Authors: Nishtar S,
Address: Heartfile, Pakistan.
Journal: J Pak Med Assoc.
Publication: 2006 Dec;56(12 Suppl 4):S120-35.
Often health systems functions are identified with service provision within a personal healthcare dimension or a public health framework. This constitutes the healthcare system which is a part of a health system, which views health in its inter-sectoral scope. It is well established that factors which determine health status range much broader than those which are within the realm of the health sector. Many socio-economic and environmental conditions are known to affect health status; liberalization of international trade, global pandemics, natural disasters and humanitarian crises can be detrimental to public health outcomes as can be changes in international cooperation and geopolitical situations, which may have implications for the manner in which health is resourced in a country such as Pakistan. As a roadmap for health systems reform in Pakistan, the Gateway Paper factors these considerations into health policy and planning underscoring the need to develop alternative policy approaches to health within its inter-sectoral scope, redefining targets within the health sector in order to garner support from across various sectors; creating inter-sectoral agencies that concentrate on prevention and health promotion at multiple levels and developing overarching policy and legislation for health promotion.