric response was constrained by weak political prioritisation of essential health services, uneven services, weak direction to civil society volunteerism for community engagement and weak regulation of private sector contribution. We conclude that a mindset shift is required from short-term tactical measures to long-term investment in PHC-oriented transformative stewardship. Future preparedness must build attention to essential service package for emergencies, mobilisation of both private and public primary care providers, effective community engagement vision across societal actors and market regulation, within a collaborative governance framework

2019-20 coronavirus outbreak · Disease · Health care · Outbreak · Pandemic · Political science · Primary health care · Public health · COVID-19 and healthcare impacts · COVID-19 and Mental Health · COVID-19 epidemiological studies · Medicine · Nursing · Virology