Socio-Economics Obstacles in Availing Health Facilities During Covid-19 in Khyber Pakhtunkhwa: A Case Study of Low-income Beneficiaries in District Hospitals in Peshawar
DOI:
https://doi.org/10.71145/rjsp.v4i1.572Keywords:
Socio-Economic Barriers, Healthcare Access, COVID-19 Pandemic, Low-Income Populations, Health Inequality, Public Health System, District Hospitals, Healthcare Utilisation, Vulnerable Groups, Social Determinants of Health, Khyber Pakhtunkhwa, Peshawar, PakistanAbstract
This study focuses on “Socio-Economic Obstacles in availing health facilities during COVID-19 in Peshawar, Khyber Pakhtunkhwa.” It investigates the socio-economic factors that increase the vulnerability of poor people to COVID-19. The objectives of the study are to focus on obstacles faced by poor people in accessing health facilities and socio-economic factors that increase vulnerability during COVID-19. The primary data was collected from a total of 384 respondents using the Cochran model and random sampling. Certain factors were significantly associated with COVID-19, including dependence on household income (P=0.000), the poverty ratio (P=0.013), knowledge about COVID-19 (P=0.000), home quarantine (P=0.016), exposure to COVID-19 (P=0.019), and access to hospital facilities (P=0.000). Furthermore, during COVID-19, the lockdown halted businesses, people lost jobs, and the poverty ratio increased. The data revealed that the COVID-19 pandemic has placed a heavy burden on health care centers. The majority of people are poor, and everyone availed of government facilities, but access to these facilities is more difficult than to private hospitals. It was also found that overpopulation, lack of management skills, and unavailability of medicines increase the vulnerability of poor people during this pandemic.
References
A. Hafeez, J. Z. Khan, K. M. Bile, R. Joomo, and M. Sheikh, (2009). Pakistan human resources for health assessment, East Mediterr Health J, vol. 16, no. Supp., pp. 145–151
Amouzou, A., Kozuki, N. &Gwatkin, D.R. (2014). Where is the gap?: the contribution of disparities within developing countries to global inequalities in under-five mortality. BMC Public Health 14, 216. https://doi.org/10.1186/1471-2458-14-216
Ather F, Sherin A.(2014). Health system financing in Pakistan: reviewing resources and opportunities. Khyber Med University J. 6(2):53-55.
Babbie.R.Earl., Rubin.A. (2008). Research Method for Social Work: Cengage Learnings. 7th
Bambra, C., Riordan, R., Ford, J., & Matthews, F. (2020). The COVID-19 pandemic and health inequalities. Journal of epidemiology and community health, 74(11), 964–968. https://doi.org/10.1136/jech-2020-214401
Bambra, C., Riordan, R., Ford, J., & Matthews, F. (2020). The COVID-19 pandemic and health inequalities. J Epidemiol Community Health, 74(11), 964-968.
Bank W. Delivering better health services to Pakistan’s poor. 2010.
Bor Jacob, Cohen Gregory, GaleaSandro.(April 2017). Population health in an era of rising income inequality: USA, 1980-2015,” The Lancet 10077(389) 1475-1490, Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30571-8/fulltext.
Bossert TJ, Mitchell AD. (2011). Health sector decentralization and local decision-making: Decision space, institutional capacities and accountability in Pakistan. SocSci Med. 72(1):39-48.
Das, K., Behera, R. L., & Paital, B. (2022). Socio-economic impact of COVID-19. In COVID-19 in the Environment (pp. 153-190). Elsevier.
Devakumar, D., Shanon, G., Bhopal, S., &Abubakkar, I. (2020). Racism and Discrimination in Covid-19 Responses. The Lancet, 395, 1194.
Ejaz I, Shaikh BT, Rizvi N. (2011). NGOs and government partnership for health systems strengthening: a qualitative study presenting viewpoints of government, NGOs and donors in Pakistan. BMC health Serv Res.11(1):p:122.
Fotso, JC.(2006). Child health inequities in developing countries: differences across urban and rural areas. Int J Equity Health 5, 9. https://doi.org/10.1186/1475-9276-5-9
Fu Y, Zhang Y.(2007). Chinese decentralization and fiscal spending structure bias: the cost of competition for growth. Manage World. 3:4–22.
Government of Pakistan FD. Pakistan Economic Survey 2018–19 2019 [Available from: http://www.finance.gov.pk/survey/chapters_19/Economic%20Indicators%201819.pdf.
Hafeez A, Mohamud BK, Shiekh MR, Shah SAI, Jooma R. (2011). Lady health workers programme in Pakistan: challenges, achievements and the way forward. JPMA.61(3):210.
Health in Pakistan: Uderstanding the Major issues.(2017) Transparent Hands Publication. https://www.transparenthands.org/list-of-top-15-health-issues-in-pakistan/
Impact of COVID-19 on people's livelihoods, their health and our food systems. Joint Statement by ILO, Fao, & Who. (2020). Retrieved on 02/02/2022from https://www.who.int/news/item/13-10-2020-impact-of-covid-19-on-people's livelihoods-their-health-and-our-food-systems
Institute of Medicine (US). How Far Have We Come in Reducing Health Disparities? Progress Since 2000: Workshop Summary. Washington (DC): National Academies Press (US); 2012. 2, What Progress in Reducing Health Disparities Has Been Made?: A Historical Perspective. Available from: https://www.ncbi.nlm.nih.gov/books/NBK114236/.
Khan, S. A. (2019). Situation Analysis of Health Care System of Pakistan: Post 18 Amendments. Health Care Current Reviews 7: 244. doi: 10.35248/2375-4273.19.7.244.
Khan, S.U., Hussain, I.(2020). Inequalities in health and health-related indicators: a spatial geographic analysis of Pakistan. BMC Public Health 20, 1800. https://doi.org/10.1186/s12889-020-09870-4
Khetrapal, S., & Bhatia, R. (2020). Impact of COVID-19 pandemic on health system & Sustainable Development Goal 3. The Indian journal of medical research, 151(5), 395–399. https://doi.org/10.4103/ijmr.IJMR_1920_20
Kurji, Z., Preman, Z. S., Mithani, Y. (2016). Analysis of the health Care system of Pakistan. J Ayub Med Coll Abbottabad, 28(3), 601-604.
Kurji, Z., Premani, Z. S., &Mithani, Y. (2016). Analysis of the health care system of Pakistan: lessonslearnt and way forward. J Ayub Med Coll Abbottabad, 28(3), 601.conomics, Islamabad.geographic analysis of Pakistan. BMC public health, 20(1), 1-9.
Kurji, Z., Premani, Z. S., Mithani, Y. (2016). Analysis of the health care system of Pakistan: lessons learnt and way forward... J Ayub Med Coll Abbottabad, 28(3), 601-604.
Li D, et al. (2018). Unequal distribution of health human resource in mainland China: what are the determinants from a comprehensive perspective? Int J Equity Health.17(1):29.
Link, B. G., & Phelan, J. (1995). Social Conditions As Fundamental Causes of Disease. Journal of Health and Social Behavior, 80–94. https://doi.org/10.2307/2626958
Mackenbach JP., Kunst AE. (1997).Measuring the Magnitude of Socio-Economic Inequalities in Health: an overview of available measures illustrated with two examples from Europe. SocSci Med.44(6):757–71.
Mandal, Ananya. (2019, February 26). Disparities in Access to Health Care. News-Medical. Retrieved on February 2, 2022 from https://www.news-medical.net/health/Disparities-in-Access-to-Health-Care.aspx.
Manzoor, I. (2020). Pakistan and the Covid-19 Challenges. Journal of Fatima Jinnah Medical University, 14(1), 1-2.
Marmot M, Friel S, Bell R, Houwelling TAJ, Taylor S. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. The Lancet. 372:1661–1669.
Nawaz, R., Zhou, Z., Khalid, N. et al. (2021). Income-related inequality in distribution of health human resource among districts of Pakistan. BMC Health Serv Res 21, 142. https://doi.org/10.1186/s12913-021-06102-2
Ndugga,N., Artiga, S. (2021). Disparities in Health & Health Care: 5 Key Question & Answers. KFF.https://www.kff.org/racial-equity-and-health-policy/issue-brief/disparities-in-health-and-health-care-5-key-question-and-answers/
Nishtar S, et al. (2013). Pakistan’s health system: performance and prospects after the 18th constitutional amendment. Lancet.381(9884):2193–206.
Noorzai AK.(2012).Failure analysis of health policy of Pakistan,” health policy in Pakistan.http://healthpolicypak.blogspot.com/
Omrani-Khoo H, Lotfi F, Safari H, Jame SZB, Moghri J, Shafii M. (2013). Equity in distribution of health care resources; assessment of need and access, using three practical indicators. Iran J Public Health. 42(11):1299.
Orach C. G. (2009). Health equity: challenges in low income countries. African health sciences, 9 Suppl 2(Suppl 2), S49–S51.
Pakistan Covid-19 Socio Economic Impact Assessment and Responses Plan. (2020,May14).k.undp.org/content/pakistan/en/home/library/development_policy/covid-19-pakistan--socio-economicframework.html?
Patel, J. A., Nielsen, F. B. H., Badiani, A. A., Assi, S., Unadkat, V. A., Patel, B., ... & Wardle, H. (2020). Poverty, inequality and COVID-19: the forgotten vulnerable. Public health, 183, 110.
Qarani WM, Kanji SI. (2015). Health system analysis: Pakistan and Afghanistan. Int J Endorsing Health Sci Res.3.
Rana SA. (2016). Preferences of doctors for working in rural Islamabad capital territory, Pakistan: A qualitative study. J Ayub Med Coll Abbottabad. 28(3):591-596.
Rout HS. (2011). Health care systems: a global survey. New century publications.
Samantha Artiga, Katherine Young, Elizabeth Cornachione, and Rachel Garfield. (November 2015).The Role of Language in Health Care Access and Utilization for Insured Hispanic Adults, (Washington, DC: KFF,https://www.kff.org/disparities-policy/issue-brief/the-role-of-language-in-health-care-access-and-utilization-for-insured-hispanic-adults/.
Sana MA. An Appraisal of Health Sector in the Backdrop of 18th Amendment. ISSRA PAPERS. p: 45.
Shah A. (2012). The 18th Constitutional Amendment: Glue or solvent for nation building and citizenship in Pakistan. Lahore J Economic. 17:p:387.
Smith, J. A., & Judd, J. (2020). COVID‐19: vulnerability and the power of privilege in aVol:51(5).
Smith, J.A. and Judd, J. (2020), COVID-19: Vulnerability and the power of privilege in a pandemic. Health Promot J Austral, 31: 158 160. https://doi.org/10.1002/hpja.333
Tan, C. S., Lokman, S., Rao, Y., Kok, S. H., & Ming, L. C. (2021). Public and private sectors collective response to combat COVID-19 in Malaysia. Journal of pharmaceutical policy and practice, 14(1), 1-4.
Tiwari, G. K., Tiwari, R. P., Pandey, R., Ray, B., Dwivedi, A., Sharma, D. N., ... & Tiwari, A. K. (2020). The life outcomes of children during COVID-19: Exploring the protective roles of the joint and nuclear families in India. Authorea Preprints.
Van Doorsaer EE.( 1997). Income related inequality in health: some international comparisons. Journal for Health Economics. 16:93–112.
Van Doorslaer E, Wagstaff A.(1992). Equity in the delivery of health care: some international comparisons. Journal for Health Economics. 4:389–411
van Doorslaer E, Wagstaff A.(2000). Equity in the delivery of health care: further international comparisons. Journal for Health Economics.
Vasquez Reyes M. (2020). The Disproportional Impact of COVID-19 on African Americans. Health and human rights, 22(2), 299–307.
W. H. Organization. (2006). working together for health: World Health Organization.
Wagstaff A.(2000).Research on equity, poverty and health outcomes. The World Bank.
W. H. Organization. (2020). Impact of Covid-19 on People Livelihoods, Their Health and Our Food System: World Health Organization.
Yue, P., Gizem Korkmaz, A., & Zhou, H. (2020). Household financial decision making amidst the COVID-19 pandemic. Emerging Markets Finance and Trade, 56(10), 2363-2377
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Review Journal of Social Psychology & Social Works
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
