Millennium development goals (MDGs-2000-2015) to sustainable development goals (SDGs-2030): a chronological landscape of public sector health care segment of Pakistan

Abstract Objective: To study health related Millennium Development Goals in context of Pakistan’s progress in improving health system of Pakistan. Methods: Chronological landscape of health conditions with temporal limit of 2000 to 2015 and progress was measured in five, ten and fifteen years of MDGs in view of Public Sector Health Care Segment (PSHCS). Statistical package IBM-SPSS-21 was used for analyzing the data. ANOVA was conducted at level of significance (p<0.05). Results: Different parameters of PSHCS in context of MDGs were analyzed to evaluate the improvement in public health conditions. No difference in infrastructure was observed during the MDGs (2000-2015) era; Hospitals (p=0.262), Basic Health-Units (p=0.910), Mother & child health centers (p=0.345), Rural Health Centers (p=0.226) Tuberculosis centers (p=0.660), Total-Beds (p=0.220) and Population per bed (p=0.772). However, significant difference was observed in no. of dispensaries (p=0.001). We also observed significant difference in workforce; Registered doctors (p=0.024) dentists (p=0.001) nurses (p=0.047) midwives (p=0.032) and lady-health-workers (p=0.007). No significant difference was observed in the expenditures; health-expenditure (p=0.515), development-expenditure (p=0.678), current-expenditure (p=0.481), percentage-change (p=0.998) expenditure as per GDP (p=0.908). Family planning sector was also without any significant change; Population growth (p=0.108), crude birth rate (p=0.705), crude death rate p=0.460) and life expectancy (p=0.319). It was observed that sick population preferred private facilities compared to the PSHCS facilities. Conclusion: We did not observe any significant difference in most of the health care segments during 2000-2015 and MDGs remained underachieved. Therefore, a way forward is proposed for improvement in PSHCS to persevere SDGs.