Subsidized dental healthcare for Pakistan?

KARACHI, Pakistan: Pakistan as a nation continues to suffer from growing population with limited health care resources. With basic healthcare needs scarcely met, the dental needs remain a fantasy for many persons belonging to lower socioeconomic status. The low healthcare budget allocations remain a hideous negligence resulting in numerous healthcare epidemics of preventable illnesses.

Pakistan like many other South Asian countries faces the challenge of betel nut, quid and smoking addictions. These addictions translate in to some of the highest rates of oral submucous fibrosis, oral leukoplakia and oral cancers in the region. The fervent efforts of the dental community in creating awareness and prevention drives are commendable, but without any government funding, the efforts remain localized.

Added to this is the fact that most of these cancers emerge in populations of lower socioeconomic status, where this habit is prevalent. These patients lack the resources to attain full treatment of any oral diseases, let alone cancers. It seems the most needy population segments remain the most impoverished in terms of oral health care facilities.

Public dental healthcare services have long served the disadvantaged communities globally. Pakistani public dental institutes and colleges have been doing the same. But these traditional public health care services have largely excluded dental services due to cost concerns.  This challenge remains in the developed nations as well. Case in point is Australia where dental services are not embedded in the universal National Health Service agenda. A research by Palencia and colleagues in 2013 echoes the same concerns. It concluded that the socioeconomic inequalities strongly dictated the discrepancy in access to dental healthcare in those countries where no public dental care cover was provided.

It is imperative that for poor Pakistani population masses dental treatments should be provided at subsidized costs, if not free to some extent. A recent effort by the Singaporean health sector to encourage dental clinics and practices for subsidy has gained momentum. This service has provided access to over 200,000 people in Singapore towards dental treatment and is growing.

Consider the impact of this subsidiary attempt on improvement of overall oral health quality of the patients. This method brings into the care bracket the most needy patients, will help obtain better statistical evidences about oral disease prevalence, and will give real time results showing the impact of dental care on the overall oral hygiene and oral disease prevention among concerned populations.

Now consider this same framework for Pakistan. Pakistan as a country with meager health resources requires strong governmental initiatives and interventions to improve healthcare access and quality for its poor population segments. To do so requires placing strong and sustainable investments in the health care sector. By integrating the same health care sectors with dental sections, a large part of population can stand to benefit.

Therefore the question is can Pakistan adopt the same subsidy models from the NHS and Singaporean health care sectors for dental care provision purposes. Ideally, this is a good cause to consider. However, ground realities may prohibit such utopian thought process. For one, the utter lack of healthcare budget and resources and government may prevent such an ambitious attempt, where more resources are needed in other areas similar areas such as primary healthcare and prevention.

Pockets of these program attempts have already taken place. The World Dental Development and Health Promotion Committee in 2004 worked towards integrating basic oral healthcare within the existing primary healthcare sectors in northern Pakistan in 2004.

The same concept has now become the mainline effort of Pakistan Dental Association in improving access to oral healthcare in schoolchildren of rural Pakistan. This attempt is focusing on teachers and students to create a sustainable awareness and education system for oral care. However, this program is not providing any free treatment services, but primarily focusing on creating a more aware and oral health conscious generation. If this project is aided with subsidized and/or free dental care provision within the primary healthcare setup, it can lead to a drastic improvement in the quality of oral healthcare.
To conclude, a subsidized health care program including dental treatments can help overcome some major challenges of treating poor socioeconomic classes of Pakistani population, which may otherwise continue to suffer from inability to access dental healthcare services.