CREATION OF THE IPHQ

BACKGROUND

Since 1988 the need for an institution of research and training in the field of Public Health was obvious in the province, as the deficiency in this sector was creating extreme operational problems in the health care work, as without proper training neither the health planning and management systems can be made to function properly, nor the health care services delivery system could be streamlined in accordance with the requirements of the Primary Health Care (PHC) approach. The net result was, and is, a perpetual increase in a mismanaged health service, clearly evident from the health indicators of the provincial population, despite heavy donor inputs. And creation of several bodies for facilitating smooth transition to an efficient health service, e.g. the Planning Cell at the provincial level, due to the fact that due to an absolute deficiency of adequately trained health management capacity at the micro level (Divisions/ Districts and below), they are not effective.

Particularly during 1995 when reorganisation for the health department was being planned, the deficiency for Public Health training at undergraduate/ postgraduate/in?service levels, and the capacity for health systems research and health human resource development, was felt as one of the pivotal constraints. Which need to be negotiated to achieve the objective of a sustainable development in the health sector.

At that given point in time, the department of Community Medicine, at the Bolan Medical College, Quetta, was the only place where there was a minimum quality manpower available on which the training, research programme, and special services in the field of Public Health could be built.

This department was already working to develop the required capacity on experimental basis since 1992-93, and the team available could be relied upon to take up the challenge for this development challenge.

CREATION OF INSTITUTE OF PUBLIC HEALTH

After consideration of all options, initially it was considered that due to its capacity, department of Community Medicine, should be given extra responsibility and enhanced status, so as to take up this task.

However, after careful analysis two major problems were established as ones which could not be resolved and would prove an insurmountable obstacle in the performance of the department of Community Medicine in the general control of the medical college. It was also recognised that due to the particular set-up of an undergraduate medical college due particularly to the extreme clinical orientation, student problems, the career aspects of the staff to be involved in this activity, and the provisions in the PMDC prescribed teaching status for a department of Community Medicine at the undergraduate level, it will be impossible to ensure sustenance of the functions needed in the field of Public Health in the province.

In addition an essential leading point for the creation of the Institute was this that the National Health Policies of 1990 and 1993 also laid down the requirement of at least one Institute of Public Health in each province for training and research in Public Health for sustained development inputs to the local and national health systems. Taking stock of all options it was finally decided that the department of Community Medicine should be up?graded and re?designated as an independent Institute of Public Health and Family Medicine, as an attached department of the Health department. Where the undergraduate functions remain the responsibility of the new Institute, as a department of Community Medicine.

This was an essentially valid option due to also this reason that the anticipated Japanese grant for the department of Community Medicine (as a part of the assistance for the basic departments of the Bolan Medical College), was planned to support the other than undergraduate functions of the new institute, and would be a strong resource for the functioning of the Institute, particularly in its initial days. It was decided that the Institute shall get all the staff working at the department of Community Medicine, with allocated resources if any, and the main campus of the Institute shall be established separately, while the present campus would be used for undergraduate purposes.

This option was also favoured in face of the examples of other such institutions in the country, and as it did not violate any existing PMDC regulations, medical education system requirements, or any other compliments. The lead example studied was of Sind Medical College, Karachi, a provincial health establishment. Where almost the entire clinical faculty is from the Jinnah Postgraduate Medical Centre, which is a semi?autonomous federal establishment.

The examples of IBA, University of Karachi; Institute of Biochemistry, University of Karachi; Institute of Ophthalmology, K.E.Medical College, Lahore; Institute of Psychiatry, Rawalpindi Medical College, Rawalpindi; etc, were also strong supporting examples.

After due process, spanning over a period of at least one year, involving senior and junior level members of health service, medical college, the normal channel of disposal of business, i.e. through Finance, P&D, S&GAD, CM Secretariat, the competent authority, being the Honourable Chief Minister Balochistan, finally approved the creation of the Institute of Public Health, declared vide orders no: SO?Dev: (H) 2641/95118550/60, dated November 1996. And IPH became destined to emerge as an Institute of Public Health with a unique nature and scope of function.