Health Care Providers in Pakistan can be categorized into the following groups;

1) Medical Doctors

To become MBBS doctor, the candidate must full fill the following criteria;

1. Pass intermediate examination in Pre-Medical sciences (about twelve years study; ten in schools, two in colleges) with at least more than 60 to 70 % marks.
   
2. Enter in "Entry Test" and qualify it
   
3. Take five years course from a medical college that is recognized by Pakistan Medical & Dental council
   
4. Pass four professional examinations organized by University and held in medical college and teaching hospitals.
   
5. Get license from Pakistan Medical & Dental council

Pakistan Medical & Dental council is an authority which sets courses for MBBS and makes sure that the Medical Colleges are worth studying. It consists of Chief Justice of Federal Supreme court, chief justices of all provincial high courts, all provincial Governors and Principals of all recognized medical colleges.

Then, the qualified doctor completes one year residential house job in one or two teaching hospitals. After this, he/she is ready and eligible for a job or private practice.
Family Physicians play the largest part in the delivery of primary care. They are the first contact of people who not only seek their help for primary care but also in acute emergencies and accidents. There is no organized Family Medicine in Pakistan. The Family Physicians work in a random manner and they have no working relationship with each other. They do not provide evidence based care to people. Many Family Physicians are involved in taking kick backs from pharmaceutical companies, pathological laboratories and private hospitals. They do not write proper prescriptions and use multiple medicines and injectables in a very irrational way. There is no definite system of referral and follow up; patients are usually referred when they become critically ill.

2) The Alternate Medical Services

In addition to going to Registered Family Physicians, people do go to Registered Hakims (traditional healers), Registered Homeopaths and quacks in vast numbers. There is a situation of rivalry between various types of primary care providers. The Hakims (traditional healers) and Registered Homeopaths are free to make/manufacture any medicine because drug policy does not cover them. They are only legal and our presidents and prime ministers even go to them. People have a strong belief that these two types of treatment are quite harmless and more effective than our scientific medicines.

There are two very popular misconceptions in Pakistan, even in highly qualified persons and some MBBS doctors as well;

1. Sexual problems, Hepatitis A, B, & C are not curable by any other medication except the Hakims.
   
2. Homeopathy is very safe in chronic ailments, especially renal stones, arthritis, etc.

To become Hakim, there is no need of any basic general education but the famous Hakims are usually Graduates or Master degree holders in non-medical education.
They categorize them selves as A-Class, B-Class and C-Class.

To become a Homeopathic doctor, the candidate must full fill the following criteria;

1. At least ten years of study in school
   
2. Four years course called "DHMS" from any out of hundreds of private colleges scattered throughout the country.
   
3. All who qualify, get registered in their counsel.

3) Traditional Quacks

They are endemic in our society. There have been many half-hearted efforts to eliminate them but they are on the rise.

4) Religious Quacks

Traditional Quacks have been a major threat to the health system for quite long but now a new category of quacks is emerging that consists of so called religious persons who not only give blessings but also dispense their own made medicines. They are very famous for treatment of Hepatitis A, B, & C.

A) Female Paramedics :

The following categories which are included under this term "Nurse" in Pakistan ;

1) Classified Nurse: The female must have passed high school examination in science to get admission into this course. She takes a four years' course in Nursing during which she has to reside in hospital. She does not pay anything for it rather she is given an attractive monthly help throughout the course. Despite all these facilities, only girls from poor background enter these courses. Such nurses are only present in big city governmental hospitals and very expensive private hospitals. Due to proper education and training, they work ethically and are aware of the importance of working within their own limits.

2) Lady Health Visitor (LHV): The female must have passed high school examination in science to get admission into this course. She takes a short course of about two years and she is basically trained in womens' health and midwifery. They are meant for villages and towns but are rarely found there. They usually practice in cities as lady doctors. Most of them exceed their limits and are involved in criminal abortion.

3) Locally Trained Nurses: This is the most available variety. Some of them are high school pass but most of them are usually middle passed or less. They are neither adequately educated nor properly trained. They are absolutely not aware of their limits. They work in clinics and most of the private hospitals. Seniors among this category work as lady doctors and are involved in criminal abortion.

4) Lady Health Worker (LHW): This type was produced by the government to induce health education and create awareness about womens' health. Females should be only middle pass and a local resident. Unfortunately, they also forget their limits and start acting as lady doctors.

5) Midwives or Traditional Birth Attendants (TBA): In Pakistan, TBAs are absolutely uneducated and non-trained. They not only are unaware of their limits but also do not understand the importance of the referral network. They are a major cause of maternal mortality and morbidity. They cause damage to mothers and newborns due to lack of knowledge and skills. They do not understand the importance of sterilization and use dirty hands on women and on newborns. They cut umbilical cords with non-sterilized knives and tie it with dirty pieces of cloth or thread. They insert harmful weeds and their own made medicines in the vagina and freely inject Oxytocin I/M as a tonic or power injection before delivery.

B) Male Paramedics

25 % of this group are qualified but 75% are just locally trained in clinics and pathology labs. We do not have life saving paramedics except in the army.

C) Highly Trained Mobile Paramedics

This is a very recent addition to the system. At the moment, these are only found in Lahore. These are fully qualified .