Assess the Effectiveness, Quality, Affordability, and Accessibility of Pakistan’s Public Healthcare System (PHS)
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Background: Healthcare access depends on geographic availability, affordability, service readiness, workforce capacity, and equity. Financial and operational barriers may limit effective healthcare utilization despite physical proximity to services. Objective: To describe patient-reported healthcare accessibility, utilization, service quality, staffing adequacy, affordability, information sources, perceived disparities, and government healthcare initiatives among healthcare users in Pakistan. Methods: This cross-sectional observational survey included 379 patients recruited by convenience sampling from Basic Health Units, dispensaries, district hospitals, and private clinics. A 21-item English- and Urdu-language questionnaire assessed nine healthcare-related domains. Categorical responses were summarized using frequencies and percentages. Results: Of 379 participants, 311 (82.1%) were female and 288 (76.0%) were aged 20–40 years. Overall, 315 (83.1%) lived within 10 km of a healthcare facility. Private clinics were the most frequently reported primary facility (174, 45.9%), while 232 (61.2%) perceived facility staffing as inadequate. Fair or poor service quality was reported by 205 (54.1%), and 205 (54.1%) had delayed or avoided healthcare because of cost. Perceived unequal healthcare quality compared with wealthier areas was reported by 269 (71.0%), while 259 (68.3%) rated government initiatives as somewhat effective or ineffective. Conclusion: Geographic proximity coexisted with substantial patient-reported financial, staffing, quality, and equity concerns. These descriptive findings identify multidimensional barriers to healthcare access but do not establish causal relationships between public-sector limitations, private-sector utilization, and financial hardship.
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