Impact of Rural Medical Care in Remote
Mountainous Region of Pakistan:
challenges and opportunities

A. Rehman Alvi¹

ABSTRACT

Objective: To share the experience of developing rural medical care and the impact on the health indicators of the population.

Methodology: The clinical data was collected prospectively using ICD-9 coding and data base was developed on a desk top computer. Information about the operative procedures and outcome were separately collected on a excel work sheet. The data from January 1998 to December 2001 were retrieved and descriptive analysis was done on epi info-6.

Results: Thirty one thousand seven hundred eighty two (31,782) patients were seen during this period, 53% were medical, 24% surgical, 16% obstetric and 7% with psychiatric illness. Out of 1990 surgical operations 32% were general surgery, 31% orthopedic, 21% pediatric, 12% obstetric and 4% urological cases. There were 21 surgical mortality including 6 operative deaths, 15 non operative deaths and 89% of the mortalities were unavoidable. The crude in hospital mortality decreased significantly from 5.5% in 1992 to 1.1% in 2001 and the contributing factors were improved structure and process of care.

Conclusion: The impact of secondary care rural medical centre (AKMC) is obvious from the clinical audit including accessibility, sustainability and quality of care. This could be a model of care in rural Pakistan where accessibility, affordability and quality of care is lacking.

KEY WORDS: Rural health care, Health care indicators, Rural surgery.

Pak J Med Sci    January - March 2009    Vol. 25 No. 1    131-136

How to cite this article:

Alvi AR. Impact of Rural Medical Care in Remote Mountainous Region of Pakistan: Challenges and opportunities. Pak J Med Sci 2009;25(1):131-136.

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1. Dr. A. Rehman Alvi, FRCS
Department of Surgery,
Aga Khan University Hospital,
Karachi - Pakistan.

Correspondence

Dr. A. Rehman Alvi, FRCS,
Department of Surgery,
Aga Khan University Hospital,
Stadium Road,
P.O.B ox 3500,
Karachi – 74800,
Pakistan.
E-mail: rehman.alvi@aku.edu

* Received for Publication: November 25, 2008
* Revision Received: January 21, 2009
* Final Revision Accepted: January 23, 2009

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