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In Depth

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Recent Health Issues

Pakistan’s drug deaths
Heartfile has published statements in media regarding the deaths of over 125 people in Lahore from contaminated drugs, which are a stark illustration of the inherent institutional and policy weaknesses in our health systems. Our publications in the media and in other academic journals on this issue can be accessed below:

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18th constitutional amendment and health
Heartfile has published statements regarding the April 2010 18th Constitutional Amendment passed by the Pakistan National Assembly. This amendment abolished the health ministry of Pakistan and devolved its portfolio to the provinces. Our articles and statements in the media and in other academic journals on this issue can be accessed below:

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Polio update
Heartfile has voiced its concern regarding the remaining reservoir of polio endemic that still remains a major issue despite massive investment and high level political commitment. Our articles and statements in the media and in other academic journals on this issue can be read below:

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Health Systems

In the past few decades, policy makers have recognized that for any significant improvement in the health profile of a country, the focus must be on health systems as a whole. Particular diseases and epidemics are simply symptoms of a larger problem, namely the affliction of the whole system. Heartfile’s significant achievements in this area are summarized below:

Health systems performance assessment

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Establishing a framework for health systems performance assessment (initiated in 2009). This was part of a WHO-led platform to ‘Strengthen Monitoring and Analysis of Country Health Systems.’ This assessment will be reported in the Pakistan Lancet Series, scheduled to be published in late 2012.

Heartfile Health Financing

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Developing an IT-supported demand side health financing tool that can enable efficient, timely and well-targeted cash transfers in order to protect the poor against catastrophic spending on health, and to establish a seed Health Equity Fund (initiated in 2008). This is being done under the name of ‘Heartfile Health Financing.’ Funding: Rockefeller Foundation.

Choked Pipes

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The publication of the book, ‘Choked Pipes: Reforming Pakistan’s Mixed Health System‘. The book charts a roadmap for health reform in Pakistan.

18th constitutional amendment in Pakistan

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Analysis of the impact of the 18th constitutional amendment in Pakistan passed in April 2010, and advocacy in support of giving prominence to health.

The Gateway Paper: Health Systems in Pakistan – a Way Forward

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The Gateway series of papers, which aim to strengthen the evidence base of health reform. The first in the series, Gateway Paper I was the first consolidated review of health systems in Pakistan. Its strategy was recognized as a blueprint for formulation of a new national health policy for Pakistan. Pro bono time contribution: Dr. Sania Nishtar.

Health Indicators of Pakistan – Gateway Paper II

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‘Health Indicators of Pakistan – Gateway Paper II‘ was authored by Dr. Sania Nishtar, who contributed time pro bono. This paper was developed under a MOU with Pakistan’s Federal Bureau of Statistics and it aimed to build their capacity for developing a system of reporting on health indicators.

The post-gateway roundtables

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Conducting a series of national meetings—the post-gateway roundtables developed consensus on the strategy proposed by the Gateway Paper (2005-07). Funding support for these meetings was provided by the Department for International Development UK and the World Bank.

Memoranda of understanding with the government on health policy development

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Developing drafts of the national and provincial (Khyber Pakhtunkwa) health policies of Pakistan under MoU with the Federal Ministry of Health and with the provincial government of Khyber Pakhtunkhwa, both of whom expressed a desire to develop a health policy based on the Gateway Paper’s approach to health systems.

Assessment of corruption in health service delivery

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Conducting an assessment of corruption in health service delivery. Funding: Asian Development Bank-supported Partnership for Transparency Fund (PTF)

Health systems research

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Research in the area of priority setting for health systems research. The study aimed at the development of a locally suited priority-setting model. Funding: Global Forum for Health Research, Geneva.

Health communication

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Research in the domain of health communication. The intervention capitalizing on the strengths of social marketing. Funding: Canadian International Development Agency. Details of the campaigns can be accessed here and publication can be accessed here.

National Action Plan on NCDs

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Developing an integrated population-based surveillance system for the ‘National Action Plan for Prevention and Control of Non-Communicable Diseases and Health Promotion in Pakistan.‘ Funding: WHO, Geneva.

Health information system

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Supporting the development of a health information system in the aftermath of the October 8, 2005 earthquake. This database system generated regular reports to facilitate the Ministry of Health in its strategic planning with regard to relief efforts.

Health population institutional disconnect in Pakistan

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Analysis of the health population institutional disconnect in Pakistan, which was published in a special supplement of the Journal of the Pakistan Medical Association.

Non Communicable Diseases

National Action Plan on NCDs in Pakistan

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In the initial stages of its development, Heartfile used innovative approaches of advocacy, leveraging social marketing and the use of media. This and other advocacy approaches enabled Heartfile to convince the government of the need for a public health programme on NCDs in Pakistan. Subsequently, Heartfile became part of a tripartite public-private partnership involving the Ministry of Health, Government of Pakistan, and the World Health Organization for development and implementation of a National Action Plan for Prevention and Control of Non-Communicable Diseases and Health Promotion in Pakistan (NAP-NCD). Details about the terms of this agreement , launching of the initiative , planning meetings leading to its development and the release of the NAP-NCD are posted online. Heartfile also took a lead role in helping initiate the process of implementation of this plan on a pro bono basis; various stages of implementation of the pilot can also be viewed. Heartfile’s current objective is to institutionalize this programme in the Ministry of Health The mentioned NAP-NCD can also be downloaded here

Heartfile’s Communication Campaigns in Pakistan

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Heartfile ran popular communication campaigns in its early years of inception, which helped create awareness about risks of NCDs. Click here to view.

Heartfile-Lodhran CVD Prevention Project

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Heartfile has established and evaluated the Heartfile-Lodhran CVD Prevention Project, which aimed to develop sustainable and low-resource-setting-sensitive strategies for prevention of NCDs. Funding: Department of International Development, UK (2001-2004). End of project evaluation can be viewed here.

Heartfile-JC Project

Heartfile has established and evaluated the Heartfile-JC Project, a pilot, which aimed to develop an approach to integrate chronic disease prevention into the work-plan of health providers in the private sector.
Funding: European Union-funded Trust for Voluntary Organizations

WHO PREMISE Study

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Heartfile was the principal investigator in Pakistan for the WHO PREMISE Study, a global study aimed at developing models for Prevention of Recurrences of Myocardial Infarction and Stroke and was represented on the Technical Committee of the study.
Funding and Collaboration: WHO Cardiovascular Disease Unit, Geneva.

WHO Risk Management Package

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Heartfile was the principal investigator in Pakistan for the WHO Risk Management Package, an international study aimed at testing the suitability of low-resource-setting-sensitive tools for secondary prevention of cardiovascular diseases.
Funding and collaboration: WHO Cardiovascular Disease Unit, Geneva. View publications.

The Riskcorn Study

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Heartfile was the principal investigator for the Riskcorn Study: the first case control study to determine risk factors for coronary heart disease in Pakistanis. Collaboration: Guys & St. Thomas’ Hospital, London.
Funding: Pakistan Medical Research Council and Guys & St Thomas’ Hospital, London. View publications. View publications.

The INTERHEART study

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Hearfile was an investigator in Pakistan for the INTERHEART study, a global study of risk factors in acute myocardial infarction, Conducted by McMaster University, Canada.

WHO Global (Price of Chronic Disease Medicines) Drug Survey

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Heartfile was the principal investigator in Pakistan for the WHO Global (Price of Chronic Disease Medicines) Drug Survey, an international study to assess barriers to the use of medicines for secondary prevention of chronic disease.
Funding and collaboration: WHO Cardiovascular Disease Unit, Geneva. View related publication.

Non-Communicable Diseases – Resources

The National Action Plan on NCDs
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The process of developing the plan
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The illustrated capacity building guide
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Surveillance

Paper describing the design
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Findings
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Survey protocol
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Questionnaire
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Field guide
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Communication tools

  • The News-Heartfile Campaign - weekly illustrated articles in ‘The News International,’ the largest circulated English daily of Pakistan
  • Jang-Heartfile Campaign - weekly illustrated articles on the ‘Sehat’ (health) page of the popular Sunday magazine of daily ‘Jang,’ the largest circulated Urdu daily of Pakistan
  • US-Heartfile Campaign – weekly thick-captioned illustrated insertions in the adolescent and youth magazine of The News International
  • Heartfile Public Awareness Leaflets – a set of seven information leaflets available on request through email
  • Video clips on Youtube for the Learn to live longer Campaign

More videos on Heartfile channel on Youtube

Community Intervention
Click here for quarterly updates while the program was being implemented