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April 2017, Volume 67, Issue 4

Letter to the Editor

Rise and stalling of public health in Pakistan

Inayat Thaver  ( Health and Population Advisor, Chief Executive, Mustashaar Social Development Advisors, Islamabad, Pakistan. )
Mariam Ashraf  ( PhD Scholar, Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia. )

Madam, the need to focus on public health perspective and personnel has been identified quite often.1,2 Interestingly, Public health in Pakistan dates back to more than three decades; the conference on "Role of hospitals in primary health care"3 in 1981 probably was a landmark for emphasizing Public Health. Contextually, aid related factors were the triggers in rapid evolution of Public Health. The late 80s and then 90s had seen these aid supports slowly, but after 9/11, there was a big surge of money from development partners (donors). Therefore, need for having trained public health practitioners increased. However, at that time only one institution in Lahore and some rudimentary beginning in Karachi had been made. Later, there has been unregulated mushrooming of various Masters in Public Health (MPH) programmes, from both private and government institutions.
The students from various disciplines started opting for this MPH/MPhil degree; incentives being approved and recognized trainings by various universities and attractive salaries. However, the bandwagon for opting public health as a career got lost or changed. We still do not have a) powerful and operational representative body (just like of other disciplines), b) there is no regulatory body for training and c) no organized effort to create job-opportunities for the fresh public health post-graduates. So, have we lost the battle, I would say no, but we have to address a lot of fixes.
An assessment carried out in six countries of outcome and impact of MPH programme concluded that graduates had a good career and contributed to their respective organizations, rather than to society at large.4 Sadly, Pakistan is also following the similar path with graduates focusing on their own career building rather than contributing to the issues and challenges faced by the country. India, our close neighbour had the advantage of having a School of Tropical Medicine in Kolkata by 1922, however, Pakistan and India both started with Bhore Committee in 1946. In India, there has been advancement in Public Health4 due to enabling environment and concerted efforts by the government; which resulted in formation of Indian Public Health Association by 1956. Maybe we are still in infancy, but trends and intents tell a lot; an urgent attention by the government as well as the concerted efforts within the discipline and fraternity can only make a difference.
Disclaimer: None to declare.
Conflict of Interest: None to declare.
Funding Disclosure: None to declare.


1. Omair A. Epidemiology - Role of health professionals in prevention of disease. J Pak Med Assoc 2016; 66: 1048-9.
2. Qidwai W. Addressing Healthcare Challenges in Pakistan?: Issues , Possible Remedies and Way Forward. J Dow Uni Health Sci 2016;10: 41-2.
3. The conference "The role of hospitals in primary health care". [Online] [Cited 2016 Dec 15]. Available from URL: Accessed on 21 August 2016.
4. Negandhi H, Negandhi P, Tiwari R, Sharma A, Zodpey S, Kulatilaka H, et al. Developing core competencies for monitoring and evaluation tracks in South Asian MPH programs. BMC Med Educ 2015; 15: 126.

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