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September 2021, Volume 71, Issue 9


Making hospitals health promotive

Shelina Bhamani  ( Department of Obstetrics and Gynaecology, Aga Khan University, Karachi, Pakistan. )
Areeba Zainab Makhdoom  ( Dean's Clinical Research Fellow, Department of Obstetrics and Gynecology, Aga Khan University, Karachi, Pakistan. )

The status of national health could be gauged by the status of health care facilities / hospitals. The better the healthcare services, the better a nation's health. The environment of hospitals and the impact they have in the lives of people are important indicators of a health promotive and progressive nation. It is not only the people in need of healthcare who benefit from the conducive environment of hospitals, but medical professionals in training are also equally impacted by the environment, and benefit largely from the opportunities that a good environment presents for learning, research and medical advancements. Healthcare, like education and other people services, forms a social infrastructure that changes the mindsets, lifestyles, approach and habits of a nation. The national character is evident from the harmony and consonance in the social infrastructure, leading to justice, equality and peace. Hospitals, by definition, should be health promotive - based on the maxim 'prevention is better than cure.' Effective hospitals should uphold best practices to help raise the standard of life, educating people on various health aspects and enabling the community for better decision-making concerning their health, hygiene, exercise, dietary intake and general lifestyles.1


The environment in healthcare hospitals in Pakistan


The Pakistani healthcare system, especially the public sector, is making slow progress. The government has introduced many reforms, however, the progress is slow due to many factors including poor governance, corruption in the health system, unavailability of resources and lack of access to these resources; and lack of coherent policy.2 Among the many challenges, the Pakistani healthcare system in public hospitals face, are issues of patient safety, effective communication, timely and efficient response and care, and equity in care.3 However, all is not lost and as a signatory of the Sustainable Development Goals (SDGs), Pakistan is working on many fronts to bring improvement, especially in healthcare and education as one of the post Covid-19 agenda. Public hospitals in general lack conducive environment for patients' well-being. There is a low focus on educating the masses and promoting self-care, personal hygiene, and aspirations. The response is mainly curative, and that too is inefficient and ineffective. Guidance and counselling services are also lacking, for example, prevention and care from commonly communicable diseases, the importance of breastfeeding, absent promotions on health check-ups for blood pressure, diabetes and other diseases. While much of this is due to lack of resources, the inability to seek quality healthcare and provide quality care is due to the general lack of awareness and illiteracy.4 Furthermore, hospitals have apparently low inclination and investment in research regarding patient care and quality of care. Most hospitals in Pakistan do not even have television screens to run health education advertisements and those that do run local news or sports channels rather than make use of technology to educate the people in waiting. The use of technology in augmenting healthcare is also missing, with low investment in using machines for medical diagnosis and patient care and management. There are many reasons for this shortcoming but primarily these shortcomings are due to lack of defined policies and guidelines on how hospitals should look like and what they should offer to the public.5




The role of hospitals has become more crucial in the post pandemic era as there is a herculean need of educating the masses for the preventive health and vaccine roll-out. Hospitals now have to play a pivotal role in taking a lead role in public health and education. In addition to it, coherent and sustainable policy at the national level and efficient governance with stringent monitoring, accountability and evaluation procedures are needed to make hospitals health promotive.

Disclaimer: Authors declare no conflict of interest.




1. NIB. Prevention is better than cure. Retrieved from NIB Website: h t t p s : / / w w w . n i b . c o m . a u / t h e - c h e c k u p / h e a l t h y - living/prevention-is-better-than-cure Cited on 13. March 2015.

2. Kurji Z, Premani Z S, Mithani Y. Analysis of the health care system of Pakistan: lessons learnt and way forward. J Ayub Med Coll Abbottabad. 2016;28: 601.

3. Khalid F, Abbasi A N. Challenges faced by Pakistani healthcare system: Clinician's perspective. J Coll Physicians Surg Pak. 2018; 28:899-901. doi: 10.29271/jcpsp.2018.12.899.

4. Saeed A, Ibrahim H. Reasons for the problems faced by patients in government hospitals: Results of a survey in a government hospital in Karachi, Pakistan. J Pak Med Assoc. 2005; 55: 45-47.

5. Irfan S M, Ijaz A. Comparison of service quality between private and public hospitals: Empirical evidences from Pakistan. J. Qual. Technol.2011; 7: 1-22.


Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: