Open AccessCommunity context of health system development: implications for health sector reform in Pakistan
Author(s) -
Mahmood Ma,
John Moss,
Rozina Karmaliani
Publication year - 2021
Publication title -
eastern mediterranean health journal/eastern mediterranean health journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.442
H-Index - 47
eISSN - 1687-1634
pISSN - 1020-3397
DOI - 10.26719/2003.9.3.464
Subject(s) - context (archaeology) , government (linguistics) , community health , health care , health policy , health sector , economic growth , health services , business , public relations , political science , environmental health , medicine , geography , economics , population , philosophy , linguistics , archaeology
To describe local sociopolitical and organizational factors that influence health system development in Karachi, Pakistan, we conducted participant observation while working with health providers and communities in one urban district to reorient services towards a primary health care district health system. We found that the community characteristics, particularly the diverse socialpolitical and cultural make-up and organizational complexity that involved multiple levels of government, influenced efforts towards collaboration and shaped the development of the health system. We conclude that for effective implementation of health sector reform there is a need to comprehend fully the community context and complexity of existing health service provision