Prevention in Punjab: Evaluating current provincial programs in Pakistan's fight against hepatitis B & C

Hepatitis remains a prominent concern in developing countries largely due to poor sanitation and hygiene practices. In Pakistan, an estimated one in every nine people is infected with either hepatitis B or C; regionally over seven million of such cases are present in the Punjab province. This paper provides a case study on Punjab's hepatitis B and C prevention and control system with particular focus on the educational facet of such provincial programs. This educational component is examined from both the caregiver and patient perspective. From the caregiver's perspective, the country hosts a high number of unqualified practitioners (approximately 50,000 – 60,000), a statistic that correlates with the fact that medical offices are a common area for hepatitis B and C transmission. Alternatively, inadequate education amongst the patient population is largely responsible for the high prevalence of the disease in Punjab. This study relies on data collected from clinical observations and interviews conducted during a month of observational study at Fatima – Jinnah Medical College in urban Lahore; federal intervention reports provide supplemental material on current governmental interventions targeted towards hepatitis B and C. This study concludes that the provincial programs face inadequate funding and prevention education is failing due to low staff motivation and lagging outreach. Finally, this paper offers a possible reorganization scheme that would increase the effectiveness of Punjab's prevention program.